Clinical implications of the body surface area method versus partition model dosimetry for yttrium-90 radioembolization using resin microspheres: a technical review
- 702 Downloads
Yttrium-90 (Y-90) radioembolization is becoming established as an effective therapeutic modality for inoperable liver tumors. For resin microspheres, the ‘body surface area (BSA)’ method and the partition model can both be used for Y-90 activity calculation. The BSA method is semi-empirical, but more commonly used due its simplicity. The partition model is more accurate, scientifically sound and personalized, but less popular due to its complexity. This article provides a technical comparison of both methods with an emphasis on its clinical implications. Future dosimetric techniques for Y-90 radioembolization based on emerging technologies are also discussed.
KeywordsYttrium-90 radioembolization Yttrium-90 selective internal radiation therapy Tumor-to-normal liver ratio Body surface area method Partition model dosimetry
- 4.Lau WY, Kennedy AS, Kim YH, Lai HK, Lee RC, Leung TW, et al. Patient selection and activity planning guide for selective internal radiotherapy with yttrium-90 resin microspheres. Int J Radiat Oncol Biol Phys. 2010 [Epub ahead of print].Google Scholar
- 7.Sirtex Medical Limited, Lane Cove, New South Wales, Australia. Sirtex Medical training manual (version TRN-US-03, http://Sirtex.com). Undated.
- 12.Kennedy AS, Nutting C, Coldwell D, Gaiser J, Drachenberg C. Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers. Int J Radiat Oncol Biol Phys. 2004;1(60):1552–630.Google Scholar
- 14.Flamen P, Vanderlinden B, Delatte P, Ghanem G, Ameye L, Van Den Eynde M, et al. Multimodality imaging can predict the metabolic response of unresectable colorectal liver metastases to radioembolization therapy with Yttrium-90 labeled resin microspheres. Phys Med Biol. 2008;21(53):6591–603.CrossRefGoogle Scholar
- 16.Riaz A, Gates VL, Atassi B, Lewandowski RJ, Mulcahy MF, Ryu RK, et al. Radiation segmentectomy: a novel approach to increase safety and efficacy of radioembolization. Int J Radiat Oncol Biol Phys. 2011;1(79):163–71.Google Scholar
- 18.Campbell JM, Wong CO, Muzik O, Marples B, Joiner M, Burmeister J. Early dose response to yttrium-90 microsphere treatment of metastatic liver cancer by a patient-specific method using single photon emission computed tomography and positron emission tomography. Int J Radiat Oncol Biol Phys. 2009;1(74):313–20.Google Scholar
- 19.Hendlisz A, Van den Eynde M, Peeters M, Maleux G, Lambert B, Vannoote J, et al. Phase III trial comparing protracted intravenous fluorouracil infusion alone or with yttrium-90 resin microspheres radioembolization for liver-limited metastatic colorectal cancer refractory to standard chemotherapy. J Clin Oncol. 2010;10(28):3687–94.CrossRefGoogle Scholar
- 30.Selwyn RG, Avila-Rodriguez MA, Converse AK, Hampel JA, Jaskowiak CJ, McDermott JC, et al. 18F-labeled resin microspheres as surrogates for 90Y resin microspheres used in the treatment of hepatic tumors: a radiolabeling and PET validation study. Phys Med Biol. 2007;21(52):7397–408.CrossRefGoogle Scholar
- 36.Kleinstreuer, C. Methods and devices for targeted injection of radioactive microspheres. U.S. Patent Application 61/127,889, July 28, 2009, NC State University, Raleigh, NC.Google Scholar