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High quality imaging and dosimetry for yttrium-90 (90Y) liver radioembolization using a SiPM-based PET/CT scanner

European Journal of Nuclear Medicine and Molecular Imaging volume 48, pages 2426–2436 (2021)Cite this article

Abstract

Purpose

Transarterial radioembolization (TARE) with yttrium-90 (90Y) microspheres is a liver-directed treatment for primary and secondary hepatic malignancies. Personalized dosimetry aims for maximum treatment effect and reduced toxicity. We aimed to compare pre-treatment voxel-based dosimetry from 99mTc macroaggregated albumin (MAA) SPECT/CT with post-treatment 90Y PET/CT for absorbed dose values, and to evaluate image quality of 90Y SiPM-based PET/CT.

Methods

Forty-two patients (28 men, 14 women, mean age: 67 ± 11 years) with advanced hepatic malignancies were prospectively enrolled. Twenty patients were treated with glass and 22 with resin microspheres. Radiation absorbed doses from planning 99mTc-MAA SPECT/CT and post-therapy 90Y PET/CT were assessed. 90Y PET/CT images were acquired for 20 min and reconstructed to produce 5-, 10-, 15-, and 20-min datasets, then evaluated using the 5-point Likert scale.

Results

The mean administered activity was 3.44 ± 1.5 GBq for glass and 1.62 ± 0.7 GBq for resin microspheres. The mean tumor absorbed doses calculated from 99mTc-MAA SPECT/CT and 90Y PET/CT were 175.69 ± 113.76 Gy and 193.58 ± 111.09 Gy (P = 0.61), respectively for glass microspheres; they were 60.18 ± 42.20 Gy and 70.98 ± 49.65 Gy (P = 0.37), respectively for resin microspheres. The mean normal liver absorbed doses from 99mTc-MAA SPECT/CT and 90Y PET/CT were 32.70 ± 22.25 Gy and 30.62 ± 20.09 Gy (P = 0.77), respectively for glass microspheres; they were 18.33 ± 11.08 Gy and 24.32 ± 15.58 Gy (P = 0.17), respectively for resin microspheres. Image quality of 90Y PET/CT at 5-, 10-, 15-, and 20-min scan time showed a Likert score of 3.6 ± 0.54, 4.57 ± 0.58, 4.84 ± 0.37, and 4.9 ± 0.3, respectively.

Conclusions

99mTc-MAA SPECT/CT demonstrated great accuracy for treatment planning dosimetry. SiPM-based PET/CT scanner showed good image quality at 10-min scan time, acquired in one bed position. A PET/CT scan time of 5 min showed acceptable image quality and suffices for dosimetry and treatment verification. This allows for inclusion of 90Y PET/CT in busy routine clinical workflows. Studies with larger patient cohorts are needed to confirm these findings.

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Data availability

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Funding

The study was partially supported by GE Healthcare.

Author information

Affiliations

  1. Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, 300 Pasteur Drive, H2200, Stanford, CA, 94305, USA

    Heying Duan, Valentina Ferri, Lucia Baratto & Andrei Iagaru

  2. Department of Radiology, Division of Interventional Radiology, Stanford University, Stanford, CA, USA

    Mohamed H. Khalaf & Daniel Y. Sze

  3. Department of Radiology, Division of Nuclear Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Shyam M. Srinivas

Authors
  1. Heying Duan
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  2. Mohamed H. Khalaf
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  5. Shyam M. Srinivas
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  6. Daniel Y. Sze
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  7. Andrei Iagaru
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Contributions

HD: content planning, data analyses, and manuscript writing and editing; MHK: data analyses and manuscript editing; VF: statistical analyses and manuscript editing; LB: data analyses and manuscript editing; SMS: concept planning and data manuscript editing; DYS: content planning and manuscript editing; AI content planning and manuscript editing

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Correspondence to Andrei Iagaru.

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Duan, H., Khalaf, M.H., Ferri, V. et al. High quality imaging and dosimetry for yttrium-90 (90Y) liver radioembolization using a SiPM-based PET/CT scanner. Eur J Nucl Med Mol Imaging 48, 2426–2436 (2021). https://doi.org/10.1007/s00259-021-05188-4

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  • DOI: https://doi.org/10.1007/s00259-021-05188-4

Keywords

  • 90Y
  • Silicon photomultiplier
  • PET/CT
  • Radioembolization
  • SIRT
  • Liver
  • Dosimetry