Monte Carlo<sup>90</sup>Y PET/CT dosimetry of unexpected focal radiation-induced lung damage after hepatic radioembolisation.

Details

Serval ID
serval:BIB_912F2E9DF2C7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Monte Carlo<sup>90</sup>Y PET/CT dosimetry of unexpected focal radiation-induced lung damage after hepatic radioembolisation.
Journal
Physics in medicine and biology
Author(s)
Auditore L., Amato E., Boughdad S., Meyer M., Testart N., Cicone F., Beigelman-Aubry C., Prior J., Schaefer N., Gnesin S.
ISSN
1361-6560 (Electronic)
ISSN-L
0031-9155
Publication state
Published
Issued date
29/09/2020
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Increasing knowledge regarding transarterial radioembolization (TARE) hepatic dose-response and dose-toxicity correlation is available but few studies have investigated dose-toxicity correlation in extra-hepatic tissues. We investigated absorbed dose levels for the appearance of focal lung damage in a case of off-target deposition of 90Y microspheres and compared them with the corresponding thresholds recommended to avoiding radiation induced lung injury following TARE.
A 64-year-old male patient received 1.6 GBq of 90Y-labelled glass microspheres for an inoperable left lobe hepatocellular carcinoma. A focal off-target accumulation of radiolabeled microspheres was detected in the left lung upper lobe at the post-treatment 90Y-PET/CT, corresponding to a radiation-induced inflammatory lung lesion at the 3-months 18F-FDG PET/CT follow-up. 90Y-PET/CT data were used as input for Monte-Carlo based absorbed dose estimations. Dose-Volume-Histograms (DVH) were computed to characterize the heterogeneity of absorbed dose distribution. The dose level associated with the appearance of lung tissue damage was estimated as the median absorbed dose measured at the edge of the inflammatory nodule. To account for respiratory movements and possible inaccuracy of image co-registration, three different methods were evaluated to define the irradiated off-target volume.
Monte Carlo-derived absorbed dose distribution showed a highly heterogeneous absorbed dose pattern at the site of incidental microsphere deposition (volume = 2.13 mL) with a maximum dose of 630 Gy. Absorbed dose levels ranging from 119 to 133 Gy, were estimated at the edge of the inflammatory nodule, depending on the procedure used to define the target volume.
This report describes an original Monte Carlo based patient-specific dosimetry methodology for the study of the radiation-induced damage in a focal lung lesion after TARE. In our patient, radiation-induced focal lung damage occurred at significantly higher absorbed doses than those currently recommended for single administration or cumulative lung dose delivered during TARE.
Keywords
GAMOS, Hepatic radioembolization, Monte Carlo dosimetry, TARE, lung inflammation
Pubmed
Web of science
Create date
02/10/2020 12:56
Last modification date
16/12/2020 7:24
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