Personalized 90 Y-resin microspheres dose determination: a retrospective study on the impact of dosimetry software on the treatment of patients with selective internal radiotherapy.

ABSTRACT

INTRODUCTION: The calculation of resin yttrium-90 ( 90 Y-) microspheres activity for selective internal radiotherapy (SIRT) needs to be investigated. METHODS AND MATERIALS Analyses using Simplicit 90 Y (Boston Scientific, Natick, Massachusetts, USA) dosimetry software were performed to determine the concordance between the absorbed doses to the tumor (D T1 and D T2 ) and healthy liver (D N1 and D N2 ) during the pre-treatment and the post-treatment phases. An optimized calculation of the activity of 90 Y-microspheres performed using dosimetry software was applied retrospectively to assess the impact of this calculation method on the treatment. RESULTS: D T1 ranged from 38.8 to 372 Gy, with a mean value of 128.9 ± 73.6 Gy and median of 121.2 Gy [interquartile range (IQR) 81.7-158.8 Gy]. The median D N1 and D N2 was 10.5 Gy (IQR 5.8-17.6). A significant correlation was between D T1 and D T2 ( r = 0.88, P < 0.001) and D N1 and D N2 ( r = 0.96, P < 0.001). The optimized activities were calculated; the target dose to the tumor compartment was 120 Gy. No activity reduction was applied in accordance with the tolerance of the healthy liver. Optimization of the microspheres dosages would have resulted in a significant increase in activity for nine treatments (0.21-2.54 GBq) and a reduction for seven others (0.25-0.76 GBq). CONCLUSIONS: The development of customized dosimetry software adapted to clinical practice makes it possible to use dosimetry to optimize the dosage for each patient.