A novel tool for motion-related dose inaccuracies reduction in 99mTc-MAA SPECT/CT images for SIRT planning.
Phys Med
; 98: 98-112, 2022 Jun.
Article
em En
| MEDLINE
| ID: mdl-35526374
ABSTRACT
INTRODUCTION:
In Selective Internal Radiation Therapy (SIRT), 90Y is administered to primary/secondary hepatic lesions. An accurate pre-treatment planning using 99mTc-MAA SPECT/CT allows the assessment of its feasibility and of the activity to be injected. Unfortunately, SPECT/CT suffers from patient-specific respiratory motion which causes artifacts and absorbed dose inaccuracies. In this study, a data-driven solution was developed to correct the respiratory motion.METHODS:
The tool realigns the barycenter of SPECT projection images and shifts them to obtain a fine registration with the attenuation map. The tool was validated using a modified dynamic phantom with several breathing patterns. We compared the absorbed dose distributions derived from uncorrected(Dm)/corrected(Dc) images with static ones(Ds) in terms of γ-passing rates, 210 Gy isodose volumes, dose-volume histograms and percentage differences of mean doses (i.e., ΔD¯m and ΔD¯c, respectively). The tool was applied to twelve SIRT patients and the Bland-Altman analysis was performed on mean doses.RESULTS:
In the phantom study, the agreement between Dc and Ds was higher (γ-passing rates generally > 90%) than Dm and Ds. The isodose volumes in Dc were closer than Dm to Ds, with differences up to 10% and 30% respectively. A reduction from a median ΔD¯m = -19.3% to ΔD¯c = -0.9%, from ΔD¯m = -42.8% to ΔD¯c = -7.0% and from ΔD¯m = 1586% to ΔD¯c = 47.2% was observed in liver-, tumor- and lungs-like structures. The Bland-Altman analysis on patients showed variations (±50 Gy) and (±4 Gy) between D¯c and D¯m of tumor and lungs, respectively.CONCLUSION:
The proposed tool allowed the correction of 99mTc-MAA SPECT/CT images, improving the accuracy of the absorbed dose distribution.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radioterapia
/
Neoplasias Hepáticas
Limite:
Humans
Idioma:
En
Revista:
Phys Med
Assunto da revista:
BIOFISICA
/
BIOLOGIA
/
MEDICINA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália