Abstract
Yttrium-90 (Y-90) transarterial radioembolization uses radioactive microspheres injected into the hepatic artery to irradiate liver tumors internally. One of the major challenges is the lack of reliable dosimetry methods for dose prediction and dose verification. We present a patient-specific dosimetry approach for personalized treatment planning based on computational fluid dynamics (CFD) simulations of the microsphere transport combined with Y-90 physics modeling called CFDose. The ultimate goal is the development of a software to optimize the amount of activity and injection point for optimal tumor targeting. We present the proof-of-concept of a CFD dosimetry tool based on a patient’s angiogram performed in standard-of-care planning. The hepatic arterial tree of the patient was segmented from the cone-beam CT (CBCT) to predict the microsphere transport using multiscale CFD modeling. To calculate the dose distribution, the predicted microsphere distribution was convolved with a Y-90 dose point kernel. Vessels as small as 0.45 mm were segmented, the microsphere distribution between the liver segments using flow analysis was predicted, the volumetric microsphere and resulting dose distribution in the liver volume were computed. The patient was imaged with positron emission tomography (PET) 2 h after radioembolization to evaluate the Y-90 distribution. The dose distribution was found to be consistent with the Y-90 PET images. These results demonstrate the feasibility of develo** a complete framework for personalized Y-90 microsphere simulation and dosimetry using patient-specific input parameters.
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Acknowledgments
This work was funded by NIH R35 CA197608, CCSG P30 (NCI P30CA093373), UC Davis Academic Federation Innovation Development Award, and NIH R21 CA237686 (ITCR). The authors thank Dr Bahman S. Roudsari, Denise T. Caudle, Michael Rusnak, and Dr. Sara St. James for the angiogram interpretation, 90Y PET scans, and dose kernel computation.
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10439_2020_2469_MOESM1_ESM.eps
Figure S1. Hepatic artery segmentation pipeline. CBCT images with a resolution of 0.25 mm and slice thickness of 1 mm are segmented to extract blood vessels using a semi-automatic approach. Supplementary material 1 (EPS 634 kb).
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Figure S2. 90Y dose kernel. (a) 90Y beta energy spectrum with a maximum energy of 2.28 MeV and peak at 860 keV. (b) Projection of the 1 mm dose point kernel computed with the 90Y spectrum shown in (a). (c) The energy deposited is highest close to the 90Y point source (located at 0 mm) and decreasing rapidly with increasing distance from the point source (note the log scale). Supplementary material 2 (EPS 140 kb).
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Figure S3. Predicted dose distribution for the lobar and selective injections separately, which are shown combined in Fig. 7c. (a) Selective injection, coronal view, with a total dose of 58.3 Gy. (b) Lobar injection, coronal view, with a total of 67 Gy. Supplementary material 3 (EPS 59 kb).
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Roncali, E., Taebi, A., Foster, C. et al. Personalized Dosimetry for Liver Cancer Y-90 Radioembolization Using Computational Fluid Dynamics and Monte Carlo Simulation. Ann Biomed Eng 48, 1499–1510 (2020). https://doi.org/10.1007/s10439-020-02469-1
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DOI: https://doi.org/10.1007/s10439-020-02469-1