title: Absorbed dose to lesion and clinical outcome after liver radioembolization with 90Y microspheres: a case report of PET-based dosimetry.
abstract: A 54-year-old woman with metastatic colorectal carcinoma underwent liver radioembolization with (90)Y resin microspheres. Microsphere biodistribution was assessed 2 h after the treatment through a 20-min long (90)Y PET scan. Isodose map and lesion dose-volume histogram (DVH) were then evaluated using a MATLAB-based code. Response to therapy was assessed performing a (18)F-FDG PET 6 months after the treatment. At (90)Y PET the patient showed a well-defined horseshoe-shaped hepatic lesion with hot margins and a cold core. The lesion presented a heterogeneous DVH with a hot margin receiving an average radiation dose as high as 287 Gy and a cold area receiving an average radiation dose of 70 Gy approximately. Six months after the treatment the patient reported a complete remission of tumour areas which received a high radiation dose, while progression of metastases was observed in the area that presented scarce microsphere localization at (90)Y PET. According to our experience, the use of (90)Y PET voxel dosimetry may provide a useful tool to assess possible correlations between microsphere biodistribution and clinical outcome of the treatment. In agreement with current literature findings, an average radiation dose greater than approximately 100 Gy may be required to sterilize liver metastases.
authors.affiliation: National Institute of Ionizing Radiation Metrology, ENEA, Centro Ricerche Casaccia, Via Anguillarese 301, 00123, Rome, Italy. marco.darienzo@enea.it
authors.forename: Marco
authors.initials: M
authors.lastname: D'Arienzo
authors.forename: Luca
authors.initials: L
authors.lastname: Filippi
authors.forename: Paola
authors.initials: P
authors.lastname: Chiaramida
authors.forename: Laura
authors.initials: L
authors.lastname: Chiacchiararelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Cianni
authors.forename: Rita
authors.initials: R
authors.lastname: Salvatori
authors.forename: Francesco
authors.initials: F
authors.lastname: Scopinaro
authors.forename: Oreste
authors.initials: O
authors.lastname: Bagni
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000528:radiation effects; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy; D008863:Microspheres; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D011874:Radiometry; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000737:chemistry
chemical_list: D015021:Yttrium Radioisotopes