title: Radioembolization dosimetry: the road ahead.
abstract: Methods for calculating the activity to be administered during yttrium-90 radioembolization (RE) are largely based on empirical toxicity and efficacy analyses, rather than dosimetry. At the same time, it is recognized that treatment planning based on proper dosimetry is of vital importance for the optimization of the results of RE. The heterogeneous and often clustered intrahepatic biodistribution of millions of point-source radioactive particles poses a challenge for dosimetry. Several studies found a relationship between absorbed doses and treatment outcome, with regard to both toxicity and efficacy. This should ultimately lead to improved patient selection and individualized treatment planning. New calculation methods and imaging techniques and a new generation of microspheres for image-guided RE will all contribute to these improvements. The aim of this review is to give insight into the latest and most important developments in RE dosimetry and to suggest future directions on patient selection, individualized treatment planning, and study designs.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E.01.132, PO Box 85500, 3508 GA, Utrecht, The Netherlands, m.l.j.smits-3@umcutrecht.nl.
authors.forename: Maarten L J
authors.initials: ML
authors.lastname: Smits
authors.forename: Mattijs
authors.initials: M
authors.lastname: Elschot
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Sze
authors.forename: Yung H
authors.initials: YH
authors.lastname: Kao
authors.forename: Johannes F W
authors.initials: JF
authors.lastname: Nijsen
authors.forename: Andre H
authors.initials: AH
authors.lastname: Iagaru
authors.forename: Hugo W A M
authors.initials: HW
authors.lastname: de Jong
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
authors.forename: Marnix G E H
authors.initials: MG
authors.lastname: Lam
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes