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| Calculation of organ dose of 90Y TheraSphere in the treatment of pancreatic cancer |
| WANG Jiangxia, WANG Wei, WANG Chuangao, GUO Jinsen, PANG Hongchao |
| China Institute for Atomic Energy, Beijing 102413 China |
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Abstract Objective To calculate the absorbed dose of 90Y TheraSphere in the pancreas and the surrounding sensitive organs after the administration in the treatment of pancreatic cancer through the establishment of an individual voxel model, and to provide technical support for the clinical application of 90Y TheraSphere in the treatment of pancreatic cancer. Methods An individualized voxel model was constructed in Geant4 software based on the CT images of the patient. 12 monoenergetic electron specific absorption fractions (SAFs) in the range of 0.01 to 1 MeV were calculated and validated against the ICRP data. The model and method were used to calculate the absorbed doses in the target organs under uniform and nonuniform distribution of 90Y microspheres in the pancreas. Results The relative errors between the SAF values calculated based on the individualized voxel model and the ICRP data after mass calibration were less than 3.89%. When 90Y was uniformly distributed in the pancreas, the absorbed dose in the pancreas was 4.69×10-7 Gy/Bq; the absorbed doses in the liver, kidneys, and spleen were 6.15×10-12, 6×10-12, and 1.65×10-11 Gy/Bq, respectively. When 90Y was distributed within the tumor, the absorbed dose in the tumor was 6.69×10-6 Gy/Bq and the absorbed dose in normal pancreas was 5.72×10-8 Gy/Bq. The fitted relationship between tumor volume V and administered activity A at the prescribed dose of 120 Gy was quadratic, with relatively low activity required for concentrated administration in the center of the tumor. Conclusion The Monte Carlo dose calculation method based on individual voxel model accurately predicted the absorbed doses in the surrounding sensitive organs (liver, kidneys, and spleen) when 90Y TheraSphere was used to treat pancreatic cancer. These results and the analysis of the factors affecting the drug delivery activity will provide data support for the clinical research of 90Y TheraSphere in pancreatic cancer.
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Received: 03 January 2024
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[1] Zheng RS, Zhang SW, Zeng HM, et al. Cancer incidence and mortality in China, 2016[J]. J Natl Cancer Center, 2022, 2（1）: 1-9.
[2] 高洁, 刘晓明, 周文华, 等. 90Y微球的研发现状与应用研究[J]. 同位素，2022，35（3）：189-199.
Gao J, Liu XM, Zhou WH, et al. Study on research and development status and application of 90Y microspheres[J]. J Isot, 2022, 35（3）: 189-199.
[3] 王斯妮, 贾中芝, 胡红杰, 等. 钇-90微球的特性、放射栓塞的操作技术及安全防护——钇-90微球放射栓塞系列回顾(一)[J]. 介入放射学杂志，2017，26（10）：952-958.
Wang SN, Jia ZZ, Hu HJ, et al. Characteristics of yttrium-90 microsphere, techniques and radiation safety of radioembolization procedure. A series review of radioembolization with yttrium-90 microspheres (part I)[J]. J Intervent Radiol, 2017, 26（10）: 952-958.
[4] 郑致远, 颜志平. 钇90放射性微球治疗肝脏恶性肿瘤的应用进展[J]. 复旦学报(医学版)，2020，47（4）：622-627.
Zheng ZY, Yan ZP. Application progress of yttrium-90 radiation microspheres in treatment of liver malignancies[J]. Fudan Univ J Med Sci, 2020, 47（4）: 622-627.
[5] 赵开通, 白家瑞, 张国建. 90Y微球在肝细胞癌治疗中的临床应用价值及研究进展[J]. 国际放射医学核医学杂志，2023，47（7）：435-438.
Zhao KT, Bai JR, Zhang GJ. Clinical application value and research progress of 90Y microspheres in the treatment of hepatocellular cancinoma[J]. Int J Radiat Med Nucl Med, 2023, 47（7）: 435-438.
[6] Kayaleh R, Krzyston H, Rishi A, et al. Transarterial radioembolization treatment of pancreatic cancer patients with liver-dominant metastatic disease using yttrium-90 glass microspheres: a single-institution retrospective study[J]. J Vasc Interv Radiol, 2020, 31（7）: 1060-1068.
[7] Bolch WE, Jokisch D, Zankl M, et al. The ICRP computational framework for internal dose assessment for reference adults: specific absorbed fractions[J]. Ann ICRP, 2016, 45（2）: 5-73.
[8] 张震, 武祯, 梁婧. 基于蒙特卡罗模拟的探伤误照器官剂量计算[J]. 中国辐射卫生，2023，32（4）：365-371,379.
Zhang Z, Wu Z, Liang J. Monte Carlo simulation-based dose calculation for organs under accidental radiation exposure in flaw detection[J]. Chin J Radiol Health, 2023, 32（4）: 365-371,379.
[9] Menzel HG, Clement C, DeLuca P. ICRP Publication 110. Realistic reference phantoms: an ICRP/ICRU joint effort. A report of adult reference computational phantom[J]. Ann ICRP, 2009, 39（2）: 1-164.
[10] 汤晓斌, 陈达, 戴耀东, 等. 用CT值推导人体组织属性参数的方法及改进[J]. 南京航空航天大学学报，2006，38（3）：373-377.
Tang XB, Chen D, Dai YD, et al. Method for converting CT numbers into mass density and elemental weights of tissue and its improvement[J]. J Nanjing Univ Aeronaut Astronaut, 2006, 38（3）: 373-377. DOI: 10.16356/j.1005-2615.2006.03.021.
[11] Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network[J]. Magn Reson Imaging, 2012, 30（9）: 1323-1341.
[12] Allison J, Amako K, Apostolakis J, et al. Recent developments in GEANT4[J]. Nucl Instrum Methods Phys Res Sec A:Accel Spectrometers Detect Assoc Equip, 2016, 835: 186-225.
[13] Zankl M, Schlattl H, Petoussi-Henss N, et al. Electron specific absorbed fractions for the adult male and female ICRP/ICRU reference computational phantoms[J]. Phys Med Biol, 2012, 57（14）: 4501-4526.
[14] Bhar M, Kadri O, Manai K. Assessment of self- and cross-absorbed SAF values for HDRK-man using GEANT4 code: internal photon and electron emitters[J]. Nucl Sci Tech, 2019, 30（10）: 149.
[15] Kesner AL, Carter LM, Ramos JCO, et al. MIRD pamphlet No. 28, Part 1: MIRDcalc—A software tool for medical internal radiation dosimetry[J]. J Nucl Med, 2023, 64（7）: 1117-1124.
[16] Sofocleous CT, Kamarinos NV. Tumor radiation-absorbed dose: the missing link in radioembolization[J]. Radiology, 2020, 296（3）: 685-686.
[17] 中国癌症研究基金会介入医学委员会, 国家放射与治疗临床医学研究中心, 国家介入医学创新联盟(筹). 晚期胰腺癌介入治疗临床操作指南(试行)(第六版)[J]. 临床肝胆病杂志，2022，38（6）：1242-1251.
Committee of Interventional Medicine, Cancer Foundation of China, National Clinical Research Center for Radiology and Therapy, National Innovation Alliance of Interventional Medicine (Prepared). Clinical practice guidelines for the interventional treatment of advanced pancreatic carcinoma (on trial) (6th edition)[J]. J Clin Hepatol, 2022, 38（6）: 1242-1251.
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