Bouchet Lionel G, Bolch Wesley E, Blanco H Pablo, Wessels Barry W, Siegel Jeffry A, Rajon Didier A, Clairand Isabelle, Sgouros George
Department of Neurological Surgery, University of Florida, Gainesville, Florida 32611-8300, USA.
J Nucl Med. 2003 Jul;44(7):1113-47.
As one of the major organs of the excretory pathway, the kidneys represent a frequent source of radiopharmaceutical uptake in both diagnostic and therapeutic nuclear medicine. The unique organization of the functional tissues of the organ ensures transient changes in suborgan localization of renal activity. Current single-region dosimetric models of the kidneys, however, force the assumption of a uniform distribution of radioactivity across the entire organ. The average absorbed dose to the kidneys predicted by such models can misrepresent local regional doses to specific substructures.
To facilitate suborgan dosimetry for the kidneys, 6 new age-dependent multiregion kidney models are presented. The outer dimensions of the models conform to those used currently in single-region kidney models, whereas interior structures are defined for the renal cortex, the medullary pyramids with papillae (2 vertical and 3 horizontal), and the renal pelvis. Absorbed fractions of energy were calculated for both photon and electron sources (10 keV to 4 MeV) located in each source region within the 6 age-dependent models. The absorbed fractions were then used to assemble S values for radionuclides of potential interest in suborgan kidney dosimetry.
For the adult, the absorbed dose to the renal cortex for (90)Y-labeled compounds retained within that subregion is approximately 1.3 times that predicted by the single-region kidney model, whereas the medullary dose is only 26% of that same single-region value. For compounds that are rapidly filtered in the kidneys, the renal cortex dose is approximately one-half of that predicted under the single-region model, whereas the tissues of the medullary pyramids receive an absorbed dose 1.5-1.8 times larger.
The multiregion model described here permits estimates of regional kidney dose not previously supported by current single-region models. Full utilization of the new model, however, requires serial imaging of the kidneys with regions of interest assigned to the renal cortex and medulla.
作为排泄途径的主要器官之一,肾脏是诊断和治疗核医学中放射性药物摄取的常见来源。该器官功能组织的独特结构确保了肾脏活性在亚器官定位上的短暂变化。然而,目前肾脏的单区域剂量学模型强制假设放射性在整个器官内均匀分布。此类模型预测的肾脏平均吸收剂量可能会错误表示特定亚结构的局部区域剂量。
为便于进行肾脏的亚器官剂量学研究,提出了6种新的年龄相关多区域肾脏模型。这些模型的外部尺寸与当前单区域肾脏模型所使用的尺寸一致,而内部结构则针对肾皮质、带有乳头的髓质锥体(2个垂直和3个水平)以及肾盂进行了定义。针对位于6种年龄相关模型内每个源区域的光子和电子源(10 keV至4 MeV)计算了能量吸收分数。然后,这些吸收分数被用于组装肾脏亚器官剂量学中潜在感兴趣的放射性核素的S值。
对于成年人,保留在该亚区域内的(90)Y标记化合物对肾皮质的吸收剂量约为单区域肾脏模型预测值的1.3倍,而髓质剂量仅为该单区域值的26%。对于在肾脏中快速滤过的化合物,肾皮质剂量约为单区域模型预测值的一半,而髓质锥体组织接受的吸收剂量则大1.5 - 1.8倍。
本文所述的多区域模型允许估计目前单区域模型无法支持的肾脏区域剂量。然而,要充分利用新模型,需要对肾脏进行序列成像,并将感兴趣区域分配到肾皮质和髓质。