使用¹²⁴I正电子发射断层显像（PET）和三维体内剂量测定法（3D-ID）软件进行¹³¹I甲状腺癌治疗的个体化剂量测定。
Patient-specific dosimetry for 131I thyroid cancer therapy using 124I PET and 3-dimensional-internal dosimetry (3D-ID) software.
作者信息
Sgouros George, Kolbert Katherine S, Sheikh Arif, Pentlow Keith S, Mun Edward F, Barth Axel, Robbins Richard J, Larson Steven M
机构信息
Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
出版信息
J Nucl Med. 2004 Aug;45(8):1366-72.
UNLABELLED
Compared with conventional, whole-organ, S-factor-based dosimetry, 3-dimensional (3D), patient-specific dosimetry better accounts for radionuclide distribution and anatomic patient variability. Its accuracy, however, is limited by the quality of the cumulated activity information that is provided as input. This input has typically been obtained from SPECT and planar imaging studies. The objective was to implement and evaluate PET-based, patient-specific, 3D dosimetry for thyroid cancer patients.
METHODS
Three to 4 PET imaging studies were obtained over a 7-d period in 15 patients with metastatic thyroid carcinoma after administration of (124)I-NaI. Subsequently, patients were treated with (131)I on the basis of established clinical parameters. Retrospective dosimetry was performed using registered (124)I PET images that were corrected for the half-life difference between (124)I and (131)I. A voxel-by-voxel integration, over time, of the resulting (131)I-equivalent PET-derived images was performed to provide a single 3D dataset representing the spatial distribution of cumulated activity values for each patient. Image manipulation and registration were performed using Multiple Image Analysis Utility (MIAU), a software package developed previously. The software package, 3D-Internal Dosimetry (3D-ID), was used to obtain absorbed dose maps from the cumulated activity image sets.
RESULTS
Spatial distributions of absorbed dose, isodose contours, dose-volume histograms (DVHs), and mean absorbed dose estimates were obtained for a total of 56 tumors. Mean absorbed dose values for individual tumors ranged from 1.2 to 540 Gy. The absorbed dose distribution within individual tumors was widely distributed ranging from a minimum of 0.3 to a maximum of 4,000 Gy.
CONCLUSION
(124)I PET-based, patient-specific 3D dosimetry is feasible, and sequential PET can be used to obtain cumulated activity images for 3D dosimetry.
未标记
与传统的基于全器官、S 因子的剂量测定法相比，三维（3D）、针对患者的剂量测定法能更好地考虑放射性核素分布和患者解剖结构的变异性。然而，其准确性受到作为输入提供的累积活度信息质量的限制。该输入通常从单光子发射计算机断层扫描（SPECT）和平面成像研究中获得。目的是为甲状腺癌患者实施并评估基于正电子发射断层扫描（PET）的、针对患者的 3D 剂量测定法。
方法
在 15 例转移性甲状腺癌患者给予（124）I - 碘化钠后，在 7 天内进行了 3 至 4 次 PET 成像研究。随后，根据既定的临床参数对患者进行（131）I 治疗。使用针对（124）I 和（131）I 之间半衰期差异进行校正的已配准（124）I PET 图像进行回顾性剂量测定。对所得的（131）I 等效 PET 衍生图像随时间进行逐体素积分，以提供一个单一的 3D 数据集，代表每位患者累积活度值的空间分布。使用先前开发的软件包多重图像分析实用程序（MIAU）进行图像操作和配准。使用软件包三维内部剂量测定法（3D - ID）从累积活度图像集获得吸收剂量图。
结果
共获得了 56 个肿瘤的吸收剂量空间分布、等剂量线轮廓、剂量 - 体积直方图（DVH）和平均吸收剂量估计值。单个肿瘤的平均吸收剂量值范围为 1.2 至 540 Gy。单个肿瘤内的吸收剂量分布广泛，范围从最小值 0.3 至最大值 4000 Gy。
结论
基于（124）I PET 的、针对患者的 3D 剂量测定法是可行的，并且连续的 PET 可用于获取用于 3D 剂量测定的累积活度图像。
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