90Y-替伊莫单抗放射性免疫疗法治疗非霍奇金淋巴瘤患者时二维与三维剂量测定方案的比较

Comparison between 2D and 3D dosimetry protocols in 90Y-ibritumomab tiuxetan radioimmunotherapy of patients with non-Hodgkin's lymphoma.

作者信息

Assié Karine, Dieudonné Arnaud, Gardin Isabelle, Buvat Irène, Tilly Hervé, Vera Pierre

机构信息

Laboratoire LITIS (EA 4108), Université de Rouen, Rouen, France.

出版信息

Cancer Biother Radiopharm. 2008 Feb;23(1):53-64. doi: 10.1089/cbr.2007.372.

DOI:10.1089/cbr.2007.372

PMID:18298329

Abstract

UNLABELLED

We compared the radiation-absorbed dose obtained from a two dimensional (2D) protocol, based on planar whole-body (WB) scans and fixed reference organ masses with dose estimates, using a 3D single-photon emission computed tomography (SPECT) imaging protocol and patient-specific organ masses.

METHODS

Six (6) patients with follicular non-Hodgkin's lymphoma underwent a computed tomography (CT) scan, 5 2D planar WB, and 5 SPECT scans between days 0 and 6 after the injection of (111)In-ibritumomab tiuxetan. The activity values in the liver, spleen, and kidneys were calculated from the 2D WB scans, and also from the 3D SPECT images reconstructed, using quantitative image processing. Absorbed doses after the administration of (90)Y-ibritumomab tiuxetan were calculated from the (111)In WB activity values combined with reference organ masses and also from the SPECT activity values and organ masses as estimated from the patient CT scan. To assess the quantitative accuracy of the WB and SPECT scans, an abdominal phantom was also studied.

RESULTS

The differences between organ masses estimated from the patient CT and from the reference MIRD models were between -10% and +98%. Using the phantom, errors in organ and tumor activity estimates were between -86% and 10% for the WB protocol and between -43% and -6% for the SPECT protocol. Patient liver, spleen, and kidney activity values determined from SPECT were systematically less than those from the WB scans. Radiation-absorbed doses calculated with the 3D protocol were systematically lower than those calculated from the WB protocol (29%+/-26%, 73%+/-26%, and 33%+/-53% differences in the liver, spleen, and kidney, respectively), except in the kidneys of 2 patients and in the liver of 1 patient.

CONCLUSIONS

Accounting for patient-specific organ mass and using SPECT activity quantification have both a great impact on estimated absorbed doses.

摘要

未标注

我们将基于平面全身（WB）扫描和固定参考器官质量的二维（2D）方案所获得的辐射吸收剂量，与使用三维单光子发射计算机断层扫描（SPECT）成像方案和患者特异性器官质量的剂量估计值进行了比较。

方法

6例滤泡性非霍奇金淋巴瘤患者在注射（111）铟-替伊莫单抗后的第0天至第6天之间接受了计算机断层扫描（CT）、5次2D平面WB扫描和5次SPECT扫描。通过2D WB扫描以及使用定量图像处理重建的3D SPECT图像计算肝脏、脾脏和肾脏的活性值。根据（111）铟WB活性值结合参考器官质量以及根据患者CT扫描估计的SPECT活性值和器官质量，计算（90）钇-替伊莫单抗给药后的吸收剂量。为了评估WB和SPECT扫描的定量准确性，还对腹部体模进行了研究。

结果

根据患者CT估计的器官质量与参考MIRD模型之间的差异在-10%至+98%之间。使用体模时，WB方案的器官和肿瘤活性估计误差在-86%至10%之间，SPECT方案的误差在-43%至-6%之间。通过SPECT确定的患者肝脏、脾脏和肾脏活性值系统性地低于WB扫描的值。除2例患者的肾脏和1例患者的肝脏外，使用3D方案计算的辐射吸收剂量系统性地低于从WB方案计算的值（肝脏、脾脏和肾脏的差异分别为29%±26%、73%±26%和33%±53%）。