Smits Maarten L J, Elschot Mattijs, Sze Daniel Y, Kao Yung H, Nijsen Johannes F W, Iagaru Andre H, de Jong Hugo W A M, van den Bosch Maurice A A J, Lam Marnix G E H
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E.01.132, PO Box 85500, 3508 GA, Utrecht, The Netherlands,
Cardiovasc Intervent Radiol. 2015 Apr;38(2):261-9. doi: 10.1007/s00270-014-1042-7. Epub 2014 Dec 24.
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.
钇-90放射性栓塞术（RE）中计算待施用活度的方法很大程度上基于经验性的毒性和疗效分析，而非剂量测定法。与此同时，人们认识到基于适当剂量测定法的治疗规划对于优化RE结果至关重要。数百万个点源放射性粒子在肝内的异质性分布以及常常出现的聚集情况给剂量测定带来了挑战。多项研究发现了吸收剂量与治疗结果之间在毒性和疗效方面的关系。这最终应能改善患者选择和个体化治疗规划。新的计算方法、成像技术以及用于图像引导RE的新一代微球都将有助于实现这些改进。本综述的目的是深入了解RE剂量测定的最新及最重要进展，并就患者选择、个体化治疗规划和研究设计提出未来方向。
