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钇-90微球放射性栓塞治疗的体内剂量学

Internal dosimetry for radioembolization therapy with Yttrium-90 microspheres.

作者信息

Fallahpoor Maryam, Abbasi Mehrshad, Parach Ali Asghar, Kalantari Faraz

机构信息

Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Medical Physics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

J Appl Clin Med Phys. 2017 Mar;18(2):176-180. doi: 10.1002/acm2.12042. Epub 2017 Jan 24.

DOI:10.1002/acm2.12042
PMID:28300366
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5689949/
Abstract

The absorbed doses in the liver and adjacent viscera in Yttrium-90 radioembolization therapy for metastatic liver lesions are not well-documented. We sought for a clinically practical way to determine the dosimetry of this advent treatment. Six different female XCAT BMIs and seven different male XCAT BMIs were generated. Using Monte Carlo GATE code simulation, the total of 100MBq Y was deposited uniformly in the source organ, liver. Self-irradiation and absorbed doses in lung, kidney and bone marrow were calculated. The mean energy of Yittrium-90 (i.e., 0.937 MeV) was used. The S-values and equivalent doses in target organs were estimated. The dose absorbed in the liver was between 84 and 53 Gy and below the target of 80 to 150 Gy. The absorbed dose in the bone marrow, lungs, and kidneys are very low and below 0.1 , 0.4, and 0.5 Gy respectively. Our study indicates that larger activities than the conventional dose of 3 GBq may be both required and safe. Further confirmations in clinical settings are needed.

摘要

钇-90放射性栓塞治疗转移性肝肿瘤时,肝脏及邻近脏器的吸收剂量尚无充分记录。我们寻求一种临床实用的方法来确定这种新治疗方法的剂量测定。生成了六种不同女性XCAT身体质量指数(BMI)和七种不同男性XCAT BMI。使用蒙特卡罗GATE代码模拟,将总共100MBq的钇均匀沉积在源器官肝脏中。计算了肺、肾和骨髓的自辐照和吸收剂量。使用钇-90的平均能量(即0.937兆电子伏)。估计了靶器官的S值和当量剂量。肝脏吸收的剂量在84至53戈瑞之间,低于80至150戈瑞的目标值。骨髓、肺和肾的吸收剂量非常低,分别低于0.1、0.4和0.5戈瑞。我们的研究表明,可能需要且安全的活度大于传统的3GBq剂量。需要在临床环境中进一步证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b678/5689949/0f0678de158a/ACM2-18-176-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b678/5689949/0f0678de158a/ACM2-18-176-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b678/5689949/0f0678de158a/ACM2-18-176-g002.jpg

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Radiat Prot Dosimetry. 2017 Apr 25;174(2):191-197. doi: 10.1093/rpd/ncw115.
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Insights into the Dose-Response Relationship of Radioembolization with Resin 90Y-Microspheres: A Prospective Cohort Study in Patients with Colorectal Cancer Liver Metastases.树脂90Y微球放射性栓塞剂量反应关系的见解:一项针对结直肠癌肝转移患者的前瞻性队列研究。
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钇-90微球选择性肝动脉放射性栓塞治疗中的辐射安全问题:患者可能受到的辐射暴露
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ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context.国际放射防护委员会第118号出版物:国际放射防护委员会关于正常组织和器官中辐射的组织反应及早期和晚期效应的声明——辐射防护背景下组织反应的阈值剂量
Ann ICRP. 2012 Feb;41(1-2):1-322. doi: 10.1016/j.icrp.2012.02.001.
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