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作者信息

Götz Theresa I, Lang Elmar W, Schmidkonz Christian, Kuwert Torsten, Ludwig Bernd

机构信息

Clinic of Nuclear Medicine, University Hospital Erlangen, 91054 Erlangen, Germany; CIML Group, Biophysics, University of Regensburg, 93040 Regensburg, Germany; Information Sciences, University of Regensburg, 93053 Regensburg, Germany.

CIML Group, Biophysics, University of Regensburg, 93040 Regensburg, Germany.

出版信息

Z Med Phys. 2021 Feb;31(1):23-36. doi: 10.1016/j.zemedi.2020.09.005. Epub 2020 Oct 20.

Abstract

BACKGROUND

Currently there is an ever increasing interest in Lu-177 targeted radionuclide therapies, which target neuro-endocrine and prostate tumours. For a patient-specific treatment, an individual dosimetry based on SPECT/CT imaging is necessary. The aim of this study is to introduce a dosimetry method, where dose voxel kernels (DVK) are predicted by a neural network.

METHODS

Kidneys are considered one of the most critical organs in any radionuclide therapy. Hence we chose kidneys of 26 patients, who underwent Lu-177-DOTATOC or PSMA therapy, as target organs for our dosimetric method. First of all, density kernels with a size of 9×9×9 voxels were considered, and the corresponding DVKs were calculated by Monte Carlo simulations. These kernels were used to train a neural network (NN), which received a density kernel as input and predicted a DVK at the output. To predict the dose distribution of an entire kidney, the organ had to be partitioned into a large number of density kernels. Afterwards the DVKs were predicted by a trained NN, and employed to reconstruct the whole-organ dose distribution by convolution with the activity distribution. This method was compared to the standard method where the activity distribution is convolved with a DVK based on a homogeneous soft tissue kernel.

RESULTS

The number of training kernels amounted to 52,274 density kernels with corresponding MC-derived DVKs. The results serve as proof of principle of the newly proposed method and showed that the NN approach yielded superior results compared to the standard method with no additional computational effort.

CONCLUSION

The NN approach is an accurate and highly competitive dosimetric method to precisely estimate absorbed radiation dose in critical organs like kidneys in clinical routine. To further improve the results, a larger number of DVKs needs to be computed by Monte Carlo simulations. An extension of the method to other organs is easily conceivable.

摘要

背景

目前,针对神经内分泌和前列腺肿瘤的镥 - 177靶向放射性核素疗法越来越受到关注。对于个性化治疗,基于单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)成像的个体剂量测定是必要的。本研究的目的是介绍一种剂量测定方法,其中剂量体素核(DVK)由神经网络预测。

方法

在任何放射性核素治疗中,肾脏被认为是最关键的器官之一。因此,我们选择了26例接受镥 - 177 - DOTATOC或前列腺特异性膜抗原(PSMA)治疗的患者的肾脏作为我们剂量测定方法的靶器官。首先,考虑大小为9×9×9体素的密度核,并通过蒙特卡罗模拟计算相应的DVK。这些核用于训练神经网络(NN),该网络将密度核作为输入,并在输出端预测DVK。为了预测整个肾脏的剂量分布,必须将器官划分为大量的密度核。然后,由训练好的NN预测DVK,并通过与活度分布卷积来重建全器官剂量分布。将该方法与标准方法进行比较,标准方法是将活度分布与基于均匀软组织核的DVK进行卷积。

结果

训练核的数量达到52,274个密度核以及相应的蒙特卡罗衍生的DVK。结果证明了新提出方法原理的可行性,并且表明与标准方法相比,NN方法在不增加额外计算量的情况下产生了更好的结果。

结论

NN方法是一种准确且极具竞争力的剂量测定方法,可在临床常规中精确估计关键器官(如肾脏)中的吸收辐射剂量。为了进一步改善结果,需要通过蒙特卡罗模拟计算更多的DVK。该方法很容易扩展到其他器官。

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