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基于多模态图像的个性化三维剂量计算方法在前列腺癌伴颅骨转移剂量学评估中的应用：一项蒙特卡罗模拟研究

Personalized three-dimensional dose calculation method based on multi-modal images in dosimetry assessment of prostate cancer with skull metastasis: a Monte Carlo simulation study.

作者信息

Tian Feng, Liu Huan, Gu Yingying, Zhang Dandan, Tang Lijun

机构信息

Department of Nuclear Medicine, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, People's Republic of China.

Department of Radiotherapy Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.

出版信息

EJNMMI Phys. 2025 Jul 1;12(1):59. doi: 10.1186/s40658-025-00781-0.

DOI:10.1186/s40658-025-00781-0
PMID:40591108
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12214214/
Abstract

BACKGROUND: The nuclear medicine treatment based on Lu-PSMA-617 has achieved excellent therapeutic effects on Prostate cancer (PCa), but there is a lack of three-dimensional dosimetry analysis of organs at risk (OARs) and distant metastatic lesions. RESULTS: This work establishes an accurate and personalized three-dimensional dose calculation method based on Monte Carlo simulation and multi-modal images of PCa patients with skull metastasis, and analyzes the three-dimensional dose distribution of metastatic lesions and OARs in the brain. Results show that due to the targeting characteristics of Lu-PSMA-617, metastatic brain lesions of all patients can receive high radiation doses with the average dose of 0.05 mGy/MBq, and the dose distribution are relatively uniform with the average homogeneity index of 1.23. In addition, the radiation dose received by most OARs are much lower than that of metastatic lesions, but for parotid glands, the dose deposited are only 3.99 times less than that of metastatic lesions due to the high absorption of Lu-PSMA-617. CONCLUSION: Therefore, it is necessary to clarify the three-dimensional dose distribution of OARs and metastatic lesions, so as to optimize the activity injected and achieve the precise killing of metastatic lesions and protection of OARs.

摘要

背景：基于镥-PSMA-617的核医学治疗对前列腺癌（PCa）取得了优异的治疗效果，但缺乏对危及器官（OARs）和远处转移病灶的三维剂量学分析。 结果：本研究基于蒙特卡罗模拟和颅骨转移PCa患者的多模态图像，建立了准确的个性化三维剂量计算方法，并分析了脑内转移病灶和OARs的三维剂量分布。结果表明，由于镥-PSMA-617的靶向特性，所有患者的脑转移病灶均可接受高辐射剂量，平均剂量为0.05 mGy/MBq，剂量分布相对均匀，平均均匀性指数为1.23。此外，大多数OARs接受的辐射剂量远低于转移病灶，但对于腮腺，由于镥-PSMA-617的高摄取，沉积剂量仅比转移病灶少3.99倍。 结论：因此，有必要明确OARs和转移病灶的三维剂量分布，以优化注射活度，实现对转移病灶的精准杀伤和对OARs的保护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/e1f58c30ac1c/40658_2025_781_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/b9d816b924ab/40658_2025_781_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/26de1b92f989/40658_2025_781_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/198895b12998/40658_2025_781_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/2d750a7d1d06/40658_2025_781_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/7b8f035a3696/40658_2025_781_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/11b38509c8d4/40658_2025_781_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/e1f58c30ac1c/40658_2025_781_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/b9d816b924ab/40658_2025_781_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/26de1b92f989/40658_2025_781_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/198895b12998/40658_2025_781_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/2d750a7d1d06/40658_2025_781_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/7b8f035a3696/40658_2025_781_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/11b38509c8d4/40658_2025_781_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b9/12214214/e1f58c30ac1c/40658_2025_781_Fig7_HTML.jpg

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Personalized three-dimensional dose calculation method based on multi-modal images in dosimetry assessment of prostate cancer with skull metastasis: a Monte Carlo simulation study.

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本文引用的文献

[1]
Dosimetry of [Lu]Lu-PSMA-Targeted Radiopharmaceutical Therapies in Patients with Prostate Cancer: A Comparative Systematic Review and Metaanalysis.

J Nucl Med. 2024-8-1

[2]
Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.

CA Cancer J Clin. 2024

[3]
Lu-PSMA Therapy.

J Nucl Med Technol. 2022-9

[4]
Prostate Cancer Treatment: Lu-PSMA-617 Considerations, Concepts, and Limitations.

J Nucl Med. 2022-6

[5]
Assessment of salivary gland function after 177Lu-PSMA radioligand therapy: Current concepts in imaging and management.

Transl Oncol. 2022-7

[6]
EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands.

Eur J Nucl Med Mol Imaging. 2022-5

[7]
Radionuclide therapy: current status and prospects for internal dosimetry in individualized therapeutic planning.

Clinics (Sao Paulo). 2019-7-29

[8]
Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial.

JAMA Oncol. 2019-6-1

[9]
Effect of External Cooling on Lu-PSMA Uptake by the Parotid Glands.

J Nucl Med. 2019-3-8

[10]
[Lu]-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-centre, single-arm, phase 2 study.

Lancet Oncol. 2018-5-8

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