Introduction: In Selective Internal Radiation Therapy (SIRT), 90Y is administered to primary/secondary hepatic lesions. An accurate pre-treatment planning using 99mTc-MAA SPECT/CT allows the assessment of its feasibility and of the activity to be injected. Unfortunately, SPECT/CT suffers from patient-specific respiratory motion which causes artifacts and absorbed dose inaccuracies. In this study, a data-driven solution was developed to correct the respiratory motion. Methods: The tool realigns the barycenter of SPECT projection images and shifts them to obtain a fine registration with the attenuation map. The tool was validated using a modified dynamic phantom with several breathing patterns. We compared the absorbed dose distributions derived from uncorrected(Dm)/corrected(Dc) images with static ones(Ds) in terms of y -passing rates, 210 Gy isodose volumes, dose-volume histograms and percentage differences of mean doses (i.e., ADm and ADc, respectively). The tool was applied to twelve SIRT patients and the Bland-Altman analysis was performed on mean doses. Results: In the phantom study, the agreement between Dc and Ds was higher (y -passing rates generally > 90%) than Dm and Ds. The isodose volumes in Dc were closer than Dm to Ds, with differences up to 10% and 30% respectively. A reduction from a median ADm = -19.3% to ADc = -0.9%, from ADm = -42.8% to ADc =-7.0% and from ADm = 1586% to ADc = 47.2% was observed in liver-, tumor-and lungs-like structures. The Bland-Altman analysis on patients showed variations (+/- 50 Gy) and (+/- 4 Gy) between Dc and Dm of tumor and lungs, respectively. Conclusion: The proposed tool allowed the correction of 99mTc-MAA SPECT/CT images, improving the accuracy of the absorbed dose distribution.

A novel tool for motion-related dose inaccuracies reduction in 99mTc-MAA SPECT/CT images for SIRT planning / Santoro, Miriam; Della Gala, Giuseppe; Paolani, Giulia; Zagni, Federico; Strolin, Silvia; Civollani, Simona; Calderoni, Letizia; Cappelli, Alberta; Mosconi, Cristina; Lodi Rizzini, Elisa; Tabacchi, Elena; Morganti, Alessio Giuseppe; Fanti, Stefano; Golfieri, Rita; Strigari, Lidia. - In: PHYSICA MEDICA. - ISSN 1724-191X. - STAMPA. - 98:(2022), pp. 98-112. [10.1016/j.ejmp.2022.04.017]

A novel tool for motion-related dose inaccuracies reduction in 99mTc-MAA SPECT/CT images for SIRT planning

Santoro, Miriam;Paolani, Giulia;Civollani, Simona;Calderoni, Letizia;Mosconi, Cristina;Lodi Rizzini, Elisa;Tabacchi, Elena;Morganti, Alessio Giuseppe;Fanti, Stefano;Golfieri, Rita;
2022

Abstract

Introduction: In Selective Internal Radiation Therapy (SIRT), 90Y is administered to primary/secondary hepatic lesions. An accurate pre-treatment planning using 99mTc-MAA SPECT/CT allows the assessment of its feasibility and of the activity to be injected. Unfortunately, SPECT/CT suffers from patient-specific respiratory motion which causes artifacts and absorbed dose inaccuracies. In this study, a data-driven solution was developed to correct the respiratory motion. Methods: The tool realigns the barycenter of SPECT projection images and shifts them to obtain a fine registration with the attenuation map. The tool was validated using a modified dynamic phantom with several breathing patterns. We compared the absorbed dose distributions derived from uncorrected(Dm)/corrected(Dc) images with static ones(Ds) in terms of y -passing rates, 210 Gy isodose volumes, dose-volume histograms and percentage differences of mean doses (i.e., ADm and ADc, respectively). The tool was applied to twelve SIRT patients and the Bland-Altman analysis was performed on mean doses. Results: In the phantom study, the agreement between Dc and Ds was higher (y -passing rates generally > 90%) than Dm and Ds. The isodose volumes in Dc were closer than Dm to Ds, with differences up to 10% and 30% respectively. A reduction from a median ADm = -19.3% to ADc = -0.9%, from ADm = -42.8% to ADc =-7.0% and from ADm = 1586% to ADc = 47.2% was observed in liver-, tumor-and lungs-like structures. The Bland-Altman analysis on patients showed variations (+/- 50 Gy) and (+/- 4 Gy) between Dc and Dm of tumor and lungs, respectively. Conclusion: The proposed tool allowed the correction of 99mTc-MAA SPECT/CT images, improving the accuracy of the absorbed dose distribution.
2022
A novel tool for motion-related dose inaccuracies reduction in 99mTc-MAA SPECT/CT images for SIRT planning / Santoro, Miriam; Della Gala, Giuseppe; Paolani, Giulia; Zagni, Federico; Strolin, Silvia; Civollani, Simona; Calderoni, Letizia; Cappelli, Alberta; Mosconi, Cristina; Lodi Rizzini, Elisa; Tabacchi, Elena; Morganti, Alessio Giuseppe; Fanti, Stefano; Golfieri, Rita; Strigari, Lidia. - In: PHYSICA MEDICA. - ISSN 1724-191X. - STAMPA. - 98:(2022), pp. 98-112. [10.1016/j.ejmp.2022.04.017]
Santoro, Miriam; Della Gala, Giuseppe; Paolani, Giulia; Zagni, Federico; Strolin, Silvia; Civollani, Simona; Calderoni, Letizia; Cappelli, Alberta; Mosconi, Cristina; Lodi Rizzini, Elisa; Tabacchi, Elena; Morganti, Alessio Giuseppe; Fanti, Stefano; Golfieri, Rita; Strigari, Lidia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/902684
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