Quantitative differences in volumetric calculations for radiation dosimetry in segmental Y90 treatment planning using hybrid angiography-CT compared with anatomic segmentation

To compare treatment volumes reconstructed from hybrid Angio-CT catheter-directed infusion imaging and Couinaud anatomic model as well as the implied differences in Y-90 radiation dosimetry. Patients who underwent transarterial radioembolization (TARE) using Y-90 glass microspheres with pretreatment...

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Bibliographic Details
Published in:British journal of radiology 2024-02, Vol.97 (1154), p.353-362
Main Authors: Kwak, Daniel H, Lionberg, Alex, Patel, Mikin, Nijhawan, Karan, Martens, Spencer, Yu, Qian, Cao, David, Youssef, Salma, Ahmed, Osman
Format: Article
Language:English
Subjects:
Angiography
Carcinoma, Hepatocellular - radiotherapy
Cone-Beam Computed Tomography - methods
Cross-Sectional Studies
Embolization, Therapeutic - methods
Humans
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - radiotherapy
Microspheres
Radiometry - methods
Retrospective Studies
Yttrium Radioisotopes - therapeutic use
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Summary:To compare treatment volumes reconstructed from hybrid Angio-CT catheter-directed infusion imaging and Couinaud anatomic model as well as the implied differences in Y-90 radiation dosimetry. Patients who underwent transarterial radioembolization (TARE) using Y-90 glass microspheres with pretreatment CT or MRI imaging as well as intraprocedural angiography-CT (Angio-CT) were analysed. Treatment volumes were delineated using both tumoural angiosomes (derived from Angio-CT) and Couinaud anatomic landmarks. Segmental and lobar treatment volumes were calculated via semi-automated contouring software. Volume and dose differences were compared by the two-tailed Student t test or Wilcoxon signed-rank test. Factors affecting volume and dose differences were assessed via simple and/or multiple variable linear regression analysis. From September 2018 to March 2021, 44 patients underwent 45 lobar treatments and 38 patients received 56 segmental treatments. All target liver lobes and all tumours were completely included within the field-of-view by Angio-CT. Tumour sizes ranged between 1.1 and 19.5 cm in diameter. Segmental volumes and treatment doses were significantly different between the Couinaud and Angio-CT volumetry methods (316 vs 404 mL, P 
ISSN:0007-1285
1748-880X
DOI:10.1093/bjr/tqad056