A guide to 90Y radioembolization and its dosimetry. (December 2019)

• Record Type: Journal Article
• Authors: Kim, S. Peter; Cohalan, Claire; Kopek, Neil; Enger, Shirin A.
• Is Part Of: Physica medica. Volume 68(2019)
• Page Start: 132
• Page End: 145
• Publication Date: 2019-12
• Subjects: Radioembolization -- Dosimetry -- 90Y -- Clinical Background; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2019.09.236
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: Radioembolization's clinical steps can be simplified into 6 steps. Most dosimetric factors have been investigated within this review. Current clinical dosimetric methods as well as the emerging methods are discussed in detail. The newly emerging dosimetry is based on SPECT/CT or PET/CT imaging modalities. Abstract: Radioembolization gains continuous traction as a primarily palliative radiation treatment for hepatic tumours. A form of nuclear medicine therapy, Yttrium-90 containing microspheres are catheter guided and injected into the right, left, or a specifically selected hepatic artery. A multitude of comprehensive planning steps exist to ensure a thorough and successful treatment. Clear clinical and physiological guidelines have been established and nuclear imaging is used to plan and verify dose distributions. Radioembolization's treatment rationale is based on tumour and blood vessel dynamics that allow a targeted treatment approach. However, radioembolization's dosimetry is grossly oversimplified. In fact, the currently utilized clinical dosimetric standards (e.g. partition method) have persisted since the 1990s. Moreover, the multitude of radioembolization's intertwining components lies disjointed within the literature. Particularly relevant to new readers, this review provides a methodical guide that presents the treatment rationale behind every clinical step. The emerging dosimetry methods and its factors are further discussed to provide a comprehensive review on an essential research direction.