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DOI: 10.1055/a-2168-2637
Prä- und posttherapeutische Dosimetrie der Radioembolisation
Pre- und post-therapeutic dosimetry in radioembolization![](https://www.thieme-connect.de/media/10.1055-s-00051909/202304/lookinside/thumbnails/10-1055-a-2168-2637-1.jpg)
Zusammenfassung
Die transarterielle Radioembolisation (TARE) mit radioaktiv markierten Mikrosphären dient der gezielten Therapie primärer und sekundärer Lebertumore. Bei 90Y-markierten Glas- und Harzmikrosphären basiert die Behandlungsplanung auf 99mTc-MAA, während für 166Ho-PLAA-Mikrosphären eine Scout-Dosis an 166Ho-PLAA-Mikrosphären mit geringerer Aktivität zur Verfügung steht. Zur Steigerung der Effektivität der Therapie im Sinne der personalisierten Medizin wird bei der TARE zunehmend die personalisierte Dosimetrie etabliert. Dies beinhaltet die Berücksichtigung der Dosisverteilungen innerhalb von Tumoren als auch im normalen Lebergewebe. Zur Berechnung der In-vivo-Verteilung der absorbierten Dosis werden nach der Therapie Bildgebungsverfahren wie SPECT, PET und für 166Ho zusätzlich die MRT eingesetzt, um den Behandlungserfolg zu beurteilen. Dieses Manuskript bietet einen umfassenden Überblick über aktuelle Dosimetriemodelle für die prä- und posttherapeutische Beurteilung im Rahmen der TARE.
Abstract
Transarterial radioembolization (TARE) using radiolabeled microspheres serves as a liver-targeted therapeutic approach for primary and secondary liver cancer. At present, treatment planning for 90Y-labeled glass and resin microspheres relies on 99mTc MAA whereas 166Ho-PLAA TARE uses a scout dose of 166Ho-PLAA microspheres with lower activity. To enhance precision and tailor treatment to individual patients, TARE is progressing towards a more patient-specific dosimetry approach. This involves consideration and reporting of dose distributions both within tumors and normal liver tissue. Post-therapy imaging techniques such as SPECT, PET, and in addition for 166Ho MRI, are used to calculate the in vivo absorbed dose for post-therapy treatment verification. This manuscript offers a comprehensive overview of current dosimetry models for pre- and post-therapeutic TARE workup.
Publikationsverlauf
Artikel online veröffentlicht:
07. Dezember 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
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