Prä- und posttherapeutische Dosimetrie der Radioembolisation

Julia Brosch-Lenz; Astrid Delker; Harun Ilhan

doi:10.1055/a-2168-2637

Angewandte Nuklearmedizin, Table of Contents

Angewandte Nuklearmedizin 2023; 46(04): 312-322
DOI: 10.1055/a-2168-2637

Live(r), Laugh, Love – Bildgebung und Therapie primärer und sekundärer Lebertumore

Übersicht

Prä- und posttherapeutische Dosimetrie der Radioembolisation

Pre- und post-therapeutic dosimetry in radioembolization

Julia Brosch-Lenz

¹Klinik und Poliklinik für Nuklearmedizin, TU München Klinikum Rechts der Isar, München, Deutschland

,

Astrid Delker

²Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum der LMU München, München

,

Harun Ilhan

³Klinik und Poliklinik für Nuklearmedizin, LMU Klinikum, München, Deutschland

⁴Radiologische, Strahlentherapeutische und Nuklearmedizinische PartG 1432, Die Radiologie, 80331 München, Deutschland

› Author Affiliations

Abstract

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.

Schlüsselwörter

Dosimetrie - TARE - MIRD - Partitions-Modell - voxelbasierte Dosimetrie

Keywords

Dosimetry - TARE - MIRD - Partition Model - voxelwise dosimetry

Full Text

References

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