The Essential Role of Monte Carlo Simulations for Lung Dosimetry in Liver Radioembolization—Part B: 166Ho Microspheres

This study compares dosimetric approaches for lung dosimetry in 166 radioembolization (Ho-TARE) with direct Monte Carlo (MC) simulations on a voxelized anthropomorphic phantom derived from a real patient’s CT scan, preserving the patient’s lung density distribution. Lung dosimetry was assessed for f...

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Published inApplied sciences Vol. 15; no. 2; p. 958
Main Authors d’Andrea, Edoardo, Politano, Andrea, Cassano, Bartolomeo, Lanconelli, Nico, Cremonesi, Marta, Patera, Vincenzo, Pacilio, Massimiliano
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 01.01.2025
Subjects
Accuracy
Anthropomorphism
Biodistribution
Dosimetry
internal dosimetry
Liver
lung shunt
Lungs
Medical imaging
Monte Carlo
Radiation
radioembolization
Simulation
SIRT
TARE
Tomography
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ISSN2076-3417
2076-3417
DOI10.3390/app15020958

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Summary:This study compares dosimetric approaches for lung dosimetry in 166 radioembolization (Ho-TARE) with direct Monte Carlo (MC) simulations on a voxelized anthropomorphic phantom derived from a real patient’s CT scan, preserving the patient’s lung density distribution. Lung dosimetry was assessed for five lung shunt (LS) scenarios with conventional methods: the mono-compartmental organ-level approach (MIRD), voxel S-value convolution for soft tissue (kST, ICRU soft tissue with 1.04 g/cm3) and lung tissue (kLT, ICRU lung tissue with 0.296 g/cm3), local density rescaling (kSTL and kLTL, respectively, for soft tissue and lung tissue), or global rescaling for a lung mean density of 0.221 g/cm3 (kLT221). Significant underestimations in the mean absorbed dose (AD) were observed, with relative differences with respect to the reference (MC) of −64% for MIRD, −93% for kST, −56% for kSTL, −76% for kLT, −68% for kLT221, and −60% for kLTL. Given the high heterogeneity of lung tissue, standard dosimetric approaches cannot accurately estimate the AD. Additionally, MC results for 166Ho showed notable spatial absorbed dose inhomogeneity, highlighting the need for tailored lung dosimetry in Ho-TARE accounting for the patient-specific lung density distribution. MC-based dosimetry thus proves to be essential for safe and effective radioembolization treatment planning in the presence of LS.
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ISSN:2076-3417
2076-3417
DOI:10.3390/app15020958