Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres

Abstract Purpose Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufact...

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Main Authors: Thomas Carlier, Silvano Gnesin, Justin K. Mikell, Maurizio Conti, John O. Prior, Niklaus Schaefer, Maria del Sol Pérez Lago, Clément Bailly, Yuni K. Dewaraja, Thiago V. M. Lima
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:EJNMMI Physics
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Online Access:https://doi.org/10.1186/s40658-025-00725-8
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author Thomas Carlier
Silvano Gnesin
Justin K. Mikell
Maurizio Conti
John O. Prior
Niklaus Schaefer
Maria del Sol Pérez Lago
Clément Bailly
Yuni K. Dewaraja
Thiago V. M. Lima
author_facet Thomas Carlier
Silvano Gnesin
Justin K. Mikell
Maurizio Conti
John O. Prior
Niklaus Schaefer
Maria del Sol Pérez Lago
Clément Bailly
Yuni K. Dewaraja
Thiago V. M. Lima
author_sort Thomas Carlier
collection DOAJ
description Abstract Purpose Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufacturer-declared vial activities and both experimental and Monte-Carlo assessments, greater than 10%, for resin/glass 90Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients. Methods We analysed patient 90Y-PET reconstructions (99 glass and 15 resin microspheres) from 4 different institutions and 4 different systems. We considered tail-fitting background scaling (TFBS) and absolute scaling (ABS), for scatter correction. Residuals after therapeutic injection were measured. Eighty-one patients were imaged with PET/CT and 33 with PET/MR. The PET measured activity (APET) was assessed in the whole liver. The ratio APET/Acalibrator was calculated for each patient, where Acalibrator was the injected activity measured by the dose calibrator corrected for residual and lung shunt. Results Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean APET/CT/Acalibrator was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (APET/MR/Acalibrator)). The mean APET/CT/Acalibrator ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS. Conclusions We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin 90Y-loaded microspheres. In 90Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.
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spelling doaj-art-65b2438c1eb74a08b8637591f4e5ed1f2025-02-09T12:54:50ZengSpringerOpenEJNMMI Physics2197-73642025-02-0112111310.1186/s40658-025-00725-8Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheresThomas Carlier0Silvano Gnesin1Justin K. Mikell2Maurizio Conti3John O. Prior4Niklaus Schaefer5Maria del Sol Pérez Lago6Clément Bailly7Yuni K. Dewaraja8Thiago V. M. Lima9Nuclear Medicine Department, University Hospital of NantesInstitute of Radiation Physics, Lausanne University Hospital and University of LausanneDepartment of Radiation Oncology, Washington University in St. LouisSiemens Medical SolutionsDepartment of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of LausanneDepartment of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of LausanneDepartment of Radiology and Nuclear Medicine, Luzerner KantonsspitalNuclear Medicine Department, University Hospital of NantesDivision of Nuclear Medicine, Department of Radiology, University of MichiganDepartment of Radiology and Nuclear Medicine, Luzerner KantonsspitalAbstract Purpose Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufacturer-declared vial activities and both experimental and Monte-Carlo assessments, greater than 10%, for resin/glass 90Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients. Methods We analysed patient 90Y-PET reconstructions (99 glass and 15 resin microspheres) from 4 different institutions and 4 different systems. We considered tail-fitting background scaling (TFBS) and absolute scaling (ABS), for scatter correction. Residuals after therapeutic injection were measured. Eighty-one patients were imaged with PET/CT and 33 with PET/MR. The PET measured activity (APET) was assessed in the whole liver. The ratio APET/Acalibrator was calculated for each patient, where Acalibrator was the injected activity measured by the dose calibrator corrected for residual and lung shunt. Results Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean APET/CT/Acalibrator was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (APET/MR/Acalibrator)). The mean APET/CT/Acalibrator ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS. Conclusions We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin 90Y-loaded microspheres. In 90Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.https://doi.org/10.1186/s40658-025-00725-8Resin microspheresGlass microspheresYttrium-90PET/CTActivity
spellingShingle Thomas Carlier
Silvano Gnesin
Justin K. Mikell
Maurizio Conti
John O. Prior
Niklaus Schaefer
Maria del Sol Pérez Lago
Clément Bailly
Yuni K. Dewaraja
Thiago V. M. Lima
Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
EJNMMI Physics
Resin microspheres
Glass microspheres
Yttrium-90
PET/CT
Activity
title Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
title_full Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
title_fullStr Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
title_full_unstemmed Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
title_short Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
title_sort discordance between 90y pet ct mr estimated activity and dose calibrator measured administered activity an international study in sirt patients treated with resin and glass microspheres
topic Resin microspheres
Glass microspheres
Yttrium-90
PET/CT
Activity
url https://doi.org/10.1186/s40658-025-00725-8
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