The Essential Role of Monte Carlo Simulations for Lung Dosimetry in Liver Radioembolization—Part B: <sup>166</sup>Ho Microspheres
This study compares dosimetric approaches for lung dosimetry in <sup>166</sup> 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 dosim...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
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| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/15/2/958 |
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| Summary: | This study compares dosimetric approaches for lung dosimetry in <sup>166</sup> 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/cm<sup>3</sup>) and lung tissue (kLT, ICRU lung tissue with 0.296 g/cm<sup>3</sup>), local density rescaling (kST<i><sub>L</sub></i> and kLT<i><sub>L</sub></i>, respectively, for soft tissue and lung tissue), or global rescaling for a lung mean density of 0.221 g/cm<sup>3</sup> (kLT<sub>221</sub>). 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 kST<i><sub>L</sub></i>, −76% for kLT, −68% for kLT<sub>221</sub>, and −60% for kLT<i><sub>L</sub></i>. Given the high heterogeneity of lung tissue, standard dosimetric approaches cannot accurately estimate the AD. Additionally, MC results for <sup>166</sup>Ho 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 |