Highlights
- •A dosimetric study of 7 cases of TARE treatments with 90Y microspheres is presented.
- •Monte Carlo calculated doses agree with convolution and MIRD results.
- •3D dose maps, dose profiles and DVHs were compared.
- •Lung doses at liver/lung interface are significantly affected by liver irradiation.
Abstract
Three-dimensional internal dosimetry is increasingly used in planning Trans-Arterial
Radio-Embolization (TARE) of HepatoCellular Carcinoma (HCC). Among the existing calculation
approaches, Monte Carlo (MC) simulation is the gold standard. Aim of this work was
to carry out a retrospective study of clinical cases of TARE to compare the performances
of different computation approaches. We developed a procedure exploiting GAMOS (GEANT4-based
Architecture for Medicine-Oriented Simulations) MC. Three dimensional absorbed dose
maps, dose profiles and Dose Volume Histograms (DVHs) were produced for liver through
MC simulations and convolution method implemented in STRATOS software. We compared
the average absorbed doses with results of Medical International Radiation Dose (MIRD)
approach.
For most patients, a reasonable agreement was found, with relative differences in
mean doses within (−20.2%,+15.6%) for MIRD vs. MC and (−12.1%, +7.6%) for STRATOS vs. MC. Discrepancies can mainly be related to the gamma-rays contribution, more precisely
taken into account in MC.
For one patient we evaluated through MC simulation a lung dose of about 2 Gy coming
from pulmonary shunt (96%) and from irradiation from liver (4%), with values up to
4.5 Gy near liver-lung interface.
3D dosimetry for TARE treatments can be satisfactorily carried out with convolution
methods as long as VOIs of regular shape are considered. MC simulations are more appropriate
for VOIs where the contribution from gamma-rays has to be carefully taken into account.
The absorbed dose distribution in presence of relevant tissue inhomogeneities can
be assessed accurately by means of MC simulations only.
Keywords
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Article info
Publication history
Published online: August 02, 2019
Accepted:
July 27,
2019
Received in revised form:
July 26,
2019
Received:
May 7,
2019
Identification
Copyright
© 2019 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
