Magnetic resonance imaging-based radiation-absorbed dose estimation of 166Ho microspheres in liver radioembolization

Seevinck, PR, Van De Maat, Gerrit H., De Wit, Tim C., Vente, Maarten A D, Nijsen, JFW, Bakker, CJG


International Journal of Radiation Oncology Biology Physics 83 (3),


Purpose: To investigate the potential of magnetic resonance imaging (MRI) for accurate assessment of the three-dimensional 166Ho activity distribution to estimate radiation-absorbed dose distributions in 166Ho-loaded poly (L-lactic acid) microsphere ( 166Ho-PLLA- MS) liver radioembolization. Methods and Materials: MRI, computed tomography (CT), and single photon emission CT (SPECT) experiments were conducted on an anthropomorphic gel phantom with tumor-simulating gel samples and on an excised human tumor-bearing liver, both containing known amounts of 166Ho- PLLA-MS. Three-dimensional radiation-absorbed dose distributions were estimated at the voxel level by convolving the 166Ho activity distribution, derived from quantitative MRI data, with a 166Ho dose point-kernel generated by MCNP (Monte Carlo N-Particle transport code) and from Medical Internal Radiation Dose Pamphlet 17. MRI-based radiation-absorbed dose distributions were qualitatively compared with CT and autoradiography images and quantitatively compared with SPECT-based dose distributions. Both MRI- and SPECT-based activity estimations were validated against dose calibrator measurements. Results: Evaluation on an anthropomorphic phantom showed that MRI enables accurate assessment of local 166Ho-PLLA-MS mass and activity distributions, as supported by a regression coefficient of 1.05 and a correlation coefficient of 0.99, relating local MRI-based mass and activity calculations to reference values obtained with a dose calibrator. Estimated MRI-based radiation-absorbed dose distributions of 166Ho-PLLA-MS in an ex vivo human liver visually showed high correspondence to SPECT-based radiation-absorbed dose distributions. Quantitative analysis revealed that the differences in local and total amounts of 166Ho-PLLA-MS estimated by MRI, SPECT, and the dose calibrator were within 10%. Excellent agreement was observed between MRI- and SPECT-based dose-volume histograms. Conclusions: Quantitative MRI was demonstrated to provide accurate three-dimensional 166Ho-PLLA-MS activity distributions, enabling localized intrahepatic radiation-absorbed dose estimation by convolution with a 166Ho dose point-kernel for liver radioembolization treatment optimization and evaluation.