Abstract
Radioembolization (RE) with yttrium-90 (90Y) microspheres, a transcatheter intraarterial therapy for patients with liver cancer, can be modeled computationally. The purpose of this work was to correlate the results obtained with this methodology using in vivo data, so that this computational tool could be used for the optimization of the RE procedure. The hepatic artery three-dimensional (3D) hemodynamics and microsphere distribution during RE were modeled for six 90Y-loaded microsphere infusions in three patients with hepatocellular carcinoma using a commercially available computational fluid dynamics (CFD) software package. The model was built based on in vivo data acquired during the pretreatment stage. The results of the simulations were compared with the in vivo distribution assessed by 90Y PET/CT. Specifically, the microsphere distribution predicted was compared with the actual 90Y activity per liver segment with a commercially available 3D-voxel dosimetry software (PLANET Dose, DOSIsoft). The average difference between the CFD-based and the PET/CT-based activity distribution was 2.36 percentage points for Patient 1, 3.51 percentage points for Patient 2 and 2.02 percentage points for Patient 3. These results suggest that CFD simulations may help to predict 90Y-microsphere distribution after RE and could be used to optimize the RE procedure on a patient-specific basis.
Highlights
Radioembolization (RE) with yttrium-90 (90Y) microspheres, a transcatheter intraarterial therapy for patients with liver cancer, can be modeled computationally
The results from computational fluid dynamics (CFD) simulations have not yet been compared to the actual microsphere distribution in real patients to assess to what extent the model represents the real-life hepatic artery hemodynamics during RE
The percentage point difference between 90Y PET/CT activity and CFD prediction [that is defined as |% Simulated distribution (CFD) - % Measured distribution(90Y PET/CT)|] was < 3 in all segments except in segment 2, which showed a difference of 6 percentage points (10.1% vs. 16.1%)
Summary
Radioembolization (RE) with yttrium-90 (90Y) microspheres, a transcatheter intraarterial therapy for patients with liver cancer, can be modeled computationally. The hepatic artery three-dimensional (3D) hemodynamics and microsphere distribution during RE were modeled for six 90Y-loaded microsphere infusions in three patients with hepatocellular carcinoma using a commercially available computational fluid dynamics (CFD) software package. Numerous investigations based on CFD models have analyzed the influence that local 3D parameter modifications (e.g., type of catheter, catheter-tip location, microsphere infusion velocity, etc.) have on the final distribution of the m icrospheres[8,9,10,11,12,13,14] This information may contribute to enhance antitumor efficacy and minimize complications due to radiation of nontarget tissues. The results from CFD simulations have not yet been compared to the actual microsphere distribution in real patients to assess to what extent the model represents the real-life hepatic artery hemodynamics during RE. This imaging modality has been shown to be a reliable tool to assess activity deposition[15], to accurately quantify the total activity delivered[16] and to estimate the absorbed d oses[17]
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