Abstract

BackgroundPET imaging of 90Y-microsphere distribution following radioembolisation is challenging due to the count-starved statistics from the low branching ratio of e+/e− pair production during 90Y decay. PET systems using silicon photo-multipliers have shown better 90Y image quality compared to conventional photo-multiplier tubes. The main goal of the present study was to evaluate reconstruction parameters for different phantom configurations and varying listmode acquisition lengths to improve quantitative accuracy in 90Y dosimetry, using digital photon counting PET/CT.MethodsQuantitative PET and dosimetry accuracy were evaluated using two uniform cylindrical phantoms specific for PET calibration validation. A third body phantom with a 9:1 hot sphere-to-background ratio was scanned at different activity concentrations of 90Y. Reconstructions were performed using OSEM algorithm with varying parameters. Time-of-flight and point-spread function modellings were included in all reconstructions. Absorbed dose calculations were carried out using voxel S-values convolution and were compared to reference Monte Carlo simulations. Dose-volume histograms and root-mean-square deviations were used to evaluate reconstruction parameter sets. Using listmode data, phantom and patient datasets were rebinned into various lengths of time to assess the influence of count statistics on the calculation of absorbed dose. Comparisons between the local energy deposition method and the absorbed dose calculations were performed.ResultsUsing a 2-mm full width at half maximum post-reconstruction Gaussian filter, the dosimetric accuracy was found to be similar to that found with no filter applied but also reduced noise. Larger filter sizes should not be used. An acquisition length of more than 10 min/bed reduces image noise but has no significant impact in the quantification of phantom or patient data for the digital photon counting PET. 3 iterations with 10 subsets were found suitable for large spheres whereas 1 iteration with 30 subsets could improve dosimetry for smaller spheres.ConclusionThe best choice of the combination of iterations and subsets depends on the size of the spheres. However, one should be careful on this choice, depending on the imaging conditions and setup. This study can be useful in this choice for future studies for more accurate 90Y post-dosimetry using a digital photon counting PET/CT.

Highlights

  • positron emission tomography (PET) imaging of 90Y-microsphere distribution following radioembolisation is challenging due to the count-starved statistics from the low branching ratio of e+/e− pair production during 90Y decay

  • This study can be useful in this choice for future studies for more accurate 90Y post-dosimetry using a digital photon counting PET/CT

  • We investigated the accuracy of 90Y digital photon counting (DPC)-PET by evaluating the effect of Ordered Subsets Expectation Maximisation (OSEM) reconstruction parameters and acquisition duration on estimating the absorbed dose distribution based on dose-volume histograms (DVHs) [44], as proposed by Siman et al [38]

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Summary

Introduction

PET imaging of 90Y-microsphere distribution following radioembolisation is challenging due to the count-starved statistics from the low branching ratio of e+/e− pair production during 90Y decay. 99mTc-MAA biodistribution does not always match with post-therapy 90Ymicrospheres distribution [6,7,8,9,10] and an assessment of the radionuclide biodistribution must be performed following treatment either by single-photon emission computed tomography (SPECT) or positron emission tomography (PET). This assessment is mainly done to detect any possible extrahepatic deposition of microspheres and determine the intrahepatic microsphere distribution over the perfused tumorous and non-tumorous liver tissue

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