Exploratory investigation of dose calculation and tumor-feeding artery identification using dual CBCT in selective internal radiation therapy with Yttrium-90 microspheres.

Abstract

<h4>Aim</h4>To explore the preliminary application of dual cone-beam CT (CBCT) for dose calculation and tumor-feeding arteries identification in ⁹⁰Y-SIRT planning.<h4>Materials and methods</h4>A retrospective study analyzed 27 patients with unresectable primary/metastatic liver tumors eligible for ⁹⁰Y-SIRT. Prior to angiography, dual CBCT and ⁹⁹mTc-MAA injection, each patient underwent CTA scan. Tumor volume (TV) and liver lobe volume (LLV) were measured from CTA and dual CBCT images (TVcta <i>vs</i> TVcbct and LLVcta <i>vs</i> LLVcbct). Liver perfusion volume (LPV) was derived from ⁹⁹mTc-MAA mapping and dual CBCT (LPVmma <i>vs</i> LPVcbct). Additionally, analyze the differences between an average calculated ⁹⁰Y dosage derived from TVcbct and LPVcbct, and dosage calculated using TVcbct combined with LPVmma, against the mean clinically administered (Radioactivity). The Paired Wilcoxon test was applied to evaluate differences between these parameters throughout the study.<h4>Results</h4>There were no significant differences in liver tumor and perfusion volume measurements (p-values of 0.792 and 0.084, respectively). There was a significant difference in LVcbct compare to LVcta (2083.88 ± 744.64 <i>vs</i> 2187.86 ± 807.28 cm³, p = 0.024), which may be due to differences in contrast agent delivery. No significant differences were found among the three methods of calculated ⁹⁰Y dosage(TVcbct + LPVcbct, TVcbct +LPVmma, radioactivity)were (1.819 ± 1.241, 1.806 ± 1.240, 1.805 ± 1.236)(all P>0.05).<h4>Conclusion</h4>Dual CBCT is a reliable alternative to the conventional method, while offering real-time procedural advantages for feeder artery identification and catheter positioning during ⁹⁰Y-SIRT.