{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:28:47Z","timestamp":1783013327238,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This work demonstrates the efficacy of voxel\u2010based <jats:sup>90<\/jats:sup>Y microsphere dosimetry utilizing post\u2010therapy SPECT\/CT imaging and applies it to the prediction of treatment response for the management of patients with hepatocellular carcinoma (HCC). A <jats:sup>90<\/jats:sup>Y microsphere dosimetry navigator (RapidSphere) within a commercial platform (Velocity, Varian Medical Systems) was demonstrated for three microsphere cases that were imaged using optimized bremsstrahlung SPECT\/CT. For each case, the <jats:sup>90<\/jats:sup>Y SPECT\/CT was registered to follow\u2010up diagnostic MR\/CT using deformable image registration. The voxel\u2010based dose distribution was computed using the local deposition method with known injected activity. The system allowed the visualization of the isodose distributions on any of the registered image datasets and the calculation of dose\u2010volume histograms (DVHs). The dosimetric analysis illustrated high local doses that are characteristic of blood\u2010flow directed brachytherapy. In the first case, the HCC mass demonstrated a complete response to treatment indicated by a necrotic region in follow\u2010up MR imaging. This result was dosimetrically predicted since the gross tumor volume (GTV) was well covered by the prescription isodose volume (V150\u00a0Gy\u00a0=\u00a085%). The second case illustrated a partial response to treatment which was characterized by incomplete necrosis of an HCC mass and a remaining area of solid enhancement in follow\u2010up MR imaging. This result was predicted by dosimetric analysis because the GTV demonstrated incomplete coverage by the prescription isodose volume (V470\u00a0Gy\u00a0=\u00a018%). The third case demonstrated extrahepatic activity. The dosimetry indicated that the prescription (125\u00a0Gy) isodose region extended outside of the liver into the duodenum (178\u00a0Gy maximum dose). This was predictive of toxicity as the patient later developed a duodenal ulcer. The ability to predict outcomes and complications using deformable image registration, calculated isodose distributions, and DVHs, points to the clinical utility of patient\u2010specific dose calculations for <jats:sup>90<\/jats:sup>Y radioembolization treatment planning.<\/jats:p>","DOI":"10.1002\/acm2.12400","type":"journal-article","created":{"date-parts":[[2018,7,2]],"date-time":"2018-07-02T06:04:58Z","timestamp":1530511498000},"page":"435-443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["SPECT\/CT image\u2010based dosimetry for Yttrium\u201090 radionuclide therapy: Application to treatment response"],"prefix":"10.1002","volume":"19","author":[{"given":"Peter S.","family":"Potrebko","sequence":"first","affiliation":[{"name":"College of Medicine University of Central Florida Orlando FL USA"},{"name":"Department of Physics University of Central Florida Orlando FL USA"},{"name":"Department of Radiation 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Poleszczuk","sequence":"additional","affiliation":[{"name":"Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy H.","family":"Fox","sequence":"additional","affiliation":[{"name":"Varian Medical Systems Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.11.060"},{"key":"e_1_2_9_3_1","unstructured":"SIR\u2010Spheres.SIRTeX Medical: package insert. 2017"},{"key":"e_1_2_9_4_1","unstructured":"TheraSphere.BTG Incorporated: package insert. 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