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Yet, the accuracy of in vivo <jats:sup>90<\/jats:sup>Y\u2010PET\/CT imaging, subject to motion blur and co\u2010registration inaccuracies, and <jats:sup>90<\/jats:sup>Y\u2010PET\/CT dose quantification, subject to availability of different voxel dosimetry algorithms, are not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to investigate the accuracy of <jats:sup>90<\/jats:sup>Y\u2010PET\/CT\u2010based activity estimates following <jats:sup>90<\/jats:sup>Y\u2010RE and characterize differences between <jats:sup>90<\/jats:sup>Y\u2010PET\/CT\u2010based voxel dosimetry algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010five patients underwent <jats:sup>90<\/jats:sup>Y\u2010PET\/CT imaging after <jats:sup>90<\/jats:sup>Y\u2010RE with TheraSphere. The net administered <jats:sup>90<\/jats:sup>Y activity (A<jats:sub>admin<\/jats:sub>) was determined using a dose calibrator and pre\u2010 and post\u2010procedure exposure rate measurements. The summation of image\u2010based activity (A<jats:sub>image<\/jats:sub>) was extracted from perfused volume (PV) and 3D\u2010isotropically 2\u2010cm expanded PV contour (PV<jats:sub>+2\u00a0cm<\/jats:sub>). Absorbed doses were calculated using voxel S\u2010value (VSV), local deposition method (LDM), and LDM with known activity (LDM<jats:sub>KA<\/jats:sub>) dosimetry algorithms. Linear regression and Bland\u2010Altman analysis quantified the relationship between A<jats:sub>image<\/jats:sub> and A<jats:sub>admin<\/jats:sub> and between mean dose estimates (D<jats:sub>LDM<\/jats:sub>, D<jats:sub>VSV<\/jats:sub>, D<jats:sub>LDM\u2010KA<\/jats:sub>) for PV, T, and perfused NL volumes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While A<jats:sub>admin<\/jats:sub> and A<jats:sub>image<\/jats:sub> in PV were highly correlated (<jats:italic>R<\/jats:italic><jats:sup>2\u00a0<\/jats:sup>&gt;\u00a00.95), the mean bias\u00a0\u00b1\u00a0standard error (SE) and (95% limits of agreement, LOA) was significantly non\u2010zero with \u221222.7\u00a0\u00b1\u00a04.7% (\u00b1\u00a028.4%). In PV<jats:sub>+2\u00a0cm<\/jats:sub>, the mean bias\u00a0\u00b1\u00a0SE (\u00b1\u00a0LOA) decreased to 1.3\u00a0\u00b1\u00a03.4% (\u00b1\u00a018.0%) consistent with zero mean error. D<jats:sub>LDM<\/jats:sub> and D<jats:sub>VSV<\/jats:sub> were highly correlated (<jats:italic>R<\/jats:italic><jats:sup>2\u00a0<\/jats:sup>&gt;\u00a00.99) for all volumes of interest (VOIs) and the mean\u00a0bias\u00a0\u00b1\u00a0SE\u00a0(\u00b1\u00a0LOA) was 2.2\u00a0\u00b1\u00a00.2% (\u00b1\u00a01.0%), 0.7\u00a0\u00b1\u00a00.4% (\u00b1\u00a02.8%), and 3.2\u00a0\u00b1\u00a00.5% (\u00b1\u00a02.8%) for PV, T, and NL, respectively. D<jats:sub>LDM\u2010KA<\/jats:sub> and D<jats:sub>VSV<\/jats:sub> were correlated with <jats:italic>R<\/jats:italic><jats:sup>2\u00a0<\/jats:sup>=\u00a00.86, 0.80, and 0.86 for PV, T, and NL, respectively. The mean\u00a0bias\u00a0\u00b1\u00a0SE\u00a0(\u00b1\u00a0LOA) between D<jats:sub>LDM\u2010KA<\/jats:sub> and D<jats:sub>VSV<\/jats:sub> was significantly non\u2010zero with \u221219.6\u00a0\u00b1\u00a05.1% (\u00b1\u00a031.0%), \u221220.8\u00a0\u00b1\u00a04.4% (\u00b1\u00a029.0%), and \u221218.1\u00a0\u00b1\u00a05.3% (\u00b1\u00a031.1%) for PV, T, and NL, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The summation of A<jats:sub>image<\/jats:sub> in PV was underestimated relative to A<jats:sub>admin<\/jats:sub>. Only by accounting for respiratory motion, limited spatial resolution, and PET\/CT co\u2010registration errors through VOI expansion was A<jats:sub>image<\/jats:sub>, on average, equal to A<jats:sub>admin<\/jats:sub>. The differences between D<jats:sub>LDM<\/jats:sub> and D<jats:sub>VSV<\/jats:sub> were not clinically relevant, though D<jats:sub>LDM\u2010KA<\/jats:sub> was approximately 20% greater than D<jats:sub>VSV<\/jats:sub>. Given the high quantitative accuracy of dose calibrators and challenges associated with accurate <jats:sup>90<\/jats:sup>Y\u2010PET\/CT quantification, LDM<jats:sub>KA<\/jats:sub> is the preferred algorithm for accurate <jats:sup>90<\/jats:sup>Y\u2010PET\/CT\u2010based dosimetry following <jats:sup>90<\/jats:sup>Y\u2010RE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17174","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T17:33:52Z","timestamp":1716312832000},"page":"6034-6045","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A comparison of methods for in vivo activity and absorbed dose quantification with PET\/CT following yttrium\u201090 radioembolization"],"prefix":"10.1002","volume":"51","author":[{"given":"Eric Courtney","family":"Henry","sequence":"first","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armeen","family":"Mahvash","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin P.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4643-7745","authenticated-orcid":false,"given":"Srinivas Cheenu","family":"Kappadath","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","first-page":"969","article-title":"The blood supply of neoplasms in the liver","volume":"30","author":"Breedis C","year":"1954","journal-title":"Am J Pathol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apradiso.2006.08.009"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2014.00255"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.01.116"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/MP.13269"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010015\u20103059\u20109"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10929080209146038"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2016.01.344"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.107.041517"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.09.004"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01084369"},{"issue":"7","key":"e_1_2_8_13_1","first-page":"1209","article-title":"Dosimetric techniques in 90Y\u2010microsphere therapy of liver cancer: the MIRD equations for dose calculations","volume":"47","author":"Gulec SA","year":"2006","journal-title":"J Nucl Med"},{"issue":"1","key":"e_1_2_8_14_1","article-title":"MIRD pamphlet no. 17: the dosimetry of nonuniform activity distributions\u2014radionuclide S values at the voxel level","volume":"40","author":"Bolch WE","year":"1999","journal-title":"J Nucl Med"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2014.00121"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jicru_ndh020"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1861412"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4960629"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.BRACHY.2022.03.007"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/wjnm.wjnm_23_20"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/APP12178418"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.22049\/ASSET\/IMAGES\/LARGE\/05_19_22049_01_CMYK.JPEG"},{"key":"e_1_2_8_23_1","unstructured":"Boston Scientific.Package Insert\u2014TheraSphere\u00ae Yttrium\u201090 Glass Microspheres.Boston Scientific;2021. 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