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Given the widespread use of the two imaging modalities and lack of well\u2010established standardized dosimetry protocols for <jats:sup>90<\/jats:sup>Y\u2010RE, there is a clinical need to systematically investigate and evaluate differences in the performance of voxel\u2010based dosimetry between <jats:sup>90<\/jats:sup>Y\u2010PET\/CT and <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To quantitatively analyze and compare <jats:sup>90<\/jats:sup>Y\u2010PET\/CT and <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT\u2010based dosimetry following <jats:sup>90<\/jats:sup>Y\u2010RE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:sup>90<\/jats:sup>Y\u2010PET\/CT and\u00a0<jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT imaging was acquired for 35 patients following <jats:sup>90<\/jats:sup>Y\u2010RE with TheraSphere for the treatment of unresectable hepatocellular carcinoma. Dosimetry was performed using the local deposition method with known activity and the mean dose (<jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub>) was calculated for perfused liver volumes (PV), tumors (T), and perfused normal livers (NL). Additionally, the absorbed dose to x% of the volume (<jats:italic>D<\/jats:italic><jats:sub>x<\/jats:sub>, x  [5%, 10%, \u2026, 90%, 95%]) and the volume receiving y Gy (<jats:italic>V<\/jats:italic><jats:sub>y<\/jats:sub>, y  [10\u00a0Gy, 20\u00a0Gy, \u2026, 190\u00a0Gy, 200\u00a0Gy]) were calculated for T and NL, respectively. Dose metrics were compared using linear regression, Bland\u2010Altman analysis, and statistical testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT and <jats:sup>90<\/jats:sup>Y\u2010PET\/CT\u2010based tumor <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> were strongly correlated (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> \u2265 0.90) with <jats:italic>D<\/jats:italic><jats:sub>x<\/jats:sub>, excluding metrics on the extrema. Intra\u2010modality comparisons of various <jats:italic>D<\/jats:italic><jats:sub>x<\/jats:sub> and <jats:italic>V<\/jats:italic><jats:sub>y<\/jats:sub> metrics yielded statistically significant differences (ANOVA, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) for both<jats:sup>90<\/jats:sup>Y\u2010PET\/CT and\u00a0<jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT. Based on statistical testing, only <jats:italic>D<\/jats:italic><jats:sub>x<\/jats:sub> metrics separated by greater than 20%\u201330% coverage, and only <jats:italic>V<\/jats:italic><jats:sub>y<\/jats:sub> metrics separated by greater than 40\u201370\u00a0Gy, reported significant differences. For PV, there was a strong correlation (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> \u2265 0.99) between <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> derived separately from <jats:sup>90<\/jats:sup>Y\u2010PET\/CT and <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT imaging. The strength of the correlation was slightly reduced for T and NL with <jats:italic>R<\/jats:italic><jats:sup>2\u00a0<\/jats:sup>=\u00a00.91 and <jats:italic>R<\/jats:italic><jats:sup>2\u00a0<\/jats:sup>=\u00a00.95, respectively. For PV, the mean bias\u00a0\u00b1\u00a0standard error (SE) and 95% limits of agreement (LOA) between <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> from the two modalities was effectively zero with \u20100.8\u00a0\u00b1\u00a00.4% (\u00b1\u00a02.5%). For T and NL, the mean bias\u00a0\u00b1\u00a0SE (\u00b1\u00a0LOA) was \u201014.5\u00a0\u00b1\u00a03.7% (\u00b1\u00a024%) and 9.4\u00a0\u00b1\u00a04.7% (\u00b1\u00a027%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The strong correlation between <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> and <jats:italic>D<\/jats:italic><jats:sub>x<\/jats:sub> suggests information from multiple dose metrics (e.g., <jats:italic>D<\/jats:italic><jats:sub>70<\/jats:sub> and <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub>) is largely redundant when establishing dose\u2010response relationships in <jats:sup>90<\/jats:sup>Y\u2010RE. <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> is highly correlated between <jats:sup>90<\/jats:sup>Y\u2010PET\/CT and <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT\u2010based dosimetry, for all liver VOIs. Relative to <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT, <jats:sup>90<\/jats:sup>Y\u2010PET\/CT, on average, yielded higher <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> to tumors (14%) and lower <jats:italic>D<\/jats:italic><jats:sub>mean<\/jats:sub> to perfused normal livers (9%). Absorbed dose differences for perfused liver volumes between <jats:sup>90<\/jats:sup>Y\u2010SPECT\/CT and <jats:sup>90<\/jats:sup>Y\u2010PET\/CT were negligible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17175","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T15:58:05Z","timestamp":1716479885000},"page":"6061-6074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Quantitative evaluation of <sup>90<\/sup>Y\u2010PET\/CT and <sup>90<\/sup>Y\u2010SPECT\/CT\u2010based dosimetry following Yttrium\u201090 radioembolization"],"prefix":"10.1002","volume":"51","author":[{"given":"Srinivas Cheenu","family":"Kappadath","sequence":"first","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Courtney","family":"Henry","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armeen","family":"Mahvash","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"issue":"5","key":"e_1_2_9_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_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apradiso.2006.08.009"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0026174"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.112.119131"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4960629"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4922685"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.113.133629"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/AA5088"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010015\u20103059\u20109"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/MP.13269"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.01.116"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.05.062"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055742"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0246848"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/2191\u2010219X\u20103\u201056"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4962472"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJMP.2020.11.016"},{"key":"e_1_2_9_19_1","article-title":"Comparison of in vivo activity and absorbed dose quantification in PET\/CT following Yttrium\u201090 radioembolization","author":"Henry EC","journal-title":"Med Phys"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(20)30290\u20109"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010022\u201005774\u20100"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13550\u2010017\u20100292\u20101"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.117.202937"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2967\/JNUMED.119.233650"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.110.075861"},{"key":"e_1_2_9_26_1","unstructured":"Package Insert\u2014TheraSphere\u00ae Yttrium\u201090 Glass Microspheres. 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