Biomedical subjects

Eric Frey

Publications and source records attributed to Eric Frey.

5 recordsLinked to original sources

PubMed2007

Therapeutic potential of 90Y- and 131I-labeled anti-CD20 monoclonal antibody in treating non-Hodgkin's lymphoma with pulmonary involvement: a Monte Carlo-based dosimetric analysis.

UNLABELLED: Pulmonary involvement is common in patients with non-Hodgkin's lymphoma (NHL). (90)Y- and (131)I-anti-CD20 antibodies (ibritumomab tiuxetan and tositumomab, respectively) have been approved for the treatment of refractory low-grade follicular NHL. In this work, we used Monte Carlo-based dosimetry to compare the potential of (90)Y and (131)I, based purely on their emission properties, in targeted therapy for NHL lung metastases of various nodule sizes and tumor burdens. METHODS: Lung metastases were simulated as spheres, with radii ranging from 0.2 to 5.0 cm, which were randomly distributed in a voxelized adult male lung phantom. Total tumor burden was varied from 0.2 to 1,641 g. Tumor uptake and retention kinetics of the 2 radionuclides were assumed equivalent; a uniform distribution of activity within tumors was assumed. Absorbed dose to tumors and lung parenchyma per unit activity in lung tumors was calculated by a Monte Carlo-based system using the MCNP4B package. Therapeutic efficacy was defined as the ratio of mean absorbed dose in the tumor to that in normal lung. Dosimetric analysis was also performed for a lung-surface distribution of tumor nodules mimicking pleural metastatic disease. RESULTS: The therapeutic efficacy of both (90)Y and (131)I declined with increasing tumor burden. In treating tumors with radii less than 2.0 cm, (131)I targeting was more efficacious than (90)Y targeting. (90)Y yielded a broader distribution of tumor absorbed doses, with the minimum 54.1% lower than the average dose; for (131)I, the minimum absorbed dose was 33.3% lower than the average. The absorbed dose to normal lungs was reduced when the tumors were distributed on the lung surface. For surface tumors, the reductions in normal-lung absorbed dose were greater for (90)Y than for (131)I, but (131)I continued to provide a greater therapeutic ratio across different tumor burdens and sizes. CONCLUSION: Monte Carlo-based dosimetry was performed to compare the therapeutic potential of (90)Y and (131)I targeting of lung metastases in NHL patients. (131)I provided a therapeutic advantage over (90)Y, especially in tumors with radii less than 2.0 cm and at lower tumor burdens. For both (90)Y- and (131)I-labeled antibodies, treatment is more efficacious when applied to metastatic NHL cases with lower tumor burdens. (131)I has advantages over (90)Y in treating smaller lung metastases.

Adult↗

PubMed2006

Lung dosimetry for radioiodine treatment planning in the case of diffuse lung metastases.

UNLABELLED: The lungs are the most frequent sites of distant metastasis in differentiated thyroid carcinoma. Radioiodine treatment planning for these patients is usually performed following the Benua-Leeper method, which constrains the administered activity to 2.96 GBq (80 mCi) whole-body retention at 48 h after administration to prevent lung toxicity in the presence of iodine-avid lung metastases. This limit was derived from clinical experience, and a dosimetric analysis of lung and tumor absorbed dose would be useful to understand the implications of this limit on toxicity and tumor control. Because of highly nonuniform lung density and composition as well as the nonuniform activity distribution when the lungs contain tumor nodules, Monte Carlo dosimetry is required to estimate tumor and normal lung absorbed dose. Reassessment of this toxicity limit is also appropriate in light of the contemporary use of recombinant thyrotropin (thyroid-stimulating hormone) (rTSH) to prepare patients for radioiodine therapy. In this work we demonstrated the use of MCNP, a Monte Carlo electron and photon transport code, in a 3-dimensional (3D) imaging-based absorbed dose calculation for tumor and normal lungs. METHODS: A pediatric thyroid cancer patient with diffuse lung metastases was administered 37 MBq of (131)I after preparation with rTSH. SPECT/CT scans were performed over the chest at 27, 74, and 147 h after tracer administration. The time-activity curve for (131)I in the lungs was derived from the whole-body planar imaging and compared with that obtained from the quantitative SPECT methods. Reconstructed and coregistered SPECT/CT images were converted into 3D density and activity probability maps suitable for MCNP4b input. Absorbed dose maps were calculated using electron and photon transport in MCNP4b. Administered activity was estimated on the basis of the maximum tolerated dose (MTD) of 27.25 Gy to the normal lungs. Computational efficiency of the MCNP4b code was studied with a simple segmentation approach. In addition, the Benua-Leeper method was used to estimate the recommended administered activity. The standard dosing plan was modified to account for the weight of this pediatric patient, where the 2.96-GBq (80 mCi) whole-body retention was scaled to 2.44 GBq (66 mCi) to give the same dose rate of 43.6 rad/h in the lungs at 48 h. RESULTS: Using the MCNP4b code, both the spatial dose distribution and a dose-volume histogram were obtained for the lungs. An administered activity of 1.72 GBq (46.4 mCi) delivered the putative MTD of 27.25 Gy to the lungs with a tumor absorbed dose of 63.7 Gy. Directly applying the Benua-Leeper method, an administered activity of 3.89 GBq (105.0 mCi) was obtained, resulting in tumor and lung absorbed doses of 144.2 and 61.6 Gy, respectively, when the MCNP-based dosimetry was applied. The voxel-by-voxel calculation time of 4,642.3 h for photon transport was reduced to 16.8 h when the activity maps were segmented into 20 regions. CONCLUSION: MCNP4b-based, patient-specific 3D dosimetry is feasible and important in the dosimetry of thyroid cancer patients with avid lung metastases that exhibit prolonged retention in the lungs.

Algorithms↗

PubMed2003

3D absorbed dose calculations based on SPECT: evaluation for 111-In/90-Y therapy using Monte Carlo simulations.

A general method is presented for patient-specific three-dimensional (3D) absorbed dose calculations based on quantitative SPECT activity measurements. The computational scheme includes a method for registration of the CT study to the SPECT image, and compensation for attenuation, scatter, and collimator-detector response including septal penetration, performed as part of an iterative reconstruction method. From SPECT images, the absorbed dose rate is calculated using an EGS4 Monte Carlo code, which converts the activity distribution to an absorbed dose rate distribution. Evaluation of the accuracy in the activity quantification and the absorbed dose calculation is based on realistic Monte Carlo simulated SPECT data of a voxel-computer phantom and (111)In and (90)Y. Septal penetration was not included in this study. The SPECT-based activity concentrations and absorbed dose distributions are compared to the actual values; the results imply that the corrections for attenuation and scatter yield results of high accuracy. The presented method includes compensation for most parameters deteriorating the quantitative image information. Inaccuracies are, however, introduced by the limited spatial resolution of the SPECT system, which are not fully compensated by the collimator-response correction. The proposed evaluation methodology may be used as a basis for future inter-comparison of different dosimetry calculation schemes.

Humans↗

PubMed2002

A 3-dimensional absorbed dose calculation method based on quantitative SPECT for radionuclide therapy: evaluation for (131)I using monte carlo simulation.

UNLABELLED: A general method is presented for patient-specific 3-dimensional absorbed dose calculations based on quantitative SPECT activity measurements. METHODS: The computational scheme includes a method for registration of the CT image to the SPECT image and position-dependent compensation for attenuation, scatter, and collimator detector response performed as part of an iterative reconstruction method. A method for conversion of the measured activity distribution to a 3-dimensional absorbed dose distribution, based on the EGS4 (electron-gamma shower, version 4) Monte Carlo code, is also included. The accuracy of the activity quantification and the absorbed dose calculation is evaluated on the basis of realistic Monte Carlo-simulated SPECT data, using the SIMIND (simulation of imaging nuclear detectors) program and a voxel-based computer phantom. CT images are obtained from the computer phantom, and realistic patient movements are added relative to the SPECT image. The SPECT-based activity concentration and absorbed dose distributions are compared with the true ones. RESULTS: Correction could be made for object scatter, photon attenuation, and scatter penetration in the collimator. However, inaccuracies were imposed by the limited spatial resolution of the SPECT system, for which the collimator response correction did not fully compensate. CONCLUSION: The presented method includes compensation for most parameters degrading the quantitative image information. The compensation methods are based on physical models and therefore are generally applicable to other radionuclides. The proposed evaluation methodology may be used as a basis for future intercomparison of different methods.

Humans↗

PubMedDate not supplied

A multicenter evaluation of commercial attenuation compensation techniques in cardiac SPECT using phantom models.

BACKGROUND: Our goal was to evaluate the ability of current commercially available attenuation compensation (AC) techniques to correct for the effects of attenuation, scatter, and loss of resolution with depth, in a series of standardized phantom experiments. METHODS AND RESULTS: The following systems were evaluated: Hawkeye (GE Medical Systems), Profile (Siemens Medical Systems), Vantage Pro (ADAC Laboratories), TAC (SMV America), M-STEP (University of Michigan, Ann Arbor), TransAct (Elscint), Beacon (Marconi Systems), and PET Advance (GE Medical Systems). Studies were performed with the use of normal and ischemic myocardium in air and with technetium 99m or fluorine 18 in torso phantoms. There was considerable variation in the uniformity of short-axis slices and defect contrast for images acquired in air (no AC). AC improved the uniformity of activity throughout normal myocardium. A simulated hot liver resulted in severe artifacts and was only partially corrected by many systems. A high-quality attenuation map appears to be an important determinant of image quality. No system produced AC images of comparable quality to those obtained in the absence of scatter/attenuating media. CONCLUSIONS: There are significant differences in the ability of commercial AC systems to reduce artifacts due to attenuation and scatter. These differences are partly the result of non-AC factors (collimation, orbit, etc). In general, systems that generated high-quality attenuation maps yielded the best results.

Algorithms↗