Yttrium-90 (Y-90) transarterial radioembolization uses radioactive microspheres injected into the hepatic artery to irradiate liver tumors internally. One of the major challenges is the lack of reliable dosimetry methods for dose prediction and dose verification. We present a patient-specific dosimetry approach for personalized treatment planning based on computational fluid dynamics (CFD) simulations of the microsphere transport combined with Y-90 physics modeling called CFDose. The ultimate goal is the development of a software to optimize the amount of activity and injection point for optimal tumor targeting. We present the proof-of-concept of a CFD dosimetry tool based on a patient's angiogram performed in standard-of-care planning. The hepatic arterial tree of the patient was segmented from the cone-beam CT (CBCT) to predict the microsphere transport using multiscale CFD modeling. To calculate the dose distribution, the predicted microsphere distribution was convolved with a Y-90 dose point kernel. Vessels as small as 0.45 mm were segmented, the microsphere distribution between the liver segments using flow analysis was predicted, the volumetric microsphere and resulting dose distribution in the liver volume were computed. The patient was imaged with positron emission tomography (PET) 2 h after radioembolization to evaluate the Y-90 distribution. The dose distribution was found to be consistent with the Y-90 PET images. These results demonstrate the feasibility of developing a complete framework for personalized Y-90 microsphere simulation and dosimetry using patient-specific input parameters.

中文翻译：

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使用计算流体动力学和蒙特卡罗模拟对肝癌 Y-90 放射栓塞进行个性化剂量测定。


钇90（Y-90）经动脉放射栓塞术是将放射性微球注入肝动脉内，对肝脏肿瘤进行内部照射。主要挑战之一是缺乏可靠的剂量测定方法来进行剂量预测和剂量验证。我们提出了一种针对个性化治疗计划的患者特异性剂量测定方法，该方法基于微球传输的计算流体动力学 (CFD) 模拟与 Y-90 物理模型（称为 CFDose）相结合。最终目标是开发一种软​​件来优化活性量和注射点，以实现最佳肿瘤靶向。我们基于在标准护理计划中进行的患者血管造影，提出了 CFD 剂量测定工具的概念验证。从锥束 CT (CBCT) 中分割出患者的肝动脉树，以使用多尺度 CFD 建模来预测微球的转运。为了计算剂量分布，将预测的微球分布与 Y-90 剂量点核进行卷积。将小至 0.45 毫米的血管进行分段，使用流量分析预测肝段之间的微球分布，计算肝脏体积中的体积微球和由此产生的剂量分布。放射栓塞术后 2 小时对患者进行正电子发射断层扫描 (PET) 成像，以评估 Y-90 分布。发现剂量分布与 Y-90 PET 图像一致。这些结果证明了使用患者特定输入参数开发个性化 Y-90 微球模拟和剂量测定完整框架的可行性。