Dose kernel convolution (DK) methods have been proposed to speed up absorbed dose calculations in molecular radionuclide therapy. Our aim was to evaluate the impact of tissue density heterogeneities (TDH) on dosimetry when using a DK method and to propose a simple density-correction method.
Methods
This study has been conducted on 3 clinical cases: case 1, non-Hodgkin lymphoma treated with 131I-tositumomab; case 2, a neuroendocrine tumor treatment simulated with 177Lu-peptides; and case 3, hepatocellular carcinoma treated with 90Y-microspheres. Absorbed dose calculations were performed using a direct Monte Carlo approach accounting for TDH (3D-RD), and a DK approach (VoxelDose, or VD). For each individual voxel, the VD absorbed dose, DVD, calculated assuming uniform density, was corrected for density, giving DVDd. The average 3D-RD absorbed dose values, D3DRD, were compared with DVD and DVDd, using the relative difference ΔVD/3DRD. At the voxel level, density-binned ΔVD/3DRD and ΔVDd/3DRD were plotted against ρ and fitted with a linear regression.
Results
The DVD calculations showed a good agreement with D3DRD. ΔVD/3DRD was less than 3.5%, except for the tumor of case 1 (5.9%) and the renal cortex of case 2 (5.6%). At the voxel level, the ΔVD/3DRD range was 0%–14% for cases 1 and 2, and −3% to 7% for case 3. All 3 cases showed a linear relationship between voxel bin-averaged ΔVD/3DRD and density, ρ: case 1 (Δ = −0.56ρ + 0.62, R2 = 0.93), case 2 (Δ = −0.91ρ + 0.96, R2 = 0.99), and case 3 (Δ = −0.69ρ + 0.72, R2 = 0.91). The density correction improved the agreement of the DK method with the Monte Carlo approach (ΔVDd/3DRD < 1.1%), but with a lesser extent for the tumor of case 1 (3.1%). At the voxel level, the ΔVDd/3DRD range decreased for the 3 clinical cases (case 1, −1% to 4%; case 2, −0.5% to 1.5%, and −1.5% to 2%). No more linear regression existed for cases 2 and 3, contrary to case 1 (Δ = 0.41ρ − 0.38, R2 = 0.88) although the slope in case 1 was less pronounced.
Conclusion
This study shows a small influence of TDH in the abdominal region for 3 representative clinical cases. A simple density-correction method was proposed and improved the comparison in the absorbed dose calculations when using our voxel S value implementation.