Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-10-2013 | Original Article

Patient-specific dosimetry for intracavitary ³²P-chromic phosphate colloid therapy of cystic brain tumours

Authors: Ana M. Denis-Bacelar, Marina Romanchikova, Sarah Chittenden, Frank H. Saran, Henry Mandeville, Yong Du, Glenn D. Flux

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2013

Abstract

Purpose

³²P-chromic phosphate colloid treatments of astrocytoma and craniopharyngioma cystic brain tumours in paediatric patients are conventionally based on a sphere model under the assumption of uniform uptake. The aims of this study were to determine the distribution of the absorbed dose delivered by ³²P on a patient-specific basis and to evaluate the accuracy with which this can be predicted from a pretherapy administration of ^99mTc-Sn colloid.

Methods

Three patients were treated with ³²P-chromic phosphate colloid following ^99mTc-Sn colloid administrations. Convolution dosimetry was performed using pretherapy and posttherapy sequential SPECT imaging, and verified with EGSnrc Monte Carlo radiation transport simulations. Mean absorbed doses to the cyst wall and dose–volume histograms were also calculated and compared with those obtained by the sphere model approach.

Results

Highly nonuniform uptake distributions of both the ^99mTc and ³²P colloids were observed and characterized by dose–volume histograms to the cyst wall. Mean absorbed doses delivered to the cyst wall, obtained with the convolution method, were on average 21 % (SD 18 %) and 50 % (SD 30 %) lower than those predicted by the ^99mTc distribution and the uniform assumption of the sphere model, respectively.

Conclusion

Absorbed doses delivered to the cyst wall by ³²P are more accurately predicted from image-based patient-specific convolution dosimetry than from simple sphere models. These results indicate the necessity to perform personalized treatment planning and verification for intracavitary irradiation of cystic brain tumours treated with radiocolloids. Patient-specific dosimetry can be used to guide the frequency and levels of repeated administrations and would facilitate data collection and comparison to support the multicentre trials necessary to progress this therapy.

Karavitaki N, Cudlip S, Adams CB, Wass JA. Craniopharyngiomas. Endocr Rev. 2006;27(4):371–97. doi:10.1210/er.2006-0002.PubMedCrossRef

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114(2):97–109. doi:10.1007/s00401-007-0243-4.PubMedCrossRef

Tihan T, Fisher PG, Kepner JL, Godfraind C, McComb RD, Goldthwaite PT, et al. Pediatric astrocytomas with monomorphous pilomyxoid features and a less favorable outcome. J Neuropathol Exp Neurol. 1999;58(10):1061–8.PubMedCrossRef

Habrand JL, Ganry O, Couanet D, Rouxel V, Levy-Piedbois C, Pierre-Kahn A, et al. The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys. 1999;44(2):255–63.PubMedCrossRef

Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102(4):316–9.PubMed

Leksell L, Liden K. A therapeutic trial with radioactive isotopes in cystic brain tumours. radioisotope techniques Vol 1, Med Physiol Appl, HM Stationery Office, Oxford. 1952;1–4.

Barriger RB, Chang A, Lo SS, Timmerman RD, DesRosiers C, Boaz JC, et al. Phosphorus-32 therapy for cystic craniopharyngiomas. Radiother Oncol. 2011;98(2):207–12. doi:10.1016/j.radonc.2010.12.001.PubMedCrossRef

Shahzadi S, Sharifi G, Andalibi R, Zali A, Ali-Asgari A. Management of cystic craniopharyngiomas with intracavitary irradiation with 32P. Arch Iran Med. 2008;11(1):30–4.PubMed

Zhao R, Deng J, Liang X, Zeng J, Chen X, Wang J. Treatment of cystic craniopharyngioma with phosphorus-32 intracavitary irradiation. Childs Nerv Syst. 2010;26(5):669–74. doi:10.1007/s00381-009-1025-1.PubMedCrossRef

10.

Derrey S, Blond S, Reyns N, Touzet G, Carpentier P, Gauthier H, et al. Management of cystic craniopharyngiomas with stereotactic endocavitary irradiation using colloidal 186Re: a retrospective study of 48 consecutive patients. Neurosurgery. 2008;63(6):1045–52. doi:10.1227/01.NEU.0000335786.10968.2F. discussion 52–3.PubMedCrossRef

11.

Hasegawa T, Kondziolka D, Hadjipanayis CG, Lunsford LD. Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery. 2004;54(4):813–20. discussion 20–2.PubMedCrossRef

12.

Voges J, Sturm V, Lehrke R, Treuer H, Gauss C, Berthold F. Cystic craniopharyngioma: long-term results after intracavitary irradiation with stereotactically applied colloidal beta-emitting radioactive sources. Neurosurgery. 1997;40(2):263–9. discussion 9–70.PubMedCrossRef

13.

Pollock BE, Lunsford LD, Kondziolka D, Levine G, Flickinger JC. Phosphorus-32 intracavitary irradiation of cystic craniopharyngiomas: current technique and long-term results. Int J Radiat Oncol Biol Phys. 1995;33(2):437–46.PubMedCrossRef

14.

Fig LM, Shapiro B, Taren J. Distribution of [32P]-chromic phosphate colloid in cystic brain tumors. Stereotact Funct Neurosurg. 1992;59(1-4):166–8.PubMedCrossRef

15.

Kumar PP, Good RR, Skultety FM, Jones EO, Chu WK. Retreatment of recurrent cystic craniopharyngioma with chromic phosphorus P 32. J Natl Med Assoc. 1986;78(6):542–3, 547–9.PubMed

16.

Taasan V, Shapiro B, Taren JA, Beierwaltes WH, McKeever P, Wahl RL, et al. Phosphorus-32 therapy of cystic grade IV astrocytomas: technique and preliminary application. J Nucl Med. 1985;26(11):1335–8.PubMed

17.

Lunsford LD, Gumerman L, Levine G. Stereotactic intracavitary irradiation of cystic neoplasms of the brain. Appl Neurophysiol. 1985;48(1-6):146–50.PubMed

18.

Kobayashi T, Kageyama N, Ohara K. Internal irradiation for cystic craniopharyngioma. J Neurosurg. 1981;55(6):896–903. doi:10.3171/jns.1981.55.6.0896.PubMedCrossRef

19.

Shapiro B, Fig LM, Gross MD. Intracavitary therapy of craniopharyngiomas. Q J Nucl Med. 1999;43(4):367–74.PubMed

20.

Janicki C, Seuntjens J. Re-evaluation of the dose to the cyst wall in P-32 radiocolloid treatments of cystic brain tumors using the dose-point-kernel and Monte Carlo methods. Med Phys. 2003;30(9):2475–81.PubMedCrossRef

21.

Loevinger R. The dosimetry of beta sources in tissue; the point-source function. Radiology. 1956;66(1):55–62.PubMed

22.

Gutin PH, Klemme WM, Lagger RL, MacKay AR, Pitts LH, Hosobuchi Y. Management of the unresectable cystic craniopharyngioma by aspiration through an Ommaya reservoir drainage system. J Neurosurg. 1980;52(1):36–40. doi:10.3171/jns.1980.52.1.0036.PubMedCrossRef

23.

Heard S, Flux GD, Guy MJ, Ott RJ. Monte Carlo simulation of 90Y Bremsstrahlung imaging. Nuclear Science Symposium Conference Record, 2004 IEEE. vol 6. 2004. p. 3579–3583. doi:10.1109/NSSMIC.2004.1466658

24.

Kawrakow I. Accurate condensed history Monte Carlo simulation of electron transport. I. EGSnrc, the new EGS4 version. Med Phys. 2000;27(3):485–98.PubMedCrossRef

25.

Stabin MG, da Luz LC. Decay data for internal and external dose assessment. Health Phys. 2002;83(4):471–5.PubMedCrossRef

26.

Eckerman KF, Endo A. MIRD: radionuclide data and decay Schemes. Reston: Society of Nuclear Medicine; 2007.

27.

Lanconelli N, Pacilio M, Lo Meo S, Botta F, Di Dia A, Aroche AT, et al. A free database of radionuclide voxel S values for the dosimetry of nonuniform activity distributions. Phys Med Biol. 2012;57(2):517–33. doi:10.1088/0031-9155/57/2/517.PubMedCrossRef

28.

Bolch WE, Bouchet LG, Robertson JS, Wessels BW, Siegel JA, Howell RW, et al. MIRD pamphlet No. 17: the dosimetry of nonuniform activity distributions – radionuclide S values at the voxel level. Medical Internal Radiation Dose Committee. J Nucl Med. 1999;40(1):11S–36S.PubMed

29.

Rojas EL, Al-Dweri FM, Lallena AM, Bodineau C, Galan P. Dosimetry for radiocolloid therapy of cystic craniopharyngiomas. Med Phys. 2003;30(9):2482–92.PubMedCrossRef

30.

Hafeli UO, Pauer GJ, Unnithan J, Prayson RA. Fibrin glue system for adjuvant brachytherapy of brain tumors with 188Re and 186Re-labeled microspheres. Eur J Pharm Biopharm. 2007;65(3):282–8. doi:10.1016/j.ejpb.2006.10.016.PubMedCrossRef

Title: Patient-specific dosimetry for intracavitary 32P-chromic phosphate colloid therapy of cystic brain tumours
Authors: Ana M. Denis-Bacelar
Marina Romanchikova
Sarah Chittenden
Frank H. Saran
Henry Mandeville
Yong Du
Glenn D. Flux
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2451-6

At a glance: The STEP trials

Springer Medicine

Patient-specific dosimetry for intracavitary ³²P-chromic phosphate colloid therapy of cystic brain tumours

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2013

Observer reproducibility of results from a low-dose 123I-metaiodobenzylguanidine cardiac imaging protocol in patients with heart failure

XVIIIth Congress of the György Hevesy Hungarian Society of Nuclear Medicine (MONT), Pécs, Hungary, 30 June – 2 July 2013

PET/MRI with a 68Ga-PSMA ligand for the detection of prostate cancer

The Second Balkan Congress of Nuclear Medicine

Recycling rate of bile acids in the enterohepatic recirculation as a major determinant of whole body 75SeHCAT retention

Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging