Dosimetry of Y-90 Liquid Brachytherapy in a Dog with Osteosarcoma Using PET/CT

A novel Y-90 liquid brachytherapy strategy is currently being studied for the treatment of osteosarcoma using a preclinical translational model in dogs to assess its potential efficacy and toxicity. In this study, dosimetry calculations are performed for Y-90 liquid brachytherapy in a dog with osteosarcoma using the Geant4 Monte Carlo code. A total of 611.83 MBq Y-90 radiopharmaceutical is administered via direct injections, and the in vivo distribution of Y-90 is assessed using a time-of-flight (TOF) PET/CT scanner.

A patient-specific geometry is built using anatomical data obtained from CT images. The material properties of tumor and surrounding tissues are calculated based on a CT number - electron density calibration. The Y-90 distribution is sampled in Geant4 from PET images using a collapsing 3-D rejection technique to determine the decay sites. Dose distributions in the tumor bed and surrounding tissues are calculated demonstrating significant heterogeneity with multiple hot spots at the injection sites. Dose volume histograms show about 33.9 percent of bone and tumor and 70.2 percent of bone marrow and trabecular bone receive a total dose over 200 Gy; about 3.2 percent of bone and tumor and 31.0 percent of bone marrow and trabecular bone receive a total dose of over 1000 Gy. Y-90 liquid brachytherapy has the potential to be used as an adjuvant therapy or for palliation purposes. Future work includes evaluation of pharmacokinetics of the Y-90 radiopharmaceutical, calibration of PET/CT scanners for the direct quantitative assessment of Y-90 activity concentration, and assessment of efficacy of the Y-90 liquid brachytherapy strategy.