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  1. Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK
    Appl Radiat Isot, 2023 Sep;199:110916.
    PMID: 37393764 DOI: 10.1016/j.apradiso.2023.110916
    A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a 3D slicer. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to 3D slicer to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
  2. Abdul Hadi MFR, Abdullah AN, Hashikin NAA, Ying CK, Yeong CH, Yoon TL, et al.
    Med Phys, 2022 Dec;49(12):7742-7753.
    PMID: 36098271 DOI: 10.1002/mp.15980
    PURPOSE: Monte Carlo (MC) simulation is an important technique that can help design advanced and challenging experimental setups. GATE (Geant4 application for tomographic emission) is a useful simulation toolkit for applications in nuclear medicine. Transarterial radioembolization is a treatment for liver cancer, where microspheres embedded with yttrium-90 (90 Y) are administered intra-arterially to the tumor. Personalized dosimetry for this treatment may provide higher dosimetry accuracy compared to the conventional partition model (PM) calculation. However, incorporation of three-dimensional tomographic input data into MC simulation is an intricate process. In this article, 3D Slicer, free and open-source software, was utilized for the incorporation of patient tomographic images into GATE to demonstrate the feasibility of personalized dosimetry in hepatic radioembolization with 90 Y.

    METHODS: In this article, the steps involved in importing, segmenting, and registering tomographic images using 3D Slicer were thoroughly described, before importing them into GATE for MC simulation. The absorbed doses estimated using GATE were then compared with that of PM. SlicerRT, a 3D Slicer extension, was then used to visualize the isodose from the MC simulation.

    RESULTS: A workflow diagram consisting of all the steps taken in the utilization of 3D Slicer for personalized dosimetry in 90 Y radioembolization has been presented in this article. In comparison to the MC simulation, the absorbed doses to the tumor and normal liver were overestimated by PM by 105.55% and 20.23%, respectively, whereas for lungs, the absorbed dose estimated by PM was underestimated by 25.32%. These values were supported by the isodose distribution obtained via SlicerRT, suggesting the presence of beta particles outside the volumes of interest. These findings demonstrate the importance of personalized dosimetry for a more accurate absorbed dose estimation compared to PM.

    CONCLUSION: The methodology provided in this study can assist users (especially students or researchers who are new to MC simulation) in navigating intricate steps required in the importation of tomographic data for MC simulation. These steps can also be utilized for other radiation therapy related applications, not necessarily limited to internal dosimetry.

  3. Hassan HJ, Hashim S, Abu Hanifah NZH, Ghoshal SK, Sanusi MSM, Binti Suhailin FH, et al.
    PMID: 34769689 DOI: 10.3390/ijerph182111170
    A particular category of jewelry is one involving bracelets and necklaces that are deliberately made to contain naturally occurring radioactive material (NORM)-purveyors making unsubstantiated claims for health benefits from the release of negative ions. Conversely, within the bounds of the linear no-threshold model, long-term use presents a radiological risk to wearers. Evaluation is conducted herein of the radiological risk arising from wearing these products and gamma-ray spectrometry is used to determine the radioactivity levels and annual effective dose of 15 commercially available bracelets (samples B1 to B15) and five necklaces (samples N16 to N20). Various use scenarios are considered; a Geant4 Monte Carlo (Geant4 MC) simulation is also performed to validate the experimental results. The dose conversion coefficient for external radiation and skin equivalent doses were also evaluated. Among the necklaces, sample N16 showed the greatest levels of radioactivity, at 246 ± 35, 1682 ± 118, and 221 ± 40 Bq, for 238U, 232Th, and 40K, respectively. For the bracelets, for 238U and 232Th, sample B15 displayed the greatest level of radioactivity, at 146 ± 21 and 980 ± 71 Bq, respectively. N16 offered the greatest percentage concentrations of U and Th, with means of 0.073 ± 0.0002% and 1.51 ± 0.0015%, respectively, giving rise to an estimated annual effective dose exposure of 1.22 mSv, substantially in excess of the ICRP recommended limit of 1 mSv/year.
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