

Ep. 553 Dosimetry University Part II: Understanding Partition and Voxel-Based Approaches with Dr. Tyler Sandow and Dr. Nima Kokabi
10 snips Jun 24, 2025
Join interventional oncologists Dr. Tyler Sandow and Dr. Nima Kokabi as they dive deep into the intricacies of Y90 procedures. They tackle lung shunt fraction calculations, comparing SPECT CT with planar imaging for optimal dosing. Their discussion covers the nuances of various dosimetry models like BSA and voxel-based approaches. The duo also addresses high lung shunt management and the integration of advanced therapies such as TACE and SBRT, rounding it off with a compelling case study on individualized dosimetry planning for liver tumors.
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Calculate Lung Shunt Accurately
- Calculate lung shunt fractions using both planar and SPECT CT imaging for accuracy.
- Use specialized software like MIM that automates lung and liver counts for precision.
DOSIMETRY: From BSA to Voxel-Based
- BSA dosing method is outdated and should be discarded due to inaccuracies.
- MIRD, partition, and voxel-based dosimetry offer increasing complexity and precision for Y90 treatment planning.
Manage Lung Radiation Dose Safely
- Keep lung radiation dose below 25-30 Gy per session and lifetime dose under 50 Gy.
- Track cumulative lung dose carefully for patients needing repeated treatments.