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Introduction: Use of SPECT/CT data is the most accurate method for patient-specific internal dosimetry when isotopes emit single gamma rays. The manual or semi-automatic segmentation of organs is a major obstacle that slows down and limits the patient-specific dosimetry. Using digital phantoms that mimic patient's anatomy can bypass the segmentation step and facilitate the dosimetry process. In this study, the results of a patient-specific dosimetry based on CT data and XCAT phantom, a flexible phantom with predefined organs, are compared. Methods: The dosimetry results (S-value and SAF) were calculated for a patient with breast cancer who received Samarium-153 ethylenediamine-N,N,N',N'-tetrakis(methylenephosphonic acid (153Sm-EDTMP). Biodistribution of activity was obtained from the SPECT scan. The anatomical data and attenuation map were extracted from CT as well as the XCAT phantom with different BMIs. GATE Monte-Carlo simulator was used to calculate the dose to different organs based on the activity distribution and segmented anatomy. Results: The whole body dosimetry results are the same for both calculations based on the CT and XCAT with different BMIs; however for target organs, the differences between SAFs and S-values are high. In the spine, the clinically important target organ for Samarium therapy, the dosimetry results obtained from phantoms with unmatched BMIs between XCAT phantom and CT are substantially different. Conclusion: We showed that atlas-based dosimetry using XCAT phantom even with matched BMI may lead to considerable errors as compared to calculations based on patient's own CT. For accurate dosimetry results, calculations should be done using CT data. [ABSTRACT FROM AUTHOR]

Single-photon emission computed tomography (SPECT)-based tracers are easily available and more widely used than positron emission tomography (PET)-based tracers, and SPECT imaging still remains the most prevalent nuclear medicine imaging modality worldwide. The aim of this study is to implement an image-based Monte Carlo method for patient-specific three-dimensional (3D) absorbed dose calculation in patients after injection of 99mTc-hydrazinonicotinamide (hynic)-Tyr3-octreotide as a SPECT radiotracer. 99mTc patient-speci?c S values and the absorbed doses were calculated with GATE code for each source-target organ pair in four patients who were imaged for suspected neuroendocrine tumors. Each patient underwent multiple whole-body planar scans as well as SPECT imaging over a period of 1-24 h after intravenous injection of 99mhynic-Tyr3-octreotide. The patient-specific S values calculated by GATE Monte Carlo code and the corresponding S values obtained by MIRDOSE program differed within 4.3% on an average for self-irradiation, and differed within 69.6% on an average for cross-irradiation. However, the agreement between total organ doses calculated by GATE code and MIRDOSE program for all patients was reasonably well (percentage difference was about 4.6% on an average). Normal and tumor absorbed doses calculated with GATE were slightly higher than those calculated with MIRDOSE program. The average ratio of GATE absorbed doses to MIRDOSE was 1.07 ± 0.11 (ranging from 0.94 to 1.36). According to the results, it is proposed that when cross-organ irradiation is dominant, a comprehensive approach such as GATE Monte Carlo dosimetry be used since it provides more reliable dosimetric results. [ABSTRACT FROM AUTHOR]