BackTable / VI / Podcast / Episode #553
Dosimetry University Part II: Understanding Partition & Voxel-Based Approaches
with Dr. Tyler Sandow and Dr. Nima Kokabi
BSA, MIRD, or voxel-based dosimetry? Join us for part 2 of Dosimetry University where interventional oncologists Dr. Tyler Sandow, Dr. Nima Kokabi, and Dr. Kavi Krishnasamy explore and debate the critical nuances of a successful Y90 procedure, covering dosing methods, lung shunt management, and when to incorporate other therapeutic approaches.
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BackTable, LLC (Producer). (2025, June 24). Ep. 553 – Dosimetry University Part II: Understanding Partition & Voxel-Based Approaches [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Tyler Sandow
Dr. Tyler Sandow is a diagnostic and interventional radiologist at Ochsner Health in Jefferson, Louisiana.
Dr. Nima Kokabi
Dr. Nima Kokabi is an interventional radiologist at Alberta Health in Chapel Hill, North Carolina.
Dr. Venkatesh Krishnasamy
Dr. Venkatesh Krishnasamy is an interventional radiologist at University of Alabama at Birmingham.
Synopsis
The episode begins with a discussion on methodologies for calculating lung shunt fractions using planar imaging versus SPECT CT. The physicians highlight the implications of various dosimetry models, including BSA (Body Surface Area), MIRD (Medical Internal Radiation Dose), and voxel-based dosimetry for determining prescribed activity. Drawing on their clinical experience, they address the management of high lung shunt fraction cases and the application of therapeutic strategies like TACE (Transarterial Chemoembolization) and SBRT (Stereotactic Body Radiotherapy). The conversation also covers the roles of cryoablation and microwave ablation in treating centrally located lesions. The episode concludes with a case study emphasizing the importance of individualized dosimetry planning.
Timestamps
00:00 - Introduction
01:05 - Lung Shunt Calculation Methods
06:42 - BSA, MIRD, and Voxel-Based Dosimetry
16:03 - High Lung Shunt Management
30:02 - Case Study: Liver Tumor Treatment
34:10 - Cryo vs Microwave: A Safer Option?
35:42 - Y-90 Procedure: Imaging and Techniques
43:35 - Dosimetry and Dose Calculations
51:10 - Post-Treatment Analysis and Outcomes
57:51 - Transplant Considerations and Aggressive Treatments
58:18 - Conclusion and Final Thoughts
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.