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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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Dosimetry University Part II: Understanding Partition & Voxel-Based Approaches with Dr. Tyler Sandow and Dr. Nima Kokabi on the BackTable VI Podcast
Ep 553 Dosimetry University Part II: Understanding Partition & Voxel-Based Approaches with Dr. Tyler Sandow and Dr. Nima Kokabi
00:00 / 01:04

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. Nima Kokabi on the BackTable VI Podcast

Dr. Nima Kokabi is an interventional radiologist at Alberta Health in Chapel Hill, North Carolina.

Dr. Venkatesh Krishnasamy on the BackTable VI Podcast

Dr. Venkatesh Krishnasamy is an interventional radiologist at University of Alabama at Birmingham.

Dr. Tyler Sandow on the BackTable VI Podcast

Dr. Tyler Sandow is a diagnostic and interventional radiologist at Ochsner Health in Jefferson, Louisiana.

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

The Materials available on BackTable 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.

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Articles

Topics

Hepatocellular Carcinoma (HCC) Condition Overview
Metastatic Colorectal Cancer (mCRC) Condition Overview
Microwave Ablation Procedure Prep
Stereotactic Body Radiation Therapy (SBRT) Procedure Prep
TACE Procedure Steps & Treatment
Y90 Radioembolization Procedure Prep

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