Dosimetry-based treatment planning for molecular radiotherapy: A summary of the 2017 report from the Internal Dosimetry Task Force

Research output: Contribution to journalReview article

Abstract

Background: The European directive on basic safety standards (Council directive 2013/ 59 Euratom) mandates dosimetry-based treatment planning for radiopharmaceutical therapies. The directive comes into operation February 2018, and the aim of a report produced by the Internal Dosimetry Task Force of the European Association of Nuclear Medicine is to address this aspect of the directive. A summary of the report is presented. Results: A brief review of five of the most common therapy procedures is included in the current text, focused on the potential to perform patient-specific dosimetry. In the full report, 11 different therapeutic procedures are included, allowing additional considerations of effectiveness, references to specific literature on quantitative imaging and dosimetry, and existing evidence for absorbed dose-effect correlations for each treatment. Individualized treatment planning with tracer diagnostics and verification of the absorbed doses delivered following therapy is found to be scientifically feasible for almost all procedures investigated, using quantitative imaging and/or external monitoring. Translation of this directive into clinical practice will have significant implications for resource requirements. Conclusions: Molecular radiotherapy is undergoing a significant expansion, and the groundwork for dosimetry-based treatment planning is already in place. The mandated individualization is likely to improve the effectiveness of the treatments, although must be adequately resourced.

Details

Authors
  • Caroline Stokke
  • Pablo Minguez Gabiña
  • Pavel Solný
  • Francesco Cicone
  • Mattias Sandström
  • Katarina Sjögreen Gleisner
  • Carlo Chiesa
  • Emiliano Spezi
  • Maria Paphiti
  • Mark Konijnenberg
  • Matt Aldridge
  • Jill Tipping
  • Michael Wissmeyer
  • Boudewijn Brans
  • Klaus Bacher
  • Carsten Kobe
  • Glenn Flux
Organisations
External organisations
  • Oslo university hospital
  • Gurutzeta/Cruces University Hospital
  • Czech Technical University in Prague
  • Sapienza University of Rome
  • Uppsala University
  • Istituto Nazionale dei Tumori
  • Cardiff University
  • Erasmus University Medical Center
  • University College London
  • Christie NHS Foundation Trust
  • Geneva University Hospital
  • Ghent University Hospital
  • Ghent University
  • University Hospital of Cologne
  • Institute of Cancer Research London
  • Pammakaristos Hospital
  • Royal Marsden Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Radiology, Nuclear Medicine and Medical Imaging

Keywords

  • Dosimetry, Molecular radiotherapy, Treatment planning
Original languageEnglish
Article number27
JournalEJNMMI Physics
Volume4
Issue number1
Publication statusPublished - 2017 Nov 21
Publication categoryResearch
Peer-reviewedYes