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Khvostunov IK, Nasonova E, Krylov V, Rodichev A, Kochetova T, Shepel N, Korovchuk O, Kutsalo P, Shegai P, Kaprin A. Cytogenetic Damage Induced by Radioiodine Therapy: A Follow-Up Case Study. Int J Mol Sci 2023; 24:ijms24065128. [PMID: 36982202 PMCID: PMC10049272 DOI: 10.3390/ijms24065128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
The risk of toxicity attributable to radioiodine therapy (RIT) remains a subject of ongoing research, with a whole-body dose of 2 Gy proposed as a safe limit. This article evaluates the RIT-induced cytogenetic damage in two rare differentiated thyroid cancer (DTC) cases, including the first follow-up study of a pediatric DTC patient. Chromosome damage in the patient's peripheral blood lymphocytes (PBL) was examined using conventional metaphase assay, painting of chromosomes 2, 4, and 12 (FISH), and multiplex fluorescence in situ hybridization (mFISH). Patient 1 (female, 1.6 y.o.) received four RIT courses over 1.1 years. Patient 2 (female, 49 y.o.) received 12 courses over 6.4 years, the last two of which were examined. Blood samples were collected before and 3-4 days after the treatment. Chromosome aberrations (CA) analyzed by conventional and FISH methods were converted to a whole-body dose accounting for the dose rate effect. The mFISH method showed an increase in total aberrant cell frequency following each RIT course, while cells carrying unstable aberrations predominated in the yield. The proportion of cells containing stable CA associated with long-term cytogenetic risk remained mostly unchanged during follow-up for both patients. A one-time administration of RIT was safe, as the threshold of 2 Gy for the whole-body dose was not exceeded. The risk of side effects projected from RIT-attributable cytogenetic damage was low, suggesting a good long-term prognosis. In rare cases, such as the ones reviewed in this study, individual planning based on cytogenetic biodosimetry is strongly recommended.
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Affiliation(s)
- Igor K Khvostunov
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Elena Nasonova
- Joint Institute for Nuclear Research (JINR), 6 Joliot-Curie St., 141980 Dubna, Russia
| | - Valeriy Krylov
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Andrei Rodichev
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Tatiana Kochetova
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Natalia Shepel
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Olga Korovchuk
- A.F. Tsyb Medical Radiological Research Center (MRRC)-Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroliova St., 249036 Obninsk, Russia
| | - Polina Kutsalo
- Joint Institute for Nuclear Research (JINR), 6 Joliot-Curie St., 141980 Dubna, Russia
| | - Petr Shegai
- Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 2 Botkinskiy Proezd, 125284 Moscow, Russia
| | - Andrei Kaprin
- Federal State Budgetary Institution, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 2 Botkinskiy Proezd, 125284 Moscow, Russia
- Federal State Autonomous Educational Institution of Higher Professional Education, Department of Oncology and Radiology Named after N.P. Kharchenko, Medical Institute, Peoples' Friendship University of Russia, 117198 Moscow, Russia
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González García F, Peinado Montes M. Dosimetry in therapeutic nuclear medicine: can we do it better? Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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González García F, Peinado Montes M. Dosimetría en medicina nuclear terapéutica: ¿Podemos hacerlo mejor? Rev Esp Med Nucl Imagen Mol 2020; 39:269-272. [DOI: 10.1016/j.remn.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022]
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Torres Berdeguez MB, Thomas S, Oliveira SM, Vasconcellos de Sá L, Lopes de Souza SA, Milián FM, Xavier da Silva A. Individual dose planning in radiosynoviorthesis treatment: Step by step. Appl Radiat Isot 2020; 163:109177. [PMID: 32392162 DOI: 10.1016/j.apradiso.2020.109177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/24/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022]
Abstract
Radiosynoviorthesis (RSO) is a minimally invasive treatment aiming for the necrosis of the pannus tissue by the use of radionuclide. The method suggested here starts with the segmentation of the joint effusion, synovial thickness, and area of the synovial membrane using the 3D Slicer software. The last step is the estimated value of the activity to be injected without considering the leakage of the radiopharmaceutical into the articular cavity. It includes the S-values obtained by Monte Carlo simulation coupled with the calculated therapeutic distance (ST90).
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Affiliation(s)
| | - Sylvia Thomas
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Susie Medeiros Oliveira
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lidia Vasconcellos de Sá
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Rio de Janeiro, RJ, Brazil
| | - Sergio Augusto Lopes de Souza
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Felix Mas Milián
- Research Center for Radiation Sciences and Technology, State University of Santa Cruz, Ilhéus, BA, Brazil
| | - Ademir Xavier da Silva
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Gupta A, Lee MS, Kim JH, Lee DS, Lee JS. Preclinical Voxel-Based Dosimetry in Theranostics: a Review. Nucl Med Mol Imaging 2020; 54:86-97. [PMID: 32377260 DOI: 10.1007/s13139-020-00640-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/22/2022] Open
Abstract
Due to the increasing use of preclinical targeted radionuclide therapy (TRT) studies for the development of novel theranostic agents, several studies have been performed to accurately estimate absorbed doses to mice at the voxel level using reference mouse phantoms and Monte Carlo (MC) simulations. Accurate dosimetry is important in preclinical theranostics to interpret radiobiological dose-response relationships and to translate results for clinical use. Direct MC (DMC) simulation is believed to produce more realistic voxel-level dose distribution with high precision because tissue heterogeneities and nonuniform source distributions in patients or animals are considered. Although MC simulation is considered to be an accurate method for voxel-based absorbed dose calculations, it is time-consuming, computationally demanding, and often impractical in daily practice. In this review, we focus on the current status of voxel-based dosimetry methods applied in preclinical theranostics and discuss the need for accurate and fast voxel-based dosimetry methods for pretherapy absorbed dose calculations to optimize the dose computation time in preclinical TRT.
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Affiliation(s)
- Arun Gupta
- 1Department of Radiology & Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Min Sun Lee
- 2Department of Radiology, School of Medicine, Stanford University, Stanford, CA USA
| | - Joong Hyun Kim
- 3Center for Ionizing Radiation, Korea Research Institute of Standards and Science, Daejeon, South Korea
| | - Dong Soo Lee
- 4Department of Nuclear Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
| | - Jae Sung Lee
- 4Department of Nuclear Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080 South Korea.,5Interdisciplinary Program in Radiation Applied Life Science, Seoul National University, Seoul, South Korea.,6Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, South Korea
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Radioiodine Therapy for Benign Thyroid Disease. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Gosewisch A, Delker A, Tattenberg S, Ilhan H, Todica A, Brosch J, Vomacka L, Brunegraf A, Gildehaus FJ, Ziegler S, Bartenstein P, Böning G. Patient-specific image-based bone marrow dosimetry in Lu-177-[DOTA 0,Tyr 3]-Octreotate and Lu-177-DKFZ-PSMA-617 therapy: investigation of a new hybrid image approach. EJNMMI Res 2018; 8:76. [PMID: 30076556 PMCID: PMC6081875 DOI: 10.1186/s13550-018-0427-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/16/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The bone marrow (BM) is a main organ at risk in Lu-177-PSMA-617 therapy of prostate cancer and Lu-177-Octreotate therapy of neuroendocrine tumours. BM dosimetry is challenging and time-consuming, as different sequential quantitative measurements must be combined. The BM absorbed dose from the remainder of the body (ROB) can be determined from sequential whole-body planar (WB-P) imaging, while quantitative Lu-177-SPECT allows for more robust tumour and organ absorbed doses. The aim was to investigate a time-efficient and patient-friendly hybrid protocol (HP) for the ROB absorbed dose to the BM. It combines three abdominal quantitative SPECT (QSPECT) scans with a single WB-P acquisition and was compared with a reference protocol (RP) using sequential WB-P in combination with sequential QSPECT images. We investigated five patients receiving 7.4 GBq Lu-177-Octreotate and five patients treated with 3.7 GBq Lu-177-PSMA-617. Each patient had WB-P and abdominal SPECT acquisitions 24 (+ CT), 48, and 72 h post-injection. Blood samples were drawn 30 min, 80 min, 24 h, 48 h, and 72 h post-injection. BM absorbed doses from the ROB were estimated from sequential WB-P images (RP), via a mono-exponential fit and mass-scaled organ-level S values. For the HP, a mono-exponential fit on the QSPECT data was scaled with the activity of one WB-P image acquired either 24, 48, or 72 h post-injection (HP24, HP48, HP72). Total BM absorbed doses were determined as a sum of ROB, blood, major organ, and tumour contributions. RESULTS Compared with the RP and for Lu-177-Octreotate therapy, median differences of the total BM absorbed doses were 13% (9-17%), 8% (4-15%), and 1% (0-5%) for the HP24, HP48, and HP72, respectively. For Lu-177-PSMA-617 therapy, total BM absorbed doses deviated 10% (2-20%), 3% (0-6%), and 2% (0-6%). CONCLUSION For both Lu-177-Octreotate and Lu-177-PSMA-617 therapy, BM dosimetry via sequential QSPECT imaging and a single WB-P acquisition is feasible, if this WB-P image is acquired at a late time point (48 or 72 h post-injection). The reliability of the HP can be well accepted considering the uncertainties of quantitative Lu-177 imaging and BM dosimetry using standardised organ-level S values.
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Affiliation(s)
- Astrid Gosewisch
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Andreas Delker
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Sebastian Tattenberg
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Julia Brosch
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Lena Vomacka
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Anika Brunegraf
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Franz Josef Gildehaus
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - Guido Böning
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
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Wendisch M, Freudenberg R, Runge R, Oehme L, Meyer G, Kunz-Schughart LA, Wunderlich G, Kotzerke J. Sodium-iodide symporter positive cells after intracellular uptake of 99mTc versus α-emitter 211At. Nuklearmedizin 2018; 51:170-8. [DOI: 10.3413/nukmed-0506-12-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 08/30/2012] [Indexed: 11/20/2022]
Abstract
SummaryPurpose: We evaluated the DNA damaging potential of Auger electrons emitted in the decay of 99mTc compared to α-particles of 211At. Material and methods: The impact of 99mTc and 211At was monitored in a NIS-expressing rat thyroid cell model PC Cl3 with varying, yet defined intra- and extracellular radionuclide distribution (using ± perchlorate). The radiotoxicity of 99mTc and 211At was studied by the comet assay under neutral and alkaline conditions and colony formation. Results: In the presence of perchlorate, the radioactivity yielding 37 % cellular survival, A37, was estimated to be (0.27 ± 0.02) MBq/ml and (450 ± 30) MBq/ml for 211At and 99mTc, respectively. In absence of perchlorate, cellular radiotracer uptake was similar for both radionuclides (2.2 %, 2.7 %), yet the A37 was reduced by 82% for the α-emitter and by 95 % for 99mTc. Cellular dose increased by a factor of 5 (211At) and 38 (99mTc). Comet assays revealed an increased DNA damage after intracellular uptake of both radiotracers. Conclusions: The data indicate damage to the cell to occur from absorbed dose without recognizable contribution from intracellular heterogeneity of radionuclide distribution. Comet assay under alkaline and neutral conditions did not reveal any shift to more complex DNA damage after radionuclide uptake. Cellular uptake of 99mTc and 211At increased cellular dose and reduced clonogenic survival.
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Detection and quantification of 223 Ra uptake in bone metastases of patients with castration-resistant prostate carcinoma, with the aim of determining the absorbed dose in the metastases. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Li T, Ao ECI, Lambert B, Brans B, Vandenberghe S, Mok GSP. Quantitative Imaging for Targeted Radionuclide Therapy Dosimetry - Technical Review. Theranostics 2017; 7:4551-4565. [PMID: 29158844 PMCID: PMC5695148 DOI: 10.7150/thno.19782] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/25/2017] [Indexed: 01/06/2023] Open
Abstract
Targeted radionuclide therapy (TRT) is a promising technique for cancer therapy. However, in order to deliver the required dose to the tumor, minimize potential toxicity in normal organs, as well as monitor therapeutic effects, it is important to assess the individualized internal dosimetry based on patient-specific data. Advanced imaging techniques, especially radionuclide imaging, can be used to determine the spatial distribution of administered tracers for calculating the organ-absorbed dose. While planar scintigraphy is still the mainstream imaging method, SPECT, PET and bremsstrahlung imaging have promising properties to improve accuracy in quantification. This article reviews the basic principles of TRT and discusses the latest development in radionuclide imaging techniques for different theranostic agents, with emphasis on their potential to improve personalized TRT dosimetry.
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Affiliation(s)
- Tiantian Li
- Biomedical Imaging Laboratory, Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau SAR, China
| | - Edwin C. I. Ao
- Biomedical Imaging Laboratory, Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau SAR, China
| | - Bieke Lambert
- Dept of Radiology and Nuclear medicine, Ghent University, De Pintelaan 185 9000 Gent, Belgium
- AZ Maria Middelares, Buiten-Ring-Sint-Denijs 30, 9000 Gent, Belgium
| | - Boudewijn Brans
- Dept of Nuclear Medicine, UZ Ghent-Ghent University, St-Pietersnieuwstraat 41, 9000 Gent, Belgium
| | - Stefaan Vandenberghe
- MEDISIP-ELIS-IBITECH-IMEC, Ghent University, St-Pietersnieuwstraat 41, 9000 Gent, Belgium
| | - Greta S. P. Mok
- Biomedical Imaging Laboratory, Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau SAR, China
- Faculty of Health Sciences, University of Macau, Macau SAR, China
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Khvostunov IK, Saenko VA, Krylov V, Rodichev A, Yamashita S. Cytogenetic biodosimetry and dose-rate effect after radioiodine therapy for thyroid cancer. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2017; 56:213-226. [PMID: 28526978 DOI: 10.1007/s00411-017-0696-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 05/11/2017] [Indexed: 06/07/2023]
Abstract
This study set out to investigate chromosomal damage in peripheral blood lymphocytes of thyroid cancer patients receiving 131I for thyroid remnant ablation or treatment of metastatic disease. The observed chromosomal damage was further converted to the estimates of whole-body dose to project the adverse side effects. Chromosomal aberration analysis was performed in 24 patients treated for the first time or after multiple courses. Blood samples were collected before treatment and 3 or 4 days after administration of 2-4 GBq of 131I. Both conventional cytogenetic and chromosome 2, 4 and 12 painting assays were used. To account for dose-rate effect, a dose-protraction factor was applied to calculate the whole-body dose. The mean dose was 0.62 Gy (95% CI: 0.44-0.77 Gy) in the subgroup of patients treated one time and 0.67 Gy (95% CI: 0.03-1.00 Gy) in re-treated patients. These dose estimates are about 1.7-fold higher than those disregarding the effect of exposure duration. In re-treated patients, the neglected dose-rate effect can result in underestimation of the cumulative whole-body dose by the factor ranging from 2.6 to 6.8. Elevated frequency of chromosomal aberrations observed in re-treated patients before radioiodine therapy allows estimation of a cumulative dose received from all previous treatments.
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Affiliation(s)
- Igor K Khvostunov
- A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Russian Ministry of Health Care, Koroliova str. 4, Obninsk, Kaluga Region, Russia, 249036.
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Japan.
| | - Vladimir A Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Japan
| | - Valeri Krylov
- A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Russian Ministry of Health Care, Koroliova str. 4, Obninsk, Kaluga Region, Russia, 249036
| | - Andrei Rodichev
- A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Russian Ministry of Health Care, Koroliova str. 4, Obninsk, Kaluga Region, Russia, 249036
| | - Shunichi Yamashita
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Japan
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Detection and quantification of 223Ra uptake in bone metastases of patients with castration resistant prostate carcinoma, with the aim of determining the absorbed dose in the metastases. Rev Esp Med Nucl Imagen Mol 2017. [PMID: 28645684 DOI: 10.1016/j.remn.2017.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSES To obtain the necessary acquisition and calibration parameters in order to evaluate the possibility of detecting and quantifying 223Ra uptake in bone metastases of patients treated for castration resistant prostate carcinoma. Furthermore, in the cases in which the activity can be quantified, to determine the absorbed dose. MATERIAL AND METHODS Acquisitions from a Petri dish filled with 223Ra were performed in the gamma camera. Monte Carlo simulations were also performed to study the partial volume effect. Formulae to obtain the detection and quantification limits of 223Ra uptake were applied to planar images of two patients 7 days post-administration of 55kBq/kg of 223Ra. In order to locate the lesions in advance, whole-body scans and SPECT/CT images were acquired after injecting 99mTc-HDP. RESULTS The optimal energy window was found to be at 82keV with a medium-energy collimator MEGP. Of the lesions found in the patients, only those that had been detected in both the AP and PA projections could be quantified. These lesions were those which had shown a higher 99mTc-HDP uptake. The estimated values of absorbed doses ranged between 0.7Gy and 7.8Gy. CONCLUSIONS Of the lesions that can be detected, it is not possible to quantify the activity uptake in some of them, which means that the absorbed dose cannot be determined either. This does not mean that the absorbed dose in these lesions can be regarded as negligible.
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Torres Berdeguez MB, Thomas S, Rafful P, Arruda Sanchez T, Medeiros Oliveira Ramos S, Souza Albernaz M, Vasconcellos de Sá L, Lopes de Souza SA, Mas Milian F, Silva AXD. A new approach for radiosynoviorthesis: A dose-optimized planning method based on Monte Carlo simulation and synovial measurement using 3D slicer and MRI. Med Phys 2017; 44:3821-3829. [PMID: 28419533 DOI: 10.1002/mp.12276] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/23/2017] [Accepted: 04/03/2017] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Recently, there has been a growing interest in a methodology for dose planning in radiosynoviorthesis to substitute fixed activity. Clinical practice based on fixed activity frequently does not embrace radiopharmaceutical dose optimization in patients. The aim of this paper is to propose and discuss a dose planning methodology considering the radiological findings of interest obtained by three-dimensional magnetic resonance imaging combined with Monte Carlo simulation in radiosynoviorthesis treatment applied to hemophilic arthropathy. METHOD The parameters analyzed were: surface area of the synovial membrane (synovial size), synovial thickness and joint effusion obtained by 3D MRI of nine knees from nine patients on a SIEMENS AVANTO 1.5 T scanner using a knee coil. The 3D Slicer software performed both the semiautomatic segmentation and quantitation of these radiological findings. A Lucite phantom 3D MRI validated the quantitation methodology. The study used Monte Carlo N-Particle eXtended code version 2.6 for calculating the S-values required to set up the injected activity to deliver a 100 Gy absorbed dose at a determined synovial thickness. The radionuclides assessed were: 90Y, 32P, 188Re, 186Re, 153Sm, and 177Lu, and the present study shows their effective treatment ranges. RESULT The quantitation methodology was successfully tested, with an error below 5% for different materials. S-values calculated could provide data on the activity to be injected into the joint, considering no extra-articular leakage from joint cavity. Calculation of effective treatment range could assist with the therapeutic decision, with an optimized protocol for dose prescription in RSO. CONCLUSION Using 3D Slicer software, this study focused on segmentation and quantitation of radiological features such as joint effusion, synovial size, and thickness, all obtained by 3D MRI in patients' knees with hemophilic arthropathy. The combination of synovial size and thickness with the parameters obtained by Monte Carlo simulation such as effective treatment range and S-value, from which is calculated the injected activity, could be used for treatment planning in RSO. Data from this methodology could be a potential aid to clinical decision making by selecting the most suitable radionuclide; justifying the procedure, fractioning the dose, and the calculated injected activity for children and adolescents, considering both the synovial size and thickness.
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Affiliation(s)
- Mirta Bárbara Torres Berdeguez
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Horácio Macedo Ave., 2030 Block G-Room 206, Technology Center,, University City, Fundão Island, 21941-914,, Rio de Janeiro, RJ, Brazil
| | - Sylvia Thomas
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Patricia Rafful
- Department of Radiology, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Tiago Arruda Sanchez
- Department of Radiology, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Susie Medeiros Oliveira Ramos
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Marta Souza Albernaz
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Lidia Vasconcellos de Sá
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Salvador Allende Ave., s/n, Recreio dos Bandeirantes,, 22783-127,, Rio de Janeiro, RJ, Brazil
| | - Sergio Augusto Lopes de Souza
- Department of Nuclear Medicine, Clementino Fraga Filho University Hospital of Federal University of Rio de Janeiro, Street Rodolpho Paulo Rocco, 255, University City, Fundão Island, 21941-913,, Rio de Janeiro, RJ, Brazil
| | - Felix Mas Milian
- CPqCTR - Research Center for Radiation Sciences and Technology, State University of Santa Cruz, Rodovia Ilhéus-Itabuna, Km 16, Salobrinho, 45662000, Ilhéus, BA, Brazil
| | - Ademir Xavier da Silva
- Department of Nuclear Engineering, Federal University of Rio de Janeiro, Horácio Macedo Ave., 2030 Block G-Room 206, Technology Center,, University City, Fundão Island, 21941-914,, Rio de Janeiro, RJ, Brazil
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Gould SM, Soultanidis GM, Marsden PK, Livieratos L. PVA cryogel test objects for image-based quantification and functional volume segmentation in nuclear medicine. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/6/067001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Šefl M, Kyriakou I, Emfietzoglou D. Technical Note: Impact of cell repopulation and radionuclide uptake phase on cell survival. Med Phys 2016; 43:2715-2720. [DOI: 10.1118/1.4948504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Pirdamooie S, Shanei A, Moslehi M. Comparison of the Absorbed Dose for (99m)Tc-Diethylenetriaminepentaacetic Acid and (99m)Tc-Ethylenedicysteine Radiopharmaceuticals using Medical Internal Radiation Dosimetry. JOURNAL OF MEDICAL SIGNALS & SENSORS 2015; 5:171-5. [PMID: 26284173 PMCID: PMC4528355 DOI: 10.4103/2228-7477.161489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/21/2015] [Indexed: 12/03/2022]
Abstract
The aim of this study was the investigation of absorbed dose to the kidneys, spleen, and liver during technetium-99 m ethylene dicysteine and technetium-99 m diethylenetriaminepentaacetic acid (99mTc-EC and 99mTc-DTPA) kidney scan. Patients who had been prepared for the kidney scan, were divided into two groups (Groups 1 and 2). The first group (Group 1) and the second group (Group 2) received intravenous injection of 99mTc-EC and 99mTc-DTP, respectively. A certain amount of radiopharmaceuticals was injected into each patient and was immediately imaged with dual-head gamma camera to calculate the activity through the conjugated view method. Then, the doses of kidney, liver, and spleen were measured using medical internal radiation dosimetry method. Finally, absorbed dose of these organs was compared. Based on these different results (P < 0.05), organs absorbed dose was significantly less with radiopharmaceutical 99mTc-EC as compared with 99mTc-DTPA.
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Affiliation(s)
- Shokufeh Pirdamooie
- Department of Physic and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Shanei
- Department of Physic and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Moslehi
- Department of Physic and Medical Engineering, Isfahan University of Medical Sciences, Isfahan, Iran
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Mínguez P, Genolla J, Celeiro JJ, Fombellida JC. Dosimetry in differentiated thyroid carcinoma. Med Phys 2012; 40:012502. [DOI: 10.1118/1.4769426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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18
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Freudenberg R, Wendisch M, Kotzerke J. Geant4-Simulations for cellular dosimetry in nuclear medicine. Z Med Phys 2011; 21:281-9. [DOI: 10.1016/j.zemedi.2011.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 08/29/2011] [Accepted: 08/29/2011] [Indexed: 10/16/2022]
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Wierts R, de Pont CD, Brans B, Mottaghy FM, Kemerink GJ. Dosimetry in molecular nuclear therapy. Methods 2011; 55:196-202. [DOI: 10.1016/j.ymeth.2011.09.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/11/2011] [Accepted: 09/13/2011] [Indexed: 01/06/2023] Open
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20
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Lopci E, Chiti A, Castellani MR, Pepe G, Antunovic L, Fanti S, Bombardieri E. Matched pairs dosimetry: 124I/131I metaiodobenzylguanidine and 124I/131I and 86Y/90Y antibodies. Eur J Nucl Med Mol Imaging 2011; 38 Suppl 1:S28-40. [PMID: 21484381 DOI: 10.1007/s00259-011-1772-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 02/22/2011] [Indexed: 11/30/2022]
Abstract
The technological advances in imaging and production of radiopharmaceuticals are driving an innovative way of evaluating the targets for antineoplastic therapies. Besides the use of imaging to better delineate the volume of external beam radiation therapy in oncology, modern imaging techniques are able to identify targets for highly specific medical therapies, using chemotherapeutic drugs and antiangiogenesis molecules. Moreover, radionuclide imaging is able to select targets for radionuclide therapy and to give the way to in vivo dose calculation to target tissues and to critical organs. This contribution reports the main studies published on matched pairs dosimetry with (124)I/(131)I- and (86)Y/(90)Y-labelled radiopharmaceuticals, with an emphasis on metaiodobenzylguanidine (MIBG) and monoclonal antibodies.
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Affiliation(s)
- Egesta Lopci
- Policlinico S.Orsola-Malpighi and University of Bologna, Bologna, Italy
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Experimental facts supporting a red marrow uptake due to radiometal transchelation in 90Y-DOTATOC therapy and relationship to the decrease of platelet counts. Eur J Nucl Med Mol Imaging 2011; 38:1270-80. [PMID: 21318451 DOI: 10.1007/s00259-011-1744-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 01/05/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to retrospectively evaluate whether the red marrow (RM) takes up (111)In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe(1)-octreotide and (86)Y-DOTATOC and to assess the correlation between the RM absorbed doses and platelet count reduction as a biological dose estimate. METHODS Data from 12 patients who underwent at 24 h p.i. high statistics (111)In single photon emission computed tomography (SPECT) and (86)Y positron emission tomography (PET) acquisitions of the chest were analysed. Uptake was measured on >7 cm spine length and converted to total RM uptake using standard RM distribution in man. RM absorbed doses were calculated assuming specific RM uptake and using the plasma and remainder of the body models. RM doses were correlated with the platelet count reduction at 4 weeks. In vitro experiments explored the metabolism of (111)In-DTPA-D-Phe(1)-octreotide and (90)Y-DOTATOC in plasma. RESULTS The correlation between the uptake of both tracers was excellent (R = 0.80), indicating that RM uptake of (86)Y-DOTATOC reflects a real physiological process and not reconstruction artefacts. The kinetics of (86)Y-DOTATOC RM activity was different than that in blood and tumours, with no activity at 4 h p.i. indicating that the uptake is not somatostatin receptor dependent. In vitro experiments showed a transchelation of both radiometals to free transferrin that could explain the RM uptake. In patients without chemotherapy and with a normal platelet count recovery, a good correlation (R = 0.96) was found between the RM doses and the platelet count reduction at the nadir. CONCLUSION These experimental facts support the existence of a true RM uptake likely related to transchelation of the radiometal to transferrin. RM uptake correlates well with the observed acute RM toxicity.
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Kletting P, Kiryakos H, Reske SN, Glatting G. Analysing saturable antibody binding based on serum data and pharmacokinetic modelling. Phys Med Biol 2010; 56:73-86. [DOI: 10.1088/0031-9155/56/1/005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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23
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Walrand S, Jamar F, van Elmbt L, Lhommel R, Bekonde EB, Pauwels S. 4-Step Renal Dosimetry Dependent on Cortex Geometry Applied to 90Y Peptide Receptor Radiotherapy: Evaluation Using a Fillable Kidney Phantom Imaged by 90Y PET. J Nucl Med 2010; 51:1969-73. [DOI: 10.2967/jnumed.110.080093] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Stokkel MPM, Handkiewicz Junak D, Lassmann M, Dietlein M, Luster M. EANM procedure guidelines for therapy of benign thyroid disease. Eur J Nucl Med Mol Imaging 2010; 37:2218-28. [DOI: 10.1007/s00259-010-1536-8] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 06/17/2010] [Indexed: 01/18/2023]
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25
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Domènech Torné FM. [Current techniques and procedures in nuclear medicine]. Med Clin (Barc) 2010; 134:589-90. [PMID: 19819492 DOI: 10.1016/j.medcli.2009.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 07/01/2009] [Indexed: 10/20/2022]
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26
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Lhommel R, van Elmbt L, Goffette P, Van den Eynde M, Jamar F, Pauwels S, Walrand S. Feasibility of 90Y TOF PET-based dosimetry in liver metastasis therapy using SIR-Spheres. Eur J Nucl Med Mol Imaging 2010; 37:1654-62. [DOI: 10.1007/s00259-010-1470-9] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 04/06/2010] [Indexed: 12/27/2022]
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Sudbrock F, Schmidt M, Simon T, Eschner W, Berthold F, Schicha H. Dosimetry for 131I-MIBG therapies in metastatic neuroblastoma, phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging 2010; 37:1279-90. [PMID: 20179922 DOI: 10.1007/s00259-010-1391-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 01/13/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE Radiation dosimetry is a basic requirement for targeted radionuclide therapies (TRT) which have become of increasing interest in nuclear medicine. Despite the significant role of the radiopharmaceutical (131)I-metaiodobenzylguanidine (MIBG) for the treatment of metastatic neuroblastoma, phaeochromocytoma and paraganglioma details for a reliable dosimetry are still sparse. This work presents our procedures, the dosimetric data and experiences with TRT using (131)I-MIBG. METHODS A total of 21 patients were treated with (131)I-MIBG between 2004 and 2008 according to a clearly defined protocol. Whole-body absorbed doses were determined by a series of scintillation probe readings for all 21 cases. Tumour absorbed doses were calculated on the basis of quantitative imaging for an entity of 25 lesions investigated individually using the region of interest (ROI) technique based on five scans each. RESULTS Typical whole-body absorbed doses are found in the region of 2 Gy (range: 1.0-2.9 Gy) whereas tumour absorbed doses in turn cover a span between 10 and 60 Gy. Nonetheless this variation of tumour absorbed doses is comparatively low. CONCLUSION The trial protocol in use is a substantial advancement in terms of reliable dosimetry. A clearly defined modus operandi for MIBG therapies should involve precisely described dosimetric procedures, e.g. a minimum of 20 whole-body measurements using a calibrated counter and at least four gamma camera scans over the whole period of the inpatient stay should be carried out. Calculation of tumour volumes is accomplished best via evaluation of SPECT and CT images.
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Affiliation(s)
- Ferdinand Sudbrock
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany.
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Vicini P, Brill AB, Stabin MG, Rescigno A. Kinetic modeling in support of radionuclide dose assessment. Semin Nucl Med 2008; 38:335-46. [PMID: 18662555 DOI: 10.1053/j.semnuclmed.2008.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this review, we trace the origins of mathematical modeling methods and pay particular attention to radiotracer applications. Nuclear medicine has been advanced greatly by the efforts of the Society of Nuclear Medicine's Medical Internal Radiation Dose Committee. Well-developed mathematical methods and tools have been created in support of a wide range of applications. Applications of mathematical modeling extend well beyond biology and medicine and are essential to analysis is a wide range of fields that rely on numerical predictions, eg, weather, economic, and various gaming applications. We start with the discovery of radioactivity and radioactive transformations and illustrate selected applications in biology, physiology, and pharmacology. We discuss compartment models as tools used to frame the context of specific problems. A definition of terms, methods, and examples of particular problems follows. We present models of different applications with varying complexity depending on the features of the particular system and function being analyzed. Commonly used analysis tools and methods are described, followed by established models which describe dosimetry along gastrointestinal and urinary excretory pathways, ending finally with a brief discussion of bone marrow dose. We conclude pointing to more recent, promising methods, not yet widely used in dosimetry applications, which aim at coupling pharmacokinetic data with other patient data to correlate patient outcome (benefits and risk) with the type, amount, kind and timing of the therapy the patient received.
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Affiliation(s)
- Paolo Vicini
- Resource Facility for Population Kinetics, Department of Bioengineering, University of Washington, Seattle, WA 98195-4290, USA.
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