1
|
Gabiña PM, Gleisner KS, Cremonesi M, Stokke C, Flux G, Cicone F, Konijnenberg M, Aldridge M, Sandstrom M, Chiesa C, Paphiti M, Hippeläinen E, Uribe C, Solny P, Gnesin S, Bernhardt P, Chouin N, Costa PF, Glatting G, Verburg F, Gear J. Results from an EANM survey on time estimates and personnel responsible for main tasks in molecular radiotherapy dosimetry. Eur J Nucl Med Mol Imaging 2023; 50:2595-2604. [PMID: 37129712 DOI: 10.1007/s00259-023-06215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Pablo Mínguez Gabiña
- Department of Medical Physics and Radiation Protection, Gurutzeta-Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Plaza Cruces S/N, 48903, Barakaldo, Spain
- Faculty of Engineering, Department of Applied Physics, UPV/EHU, Bilbao, Spain
| | | | - Marta Cremonesi
- Radiation Research Unit, Department of Medical Imaging and Radiation Sciences, Istituto Europeo Di Oncologia, Milan, Italy
| | - Caroline Stokke
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Department of Physics, University of Oslo, Oslo, Norway
| | - Glenn Flux
- Joint Department of Physics, Royal Marsden NHSFT and Institute of Cancer Research, Sutton, UK
| | - Francesco Cicone
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
- Nuclear Medicine Unit, University Hospital "Mater Domini", Catanzaro, Italy
| | - Mark Konijnenberg
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matt Aldridge
- Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Maidstone, ME16 9QQ, UK
| | - Mattias Sandstrom
- Section of Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Carlo Chiesa
- Nuclear Medicine Division, Foundation IRCCS Istituto Nazionale Tumori, Via Giacomo Venezian 1, 20133, Milan, Italy
| | - Maria Paphiti
- Medical Physics Department, Pammakaristos Hospital of Divine Providence, Iakovaton 43, 11144, Athens, Greece
| | - Eero Hippeläinen
- Department of Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Carlos Uribe
- Functional Imaging, BC Cancer, Vancouver, BC, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Pavel Solny
- National Radiation Protection Institute, Bartoskova 1450/28, 140 00, Praha 4, Nusle, Czech Republic
| | - Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Peter Bernhardt
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, University, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering (MFT), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Nicolas Chouin
- Nantes Université, Inserm, CNRS, Université d'Angers, Oniris, CRCI2NA, Nantes, France
| | - Pedro Fragoso Costa
- Department of Nuclear Medicine, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
- Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany
| | - Gerhard Glatting
- Medical Radiation Physics, Department of Nuclear Medicine, Ulm University, Ulm, Germany
| | - Frederik Verburg
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHSFT and Institute of Cancer Research, Sutton, UK.
| |
Collapse
|
2
|
Herrmann K, Giovanella L, Santos A, Gear J, Ozgen Kiratli P, Kurth J, Denis-Bacelar AM, Hustinx R, Patt M, Wahl RL, Paez D, Giammarile F, Jadvar H, Pandit-Taskar N, Ghesani M, Kunikowska J. Joint EANM, SNMMI, and IAEA Enabling Guide: How to Set up a Theranostics Center. J Nucl Med 2022; 63:1836-1843. [PMID: 35450957 DOI: 10.2967/jnumed.122.264321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/20/2022] [Indexed: 01/14/2023] Open
Abstract
The theranostics concept using the same target for both imaging and therapy dates back to the middle of the last century, when radioactive iodine was first used to treat thyroid diseases. Since then, radioiodine has become broadly established clinically for diagnostic imaging and therapy of benign and malignant thyroid disease, worldwide. However, only since the approval of SSTR2-targeting theranostics following the NETTER-1 trial in neuroendocrine tumors, and the positive outcome of the VISION trial has theranostics gained substantial attention beyond nuclear medicine. The roll-out of radioligand therapy for treating a high-incidence tumor such as prostate cancer requires the expansion of existing and the establishment of new theranostics centers. Despite wide global variation in the regulatory, financial and medical landscapes, this guide attempts to provide valuable information to enable interested stakeholders to safely initiate and operate theranostic centers. This enabling guide does not intend to answer all possible questions, but rather to serve as an overarching framework for multiple, more detailed future initiatives. It recognizes that there are regional differences in the specifics of regulation of radiation safety, but common elements of best practice valid globally.
Collapse
Affiliation(s)
- Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Duisburg, Germany; .,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Luca Giovanella
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Andrea Santos
- Department of Nuclear Medicine, Hospital Cuf Descobertas, Lisbon, Portugal
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Sutton, Sutton, United Kingdom
| | | | - Jens Kurth
- Department of Nuclear Medicine, Rostock University Medical Center, Rostock, Germany
| | | | - Roland Hustinx
- Division of Nuclear Medicine and Oncological Imaging, University Hospital of Liège, Liège, Belgium.,GIGA-CRC in vivo imaging, University of Liège, Liège, Belgium
| | - Marianne Patt
- Department for Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Richard L Wahl
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
| | - Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, University of Southern California, Los Angeles, California
| | - Neeta Pandit-Taskar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Munir Ghesani
- Diagnostic, Molecular & Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; and
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
3
|
Gear J. Milestones in dosimetry for nuclear medicine therapy. Br J Radiol 2022; 95:20220056. [PMID: 35451857 PMCID: PMC10996314 DOI: 10.1259/bjr.20220056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 11/05/2022] Open
Abstract
Nuclear Medicine therapy has reached a critical juncture with an unprecedented number of patients being treated and an extensive list of new radiopharmaceuticals under development. Since the early applications of these treatments dosimetry has played a vital role in their development, in both aiding optimisation and enhancing safety and efficacy. To inform the future direction of this field, it is useful to reflect on the scientific and technological advances that have occurred since those early uses. In this review, we explore how dosimetry has evolved over the years and discuss why such initiatives were conceived and the importance of maintaining standards within our practise. Specific milestones and landmark publications are highlighted and a thematic review and significant outcomes during each decade are presented.
Collapse
Affiliation(s)
- Jonathan Gear
- The Joint Department of Physics, The Royal Marsden NHS
Foundation Trust & Institute of Cancer Research,
Sutton, United Kingdom
| |
Collapse
|
4
|
Joint EANM, SNMMI and IAEA enabling guide: how to set up a theranostics centre. Eur J Nucl Med Mol Imaging 2022; 49:2300-2309. [PMID: 35403861 PMCID: PMC9165261 DOI: 10.1007/s00259-022-05785-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 03/25/2022] [Indexed: 01/14/2023]
Abstract
The theranostics concept using the same target for both imaging and therapy dates back to the middle of the last century, when radioactive iodine was first used to treat thyroid diseases. Since then, radioiodine has become broadly established clinically for diagnostic imaging and therapy of benign and malignant thyroid disease, worldwide. However, only since the approval of SSTR2-targeting theranostics following the NETTER-1 trial in neuroendocrine tumours and the positive outcome of the VISION trial has theranostics gained substantial attention beyond nuclear medicine. The roll-out of radioligand therapy for treating a high-incidence tumour such as prostate cancer requires the expansion of existing and the establishment of new theranostics centres. Despite wide global variation in the regulatory, financial and medical landscapes, this guide attempts to provide valuable information to enable interested stakeholders to safely initiate and operate theranostics centres. This enabling guide does not intend to answer all possible questions, but rather to serve as an overarching framework for multiple, more detailed future initiatives. It recognizes that there are regional differences in the specifics of regulation of radiation safety, but common elements of best practice valid globally.
Collapse
|
5
|
Della Gala G, Bardiès M, Tipping J, Strigari L. Overview of commercial treatment planning systems for targeted radionuclide therapy. Phys Med 2021; 92:52-61. [PMID: 34864422 DOI: 10.1016/j.ejmp.2021.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/23/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION Targeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or directly injected into the arteries that supply blood to liver tumour vasculature, indicated as Selective RT (SRT). The aim of this work is to offer a panoramic view on the increasing number of commercially-available TRT treatment planning systems (TPSs). MATERIALS AND METHODS A questionnaire was sent to manufacturers' representatives. Academic software were not considered. Questions were grouped as follows: general information, clinical workflow, calibration procedure, image processing/reconstruction, image registration and segmentation tools, time-activity curve (TAC) fitting and absorbed dose calculation. RESULTS All software reported have CE-marking. TPSs were divided between SRT-dedicated software [4] and MRT [5] dosimetry software. In SRT, since no kinetic process is involved, absorbed dose calculation does not require TAC fitting, and image registration is not fully developed in all TPS. All software requires a radionuclide-specific calibration. In SRT, a relative image calibration can be obtained by scaling the counts to a known activity. Automated VOI contouring and rigid/deformable propagation between different acquisitions time-points is implemented in most TPSs, although DICOM export is rare. Different TAC fits are available depending on the number of time-points. Voxel S-value and Local deposition methods are the most frequent dosimetric approaches; dose-voxel kernel convolution and semi-Monte Carlo method are also available. CONCLUSIONS Available TPSs allows performing personalized dosimetry in clinical practice. Individual variations in methodology/algorithms must be considered in the standardisation/harmonization processes.
Collapse
Affiliation(s)
- Giuseppe Della Gala
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Manuel Bardiès
- Département de Médecine Nucléaire, Institut Régional du Cancer de Montpellier (ICM), Montpellier F-34298, France; IRCM, UMR 1194 INSERM, Université de Montpellier and Institut Régional du Cancer de Montpellier (ICM), Montpellier F-34298, France
| | - Jill Tipping
- The Christie NHS Foundation Trust, Manchester, UK
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| |
Collapse
|
6
|
Gear J, McGowan D, Rojas B, Craig AJ, Smith AL, Scott CJ, Scuffam J, Aldridge M, Tipping J. The internal dosimetry user group position statement on molecular radiotherapy. Br J Radiol 2021; 94:20210547. [PMID: 34433005 PMCID: PMC9328072 DOI: 10.1259/bjr.20210547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The Internal Dosimetry User Group (IDUG) is an independent, non-profit group of medical professionals dedicated to the promotion of dosimetry in molecular radiotherapy (www.IDUG.org.uk). The Ionising Radiation (Medical Exposure) Regulations 2017, IR(ME)R, stipulate a requirement for optimisation and verification of molecular radiotherapy treatments, ensuring doses to non-target organs are as low as reasonably practicable. For many molecular radiotherapy treatments currently undertaken within the UK, this requirement is not being fully met. The growth of this field is such that we risk digressing further from IR(ME)R compliance potentially delivering suboptimal therapies that are not in the best interest of our patients. For this purpose, IDUG proposes ten points of action to aid in the successful implementation of this legislation. We urge stakeholders to support these proposals and ensure national provision is sufficient to meet the criteria necessary for compliance, and for the future advancement of molecular radiotherapy within the UK.
Collapse
Affiliation(s)
- Jonathan Gear
- The Internal Dosimetry User Group, England, United Kingdom.,The Joint Department of Physics, The Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, United Kingdom
| | - Daniel McGowan
- The Internal Dosimetry User Group, England, United Kingdom.,Radiation Physics and Protection, Oxford University Hospitals NHS Foundation Trust, England, United Kingdom
| | - Bruno Rojas
- The Internal Dosimetry User Group, England, United Kingdom.,The Joint Department of Physics, The Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, United Kingdom
| | - Allison J Craig
- The Internal Dosimetry User Group, England, United Kingdom.,The Joint Department of Physics, The Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, United Kingdom
| | - April-Louise Smith
- The Internal Dosimetry User Group, England, United Kingdom.,Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Catherine J Scott
- The Internal Dosimetry User Group, England, United Kingdom.,Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - James Scuffam
- The Internal Dosimetry User Group, England, United Kingdom.,Nuclear Medicine Physics, The Royal Surrey NHS Foundation Trust, England, United Kingdom
| | - Matthew Aldridge
- The Internal Dosimetry User Group, England, United Kingdom.,Maidstone and Royal Tunbridge Wells NHS Trust, England, United Kingdom
| | - Jill Tipping
- The Internal Dosimetry User Group, England, United Kingdom.,Nuclear Medicine, The Christie NHS Foundation Trust, England, United Kingdom
| |
Collapse
|
7
|
Flux G, Buscombe J. BNMS position statement on molecular radiotherapy. Nucl Med Commun 2021; 42:1061-1063. [PMID: 34284439 PMCID: PMC8445360 DOI: 10.1097/mnm.0000000000001458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/11/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Glenn Flux
- Department of Physics, Royal Marsden Hospital, Sutton, Surrey
| | - John Buscombe
- British Nuclear Medicine Society, University of Nottingham Innovation Park, Nottingham, UK
| |
Collapse
|