Dosimetry in radionuclide therapy: the clinical role of measuring radiation dose - 01/02/22

Doi : 10.1016/S1470-2045(21)00657-4

Courtney Lawhn-Heath, MD ^a, Thomas A Hope, MD ^a,^b,^e, Juana Martinez, MD ^f, Edward K Fung, PhD ^f, Jaehoon Shin, MD ^a, Youngho Seo, ProfPhD ^a,^b,^c,^g, Robert R Flavell, MD ^a,^b,^d,⁎

^a Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA

^b Helen Diller Family Cancer Center, University of California San Francisco, San Francisco, CA, USA

^c Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA

^d Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, CA, USA

^e Department of Radiology, San Francisco VA Medical Center, San Francisco, CA, USA

^f Department of Radiology, Weill Cornell Medical Center, New York, NY, USA

^g Department of Nuclear Engineering, University of California Berkeley, Berkeley, CA, USA

^* Correspondence to: Assoc Prof Robert R Flavell, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco CA 94107 USA

Summary

Radionuclide therapy is a rapidly expanding oncological treatment method. Overwhelmingly, the application of radionuclide therapy in clinical practice relies on fixed or empirical dosing strategies. In principle, the application of dosimetry promises to improve patient outcomes by tailoring administered radionuclide therapy activities to each patient’s unique tumour burden and tumour uptake. However, robust prospective data are scarce due to few prospective randomised clinical trials investigating the use of dosimetry in radionuclide therapy. In this Review, we describe the role of dosimetry as it has been applied historically and in modern clinical practice and its potential future applications. We further emphasise areas of future growth and a potential pathway to optimised personalised activity modulation of radionuclide therapy

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Plan

Introduction

Dosimetry basics

Approaches to dosimetry in radionuclide therapy

Dosimetry in radionuclide therapy: past and present

Thyroid cancer: ¹³¹I

NETs: ¹⁷⁷Lu-Dotatate

Prostate cancer: ¹⁷⁷Lu-PSMA-617

Neuroblastoma and paraganglioma: ¹³¹I-metaiodobenzylguanidine

Hepatocellular carcinoma and liver metastases: ⁹⁰Y radioembolisation

Dosimetry in radionuclide therapy: challenges and future applications

Conclusion

Search strategy and selection criteria

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Vol 23 - N° 2

P. e75-e87 - février 2022 Retour au numéro

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Dosimetry in radionuclide therapy: the clinical role of measuring radiation dose - 01/02/22

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