Physical aspects of scintigraphybased dosimetry for nuclear medicine therapy

L. Geworski; A. Schaefer; B. O. Knoop; J. Pinkert; M. Plotkin; C. M. Kirsch

doi:10.3413/nukmed-0283

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2010; 49(03): 85-95
DOI: 10.3413/nukmed-0283

Original article

Schattauer GmbH

Physical aspects of scintigraphybased dosimetry for nuclear medicine therapy

Physikalische Aspekte szintigraphisch basierter Dosimetrie bei nuklear medizinischen Therapien

L. Geworski

¹Department of Radiation Protection and Medical Physics, Hannover Medical School, Hannover

,

A. Schaefer

²Department of Nuclear Medicine, Saarland University Medical Center, Homburg

,

B. O. Knoop

¹Department of Radiation Protection and Medical Physics, Hannover Medical School, Hannover

,

J. Pinkert

³Bayer Vital GmbH, Leverkusen

,

M. Plotkin

⁴Clinic for Nuclear Medicine, University Hospital Charité, Berlin, Germany

,

C. M. Kirsch

²Department of Nuclear Medicine, Saarland University Medical Center, Homburg

› Author Affiliations

Abstract

Summary

In nuclear medicine therapy the treatment of tumours by radiation exposure from internally deposited labelled antibodies or labelled peptides is currently an active field of investigation. To permit the efficient delivery of high amounts of radiation dose to tumours while limiting the radiation dose to critical organs dosimetry calculations have to be performed. These are relying on scintigraphic data being input to the well known MIRD formalism.

This paper focuses on the methods and the difficulties associated with the scintigraphic determination of organ kinetics. The physical properties of the well-known scintigraphic imaging modalities, PET, SPECT and planar scintigraphy, are discussed thereby taking into account the properties of the appropriate radionuclides currently being available for therapy and dosimetry. Several arguments are given and disputed for the limited clinical use of PET and SPECT in dosimetry and the ongoing preference of planar whole-body imaging as the method of choice. The quantitative restrictions still inherent to this method are also discussed in detail. Procedural recommendations are proposed covering all processes related to data acquisition, data correction and data analysis which finally lead to reliable estimations of organ dose.

Zusammenfassung

Die Anwendung radioaktiv markierter Antikörper bzw. Peptide in der nuklearmedizinischen Therapie ist ein Forschungsgebiet, das zunehmend an Bedeutung gewinnt. Die Dosimetrie soll hierbei die Abschätzung der maximal möglichen Tumordosis ermöglichen unter Berücksichtigung der mit der ionisierenden Strahlung verbundenen Risiken insbesondere für die kritischen Organe. Grundlage derartiger Berechnungen ist die Ermittlung von Daten (z. B. der Biokinetik radioaktiv markierter Substanzen), die über die nuklearmedizinische Bildgebung bestimmt und als Eingangsgrößen für den bekannten MIRD-Formalismus verwendet werden.

In dieser Arbeit werden die Methoden und die Schwierigkeiten beschrieben, die mit der szintigraphischen Bestimmung von Organkinetiken verbunden sind. Die physikalischen Eigenschaften der szintigraphischen Bildgebungsverfahren PET, SPECT und planare Szintigraphie werden in Hinblick auf ihre klinischen Einsatzmöglichkeiten in der Dosimetrie eingehend erörtert. Die Eigenschaften der für Therapie und Dosimetrie verfügbaren Radionuklide werden berücksichtigt. Der Einsatz der planaren Szintigraphie als Methode der Wahl wird in ihren Grenzen dargestellt und diskutiert. Darauf basierend werden Empfehlungen zur Durchführung der Dosimetrie inkorporierter Radionuklide ausgesprochen, welche alle hierzu notwendigen Schritte umfassen, beginnend mit der Datenakquisition über die erforderlichen Korrekturen bis zur Datenauswertung. Hierdurch soll eine verlässliche Abschätzung von Organdosen bei nuklearmedizinischen Therapien gewährleistet werden.

Keywords

Dosimetry - nuclear medicine therapy - scintigraphy

Schlüsselwörter

Dosimetrie - nuklearmedizinische Therapie - Szintigraphie

Full Text

References

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