Image-Based Dosimetry of Radionuclide Therapy

Lim Ilhan

doi:10.11106/jkta.2013.6.1.26

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Ilhan: Image-Based Dosimetry of Radionuclide Therapy

Original Article

J Korean Thyroid Assoc 2013;6(1):26-33.

Published online: 3 May 2013

DOI: https://doi.org/10.11106/jkta.2013.6.1.26

Image-Based Dosimetry of Radionuclide Therapy

Lim Ilhan

Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Korea

Address reprint requests to Ilhan Lim, MD, Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon-gu, Seoul 139-706, Korea Tel: 82-2-970-2241, Fax: 82-2-970-2422, E-mail: ilhan@kcch.re.kr

Received 10 May 2013 Accepted 10 May 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radionuclide therapies have been applied in the diverse fields of medicine, and it has been demonstrated the usefulness of it, especially in the field of oncology. Accurate dosimetric assessment is imperative during radionuclide therapy, in order to optimize the treatment efficacy for target sites and to minimize the radiation exposure for normal organ. Recent advancement in imaging technology permits the precise determination of the absorbed dose non-invasively. This imaging based dosimetry can be routinely applicable to the bedside in the near future.

Keywords: Dosimetry, Radionuclide therapy, Image-based dosimetry

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Fig. 1.

Imaging and dosimetry in clinical trials of targeted radionuclide therapy.

Fig. 2.

Dosimetry after I–131 Rituximab treatment for lymphoma using planar gamma camera imaging.³⁴⁾

Fig. 3.

Transaxial slice of a dose distribution resulting from I–131 mIBG therapy of neuroblastoma,³⁵⁾ (A) SPECT slice acquired post-therapy. (B) Corresponding absorbed dose distribution. (C) Rendered view of absorbed dose distribution. (D) Isodose contours from targeted therapy superimposed onto registered CT slice.

Fig. 4.

I-124 PET imaging based dosimetry.¹⁷⁾ Representative coronal slices of absorbed dose (D) maps of two different data sets: torso (measured) (A) and head (modeled) (B).

Fig. 5.

A pretherapy I-124 PET scan (A, 24 hours after administration of 25 MBq I–124) and a posttherapy I–131 whole-body scintigraphy scan (B, 7 days after administration of 10 GBq I–131) in the same patient demonstrate the advantages of PET including increased sensitivity and better spatial resolution.³⁶⁾ In the PET image (A) two foci of increased activity can clearly be detected whereas in the whole-body scintigraphy scan (B) only diffuse activity is seen.

Fig. 6.

Quantification of remnant thyroid tissue using whole body scan after I–131 treatment.^27,28) Measurement of neck remnant thyroid tissue count by ROI (A). Measurement of skull count by ROI (B). Calculated the thyroid-to-background ratio (TBR). Comparison of remnant thyroid tissue between after endoscopic thyroidectomy (ET) and open thyroidectomy (OT) (C). Another quantification method of remnant thyroid tissue (D).

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