Dosimetry for Radiopharmaceutical Therapy: Practical Implementation, From the AJR Special Series on Quantitative...

Area of Science:

• Nuclear Medicine
• Medical Physics
• Oncology

Background:

• Radiopharmaceutical therapy (RPT) shows growing clinical use but lacks optimization due to poorly defined dose-response and dose-toxicity relationships.
• Current RPT practices often rely on population-average dose estimates, hindering personalized treatment strategies.

Purpose of the Study:

• To review the determination of patient-specific radiation doses for target tissues and at-risk normal tissues in RPT.
• To highlight the transition towards individualized dosimetry for improved RPT outcomes.

Main Methods:

• Discussion of relevant quantities, units, and radionuclides used in RPT.
• Overview of dose prescription algorithms and the dosimetry workflow.
• Exploration of bioeffects modeling for RPT.

Main Results:

• Internal dosimetry is evolving from population averages to patient-specific sub-organ/sub-tumor dose estimations.
• Development of software is facilitating the adoption of these advanced dosimetry methods.
• Patient-specific dosimetry enables the creation of reliable dose-response and dose-toxicity relationships.

Conclusions:

• Patient-specific dosimetry is crucial for optimizing RPT.
• Implementing individualized dosimetry will drive the expansion and clinical effectiveness of RPT.