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All radioactive nuclides emit high-energy particles or electromagnetic waves. When this radiation encounters living cells, it can cause heating, break chemical bonds, or ionize molecules. The most serious biological damage results when these radioactive emissions fragment or ionize molecules. For example, α and β particles emitted from nuclear decay reactions possess much higher energies than ordinary chemical bond energies. When these particles strike and penetrate matter, they...
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Rethinking Dosimetry: A European Perspective.

Johannes Tran-Gia1, Francesco Cicone2, Michel Koole3

  • 1Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; tran_j@ukw.de.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|May 22, 2025
PubMed
Summary
This summary is machine-generated.

Radiopharmaceutical therapy (RPT) needs personalized dosimetry for better outcomes. Implementing dosimetry is key to advancing RPT and achieving precision oncology, despite current challenges.

Keywords:
MRTabsorbed dosedosimetrymolecular radiotherapyradionuclide therapyradiopharmaceutical therapy

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Area of Science:

  • Nuclear Medicine
  • Medical Physics
  • Oncology

Background:

  • Radiopharmaceutical therapy (RPT) is evolving towards personalized treatment, driven by molecular imaging and clinical evidence.
  • Historically, RPT relied on fixed activities, unlike external-beam radiotherapy's integrated dosimetry.
  • Personalized RPT is crucial for patients with longer life expectancies and better performance status.

Purpose of the Study:

  • To examine the current state of RPT dosimetry, challenges, and opportunities from a European perspective.
  • To foster a constructive discussion on RPT dosimetry implementation.
  • To highlight pathways for integrating dosimetry into clinical practice.

Main Methods:

  • Review of current RPT dosimetry practices and challenges.
  • Discussion of differences between dosimetry-driven treatment planning and post-therapy verification.
  • Analysis of regulatory, infrastructural, and resource barriers.

Main Results:

  • Clinical implementation of RPT dosimetry is limited due to a cycle of insufficient evidence and adoption.
  • Post-therapy absorbed dose verification is a practical entry point for clinical adoption.
  • Harmonized standards, improved imaging, and tailored dose-effect relationships are needed.

Conclusions:

  • Breaking the cycle of limited evidence is essential for advancing RPT.
  • Standardized, evidence-based dosimetry can move RPT beyond fixed protocols towards individualized treatment.
  • Generating high-quality clinical evidence and improving accessibility are crucial for routine dosimetry integration.