Personalized dosimetry in molecular radiotherapy: Current advances and clinical challenges

Personalized dosimetry is increasingly recognized as a key component of molecular radiotherapy. The aim of this study is to present recent advances in individualized dosimetry and to discuss current challenges in its clinical implementation. Quantitative imaging techniques, such as SPECT/CT, enable absorbed dose calculations, while voxel-based dosimetry offers improved precision in dose distribution, spatial resolution, and biological relevance compared to conventional organ-based methods. Clinical evidence supports the role of individualized dosimetry in improving therapeutic outcomes and reducing toxicity. However, routine clinical adoption remains limited due to workflow complexity, increased workload, and lack of standardization. Emerging artificial intelligence (AI) applications provide promising solutions for automation and optimization. Personalized dosimetry is expected to improve therapeutic efficacy while minimizing toxicity, supporting its integration into routine clinical practice.