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SESSION CANCELLED! Internal Dose in Nuclear Medicine Therapy

Wednesday 02/08/2023

Room: Memorial Union 49

08:00 - 09:30

Chair(s): Michael Stabin

WAM-A.1  08:00  Standardized Radiopharmaceutical Dosimetry Methods. Stabin Michael*

Internal dosimetry methods for radiopharmaceuticals have been well established for many years. In this talk, methods for use of animal data (in preclinical studies) and human data (in clinical trials) will be described. Imaging of human patients or volunteers may be quantified via planar or tomographic imaging. Establishing the number and spacing of time points for data acquisition depends on the number of phases of uptake or clearance of any radiopharmaceutical. Then, standard methods are well established to determine radiation dose to normal tissues, including marrow, and tumors. The RADAR committee of the Society of Nuclear Medicine and Molecular Imaging has established the theoretical and practical basis for such calculations, including a step- by-step guide for all aspects of such calculations, published in 2022. The elements of the calculations, with numerical examples, will be presented. Such calculations are needed for approval of any new radiopharmaceutical, diagnostic or therapeutic, but such calculations are particularly important for patients receiving therapy administrations.

WAM-A.2  08:30  Clinical Applications of Radiopharmaceuticals in Therapy. Flux G*

The first radiotherapeutic treatment was given by the endocrinologist Dr Saul Hertz and the physicist Dr Arthur Roberts on March 31st 1941 when a lady named Elizabeth was administered 79 MBq of a cocktail of I-130 and I-131 for benign thyroid disease. From the outset every attempt was made to estimate the absorbed doses delivered. The potential to image the drug pre-and post-administration and to calculate the absorbed doses delivered is unique to this treatment and offers unprecedented opportunities - and challenges - to healthcare physics within the framework of justification and optimisation. The rationale behind the scientific and simplistic approaches to treatment will be reviewed, including the potential to aim ‘magic bullets’ for precision medicine, and resource implications.

WAM-A.3  09:00  Relating Radiation Doses to Biological Effects in Radiopharmaceutical Therapy. Strigari L*

Radiopharmaceutical therapy (RPT) is a targeted approach to treating many types of cancer. Generally, a given amount of activity is systemically or locally administered using pharmaceuticals that bind preferentially to cancer cells or accumulate by physiological mechanisms. In other settings, ad hoc devices (microspheres labeled with 90Y or 166Ho) are used for selective internal therapy of primary or secondary liver disease. In both scenarios, the cumulated activity in each organ and tissue can be quantified using nuclear medicine imaging to determine the absorbed dose to the target and healthy tissues. Several absorbed dose-effect relationships have been proposed in the literature for predicting patient outcomes (e.g., overall survival), tumor control, and radiation-induced toxicity. The proposed absorbed dose-effect relationships are based on several dose calculation methods, including mono-compartimental, partition, or voxel-based approaches. The talk aims to provide an overview of proposed models and the proposed constraints, considering the calculation methods for estimating the absorbed dose. The talk will present a few examples in which the application of artificial intelligence strategies can add value for treatment personalisation in RPT.

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