Estimation of volumetric dose distribution delivery deviations vs. dose planned in <sup>131</sup>I hyperthyroidism treatment: preliminary results
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Abstract
In 2013, the European Association of Nuclear Medicine Dosimetry Committee recommends a “Standard Operational Procedures for Hyperthyroidism Pre-Therapeutic Dosimetry” based on the assessment of the individual 131I uptake and kinetics. To estimate the 3D dose delivery deviations from prescribed dose during patient specific application of this SOP, a computer Matlab application was developed and verified. It was design to execute: radiopharmaceutical curve fitting, cumulated activity calculations, functional thyroid mass estimation, obtain the therapeutic planning activity to warranty the prescribed dose and produce the 3D planning dose map and related dosimetry parameters. 6 patients with 150-400Gy prescribed dose data planning (average 241,67Gy) were analysed using the developed application. The developed system was verify successfully using a test image phantom and 6 known pharmacokinetics data. The tridimensional thyroid volume cumulated activity and dose distributions were heterogeneous. 3D dose distribution showed standard deviations between 18.01-27.08 % of prescribed dose. The differences between maximum and minimum dose value per voxel/MBq were 74-129%. According to the result, between 50,2 % and 71,4 % of patient’s thyroid will be treat with a dose of DP±20 % of planned dose, the rest will be overdose or sub dose. Conclusions: the 3D treatment planning dose distribution were completely no-homogenous, the significant difference observed should be study in the future more deeply in order to optimized the hyperthyroidism iodine treatment.
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How to Cite
López Díaz, A., Martín, J. M., Pérez, A., & Ramos Rodríguez, E. O. (2019). Estimation of volumetric dose distribution delivery deviations vs. dose planned in <sup>131</sup>I hyperthyroidism treatment: preliminary results. Nucleus, (65), 1-5. Retrieved from http://nucleus.cubaenergia.cu/index.php/nucleus/article/view/669
Section
Ciencias Nucleares
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[14] TORRES LA, COCA M, CORNEJO N, et. al. Radionuclide targeted theraphy: three-dimensional dose estimations for treatment planning. ALASBIMN journal. 2011; 14(54).
[15] IAEA. Quantitative nuclear medicine imaging: concepts, requirements and methods. Vienna: IAEA, 2014.
[2] HÄNSCHEID H, LASSMANN M, REINERS C. Dosimetry prior to I-131 therapy of benign thyroid disease. Z Med Phys. 2011;21: 250-257.
[3] ISSELT JV, KLERK JD, LIPS C. Radioiodine treatment of hyperthyroidism: fixed or calculated doses; intelligent design or science?. Eur J Nucl Med Mol Imaging. 2007; 34: 1883-1834.
[4] MERRILL S, HOROWITZ J, TRAINO A, et. al. Accuracy and optimal timing of activity measurements in estimating the absorbed dose of radioiodine in the treatment of Graves’ disease. Phys Med Biol. 2011; 56: 557-571.
[5] HÄNSCHEID H, CANZI C, ESCHNER W, et. al. EANM Dosimetry committee series on standard operational procedures for pre-therapeutic dosimetry II. Dosimetry prior to radioiodine therapy of benign thyroid diseases. Eur J Nucl Med Mol Imaging [Internet]. 2013. https://www.eanm.org/publications/guidelines/2013_published_DC_SOP_Benign_Thyroid_Diseases.pdf.
[6] BOLCH W, BOUCHET L, ROBERTSON J, et. al. The dosimetry of nonuniform activity distributions-radionuclide S values at the voxel level. Medical Internal Radiation Dose Committee. MIRD pamphlet No. 17. J Nucl Med. 1999; 40: 11S-36S.
[7] RAMOS RODRÍGUEZ EO. Implementación del método de los factores S para dosimetría 3D con 131I en el tratamiento del hipertiroidismo. Tesis de Diploma en Opción al Título de Ingeniero en Tecnologías Nucleares y Energéticas. La Habana: INSTEC, 2016.
[8] PACILIO M, AMATO E, LANCONELLI N, BASILE C, et. al. Differences in 3D dose distributions due to calculation method of voxel S-values and the influence of image blurring in SPECT. Phys Med Biol. 2015; 60: 1945-1964.
[9] LÓPEZ A, REYNOSA R, PALAU A, MARTÍN JM, et. al. Methodology for gamma cameras calibration for I-131 uptake quantification in hyperthyroidism diseases. XV Workshop on Nuclear Physics and IX International Symposium on Nuclear and Related Techniques WONP-NURT'2015; February 9-13, 2015. Havana, Cuba.
[10] MALAGO R, D’ONOFRIO M, FERDEGHINI M, MANTOVANI W, et. al. Thyroid volumetric quantification comparative evaluation between conventional and volumetric ultrasonography. J Ultrasound Med. 2008; 27: 1727-1733.
[11] CUMALI A, GOLDSMITH SJ. Nuclear medicine therapy principles and clinical applications. Springer Science+Business. Media New York, 2013.
[12] DEWARAJA Y, FREY E, SGOUROS G, et. al. MIRD Pamphlet No. 23: Quantitative SPECT for patient-speci?c 3-dimensional dosimetry in internal radionuclide therapy.. J Nucl Med. 2012; 53(8): 1310-1325.
[13] DEWARAJA Y, LJUNGBERG M, GREEN A, et. al. MIRD Pamphlet No. 24: Guidelines for quantitative 131I SPECT in dosimetry applications. J Nucl Med. 2013; 54(12): 2182-2188.
[14] TORRES LA, COCA M, CORNEJO N, et. al. Radionuclide targeted theraphy: three-dimensional dose estimations for treatment planning. ALASBIMN journal. 2011; 14(54).
[15] IAEA. Quantitative nuclear medicine imaging: concepts, requirements and methods. Vienna: IAEA, 2014.