Kolbert Katherine S, Pentlow Keith S, Pearson Joel R, Sheikh Arif, Finn Ronald D, Humm John L, Larson Steven M
Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
J Nucl Med. 2007 Jan;48(1):143-9.
The objective of this work was to determine normal organ (131)I dosimetry in patients undergoing radioiodide therapy for thyroid cancer by use of serial scanning with (124)I PET.
A total of 26 patients who had papillary and follicular metastatic thyroid cancer and who were already enrolled in a Memorial Sloan-Kettering Cancer Center (131)I thyroid cancer protocol were selected for this study. Imaging before (131)I therapy consisted of multiple, whole-body (124)I PET studies over a period of 2-8 d, an (18)F-FDG PET scan and, for some, a diagnostic CT scan. With a set of in-house-developed software tools (3-dimensional internal dosimetry [3D-ID] and Multiple Image Analysis Utility [MIAU]), the following procedures were performed: all PET emission and transmission and CT image sets were aligned; half-life-corrected tomographic images of (131)I activity were integrated voxel by voxel to produce cumulated (131)I activity images; and the latter images were, in turn, convolved with a (131)I electron-photon point kernel to produce images of (131)I dose distribution. Cumulated activity values and calculated residence times obtained from our patient-specific dosimetry software (3D-ID) were used as inputs to OLINDA, and volume difference-adjusted comparisons were made between the mean dose estimates.
With 3D-ID, dose volume histograms and mean doses were calculated for 14 organs, and results were expressed in Gy/GBq. The highest mean dose, 0.26 Gy/GBq, was seen in the right submandibular gland, whereas the lowest mean dose, 0.029 Gy/GBq, was seen in the brain.
This is the first comprehensive study of normal organ dosimetry in patients by use of a quantitative tomographic imaging modality.
本研究的目的是通过使用（124）I PET 进行系列扫描，确定接受甲状腺癌放射性碘治疗患者的正常器官（131）I 剂量学。
本研究共选取了 26 例患有乳头状和滤泡状转移性甲状腺癌且已参加纪念斯隆凯特琳癌症中心（131）I 甲状腺癌方案的患者。（131）I 治疗前的成像包括在 2 - 8 天内进行多次全身（124）I PET 研究、一次（18）F - FDG PET 扫描，部分患者还进行了诊断性 CT 扫描。使用一套内部开发的软件工具（三维内部剂量学[3D - ID]和多图像分析实用程序[MIAU]），进行了以下操作：对所有 PET 发射、透射和 CT 图像集进行配准；对（131）I 活性的半衰期校正断层图像逐体素进行积分，以生成累积（131）I 活性图像；然后将后者的图像与（131）I 电子 - 光子点核进行卷积，以生成（131）I 剂量分布图像。从我们的患者特异性剂量学软件（3D - ID）获得的累积活性值和计算出的停留时间用作 OLINDA 的输入，并对平均剂量估计值进行体积差异调整后的比较。
使用 3D - ID，计算了 14 个器官的剂量体积直方图和平均剂量，结果以 Gy/GBq 表示。右下颌下腺的平均剂量最高，为 0.26 Gy/GBq，而脑的平均剂量最低，为 0.029 Gy/GBq。
这是首次使用定量断层成像方式对患者正常器官剂量学进行的全面研究。
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