Ljungberg Michael, Sjögreen Gleisner Katarina
Department of Medical Radiation Physics, Lund University, 221 85 Lund, Sweden.
Biomedicines. 2016 Nov 15;4(4):25. doi: 10.3390/biomedicines4040025.
For treatment of systemic malignancies, when external radiation therapy is not applicable, radionuclide therapy can be an alternative. In this form of therapy, radionuclides are administered to the patient, often in a form where the radionuclide is labelled to a molecule that plays the active part in the localization of the tumor. Since the aim is to impart lethal damage to tumor cells while maintaining possible side-effects to normal tissues at tolerable levels, a proper and accurate personalized dosimetry should be a pre-requisite. In radionuclide therapy, there is a need to measure the distribution of the radiopharmaceutical in vivo, as well as its re-distribution over time, in order estimate the total energy released in radioactive decays and subsequent charged-particle interactions, governing the absorbed dose to different organs and tumors. Measurements are usually performed by molecular imaging, more specifically planar and SPECT (Single-Photon Emission Computed Tomography) imaging, combined with CT. This review describes the different parts in the dosimetry chain of radionuclide therapy. Emphasis is given to molecular imaging tools and the requirements for determining absorbed doses from quantitative planar and SPECT images. As example solutions to the different problems that need to be addressed in such a dosimetric chain, we describe our tool, Lundadose, which is a set of methods that we have developed for personalized dosimetry.
对于全身性恶性肿瘤的治疗，当外部放射治疗不适用时，放射性核素治疗可以作为一种替代方法。在这种治疗形式中，放射性核素通常以标记到在肿瘤定位中起活性作用的分子的形式给予患者。由于目的是对肿瘤细胞造成致命损伤，同时将对正常组织的可能副作用维持在可耐受水平，适当且准确的个性化剂量测定应是一个先决条件。在放射性核素治疗中，需要测量放射性药物在体内的分布及其随时间的重新分布，以便估计放射性衰变和随后的带电粒子相互作用中释放的总能量，从而确定不同器官和肿瘤所吸收的剂量。测量通常通过分子成像进行，更具体地说是平面成像和单光子发射计算机断层扫描（SPECT）成像，并结合CT。本综述描述了放射性核素治疗剂量测定链中的不同部分。重点是分子成像工具以及从定量平面和SPECT图像确定吸收剂量的要求。作为在这种剂量测定链中需要解决的不同问题的示例解决方案，我们描述了我们的工具Lundadose，它是我们为个性化剂量测定开发的一组方法。
