Weber Manuel, Binse Ina, Nagarajah James, Bockisch Andreas, Herrmann Ken, Jentzen Walter
Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany.
Department of Radiology and Nuclear Medicine, Nijmegen, the Netherlands.
Q J Nucl Med Mol Imaging. 2019 Sep;63(3):235-252. doi: 10.23736/S1824-4785.19.03201-1. Epub 2019 Jul 11.
Radioiodine therapy of thyroid cancer was the first successful radionuclide therapy in the treatments of cancer, although its clinical use is empirical and not based on precise dosimetry. 124I is a positron-emitting radionuclide and positron emission tomography/computed tomography (PET/CT) with 124I currently provides the most accurate estimation of the absorbed (radiation) dose to thyroid cancer lesions. In the application, serial 124I PET/CT scans are performed to determine the time uptake curves and to delineate the volumes of the lesions. The 124I data are then used to project the absorbed dose per unit administered 131I activity. The results are part of the decision-making process to individually guide treatment plans, in particular by tailoring the therapeutic 131I activity in radioiodine therapy. The aim of this review is to provide an overview of 124I PET/CT lesion dosimetry of differentiated thyroid cancer including: 1) an historical overview; 2) the general properties of 124I and its activity measurement; 3) the main factors impairing PET image quantification; 4) an optimized lesion dosimetry protocol used in our group to make this manuscript self-contained; as well as 5) a summary of important clinical studies.
甲状腺癌的放射性碘治疗是癌症治疗中首个成功的放射性核素治疗，尽管其临床应用是经验性的，并非基于精确的剂量测定。124I是一种发射正电子的放射性核素，目前使用124I的正电子发射断层扫描/计算机断层扫描（PET/CT）能最准确地估计甲状腺癌病灶的吸收（辐射）剂量。在应用中，需进行系列124I PET/CT扫描以确定时间摄取曲线并勾勒病灶体积。然后利用124I数据推算每单位给予的131I活度的吸收剂量。这些结果是个体化指导治疗方案决策过程的一部分，特别是在放射性碘治疗中通过调整治疗性131I活度来实现。本综述的目的是概述分化型甲状腺癌的124I PET/CT病灶剂量测定，内容包括：1）历史概述；2）124I的一般特性及其活度测量；3）影响PET图像定量的主要因素；4）我们团队使用的优化病灶剂量测定方案，以使本文内容完整；以及5）重要临床研究总结。
