Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy.
Scientific Direction, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
Sensors (Basel). 2023 Feb 26;23(5):2599. doi: 10.3390/s23052599.
Treatment personalization in Molecular Radiotherapy (MRT) relies on pre- and post-treatment SPECT/ PET-based images and measurements to obtain a patient-specific absorbed dose-rate distribution map and its evolution over time. Unfortunately, the number of time points that are available per patient to investigate individual pharmacokinetics is often reduced by limited patient compliance or SPECT or PET/CT scanner availability for dosimetry in busy departments. The adoption of portable sensors for in-vivo dose monitoring during the entire treatment could improve the assessment of individual biokinetics in MRT and, thus, the treatment personalization. The evolution of portable devices, non-SPECT/PET-based options, already used for monitoring radionuclide activity transit and accumulation during therapy with radionuclides (i.e., MRT or brachytherapy), is presented to identify valuable ones, which combined with conventional nuclear medicine imaging systems could be effective in MRT. External probes, integration dosimeters and active detecting systems were included in the study. The devices and their technology, the range of applications, the features and limitations are discussed. Our overview of the available technologies encourages research and development of portable devices and dedicated algorithms for MRT patient-specific biokinetics study. This would represent a crucial advancement towards personalized treatment in MRT.
分子放疗（MRT）中的个体化治疗依赖于治疗前后的 SPECT/PET 图像和测量值，以获得患者特异性吸收剂量率分布图谱及其随时间的变化。然而，在繁忙的科室中，由于患者配合度有限或 SPECT 或 PET/CT 扫描仪可用于剂量测定，每个患者可用于研究个体药代动力学的时间点通常会减少。在整个治疗过程中采用便携式传感器进行体内剂量监测，可以改善 MRT 中个体生物动力学的评估，从而实现治疗个体化。本研究介绍了用于监测放射性核素治疗期间放射性核素活性传递和积累的便携式设备（即 MRT 或近距离放疗）的非 SPECT/PET 选项的演变，以确定有价值的选项，这些选项与常规核医学成像系统结合使用可能对 MRT 有效。研究中包括外部探头、积分剂量计和主动探测系统。讨论了这些设备及其技术、应用范围、特点和局限性。我们对现有技术的综述鼓励对 MRT 患者特异性生物动力学研究的便携式设备和专用算法的研究和开发。这将是 MRT 个性化治疗的重要进展。
