Patient-specific dosimetry for 131I thyroid cancer therapy using 124I PET and 3-dimensional-internal dosimetry (3D-ID) software.

UNLABELLED Compared with conventional, whole-organ, S-factor-based dosimetry, 3-dimensional (3D), patient-specific dosimetry better accounts for radionuclide distribution and anatomic patient variability. Its accuracy, however, is limited by the quality of the cumulated activity information that is provided as input. This input has typically been obtained from SPECT and planar imaging studies. The objective was to implement and evaluate PET-based, patient-specific, 3D dosimetry for thyroid cancer patients. METHODS Three to 4 PET imaging studies were obtained over a 7-d period in 15 patients with metastatic thyroid carcinoma after administration of (124)I-NaI. Subsequently, patients were treated with (131)I on the basis of established clinical parameters. Retrospective dosimetry was performed using registered (124)I PET images that were corrected for the half-life difference between (124)I and (131)I. A voxel-by-voxel integration, over time, of the resulting (131)I-equivalent PET-derived images was performed to provide a single 3D dataset representing the spatial distribution of cumulated activity values for each patient. Image manipulation and registration were performed using Multiple Image Analysis Utility (MIAU), a software package developed previously. The software package, 3D-Internal Dosimetry (3D-ID), was used to obtain absorbed dose maps from the cumulated activity image sets. RESULTS Spatial distributions of absorbed dose, isodose contours, dose-volume histograms (DVHs), and mean absorbed dose estimates were obtained for a total of 56 tumors. Mean absorbed dose values for individual tumors ranged from 1.2 to 540 Gy. The absorbed dose distribution within individual tumors was widely distributed ranging from a minimum of 0.3 to a maximum of 4,000 Gy. CONCLUSION (124)I PET-based, patient-specific 3D dosimetry is feasible, and sequential PET can be used to obtain cumulated activity images for 3D dosimetry.

[1]  Quimby Eh,et al.  Dosage determination with radioactive isotopes. , 1948 .

[2]  M. Ljungberg.  Evaluation and validation of dose calculation procedures in patient-specific radionuclide therapy , 2002 .

[3]  R. Wahl.  The clinical importance of dosimetry in radioimmunotherapy with tositumomab and iodine I 131 tositumomab. , 2003, Seminars in oncology.

[4]  Pierre Vera,et al.  Voxeldoes: a computer program for 3-D dose calculation in therapeutic nuclear medicine. , 2003, Cancer biotherapy & radiopharmaceuticals.

[5]  A. Scott,et al.  Dose-volume histogram representation of patient dose distribution in three-dimensional internal dosimetry , 1994 .

[6]  Habib Zaidi,et al.  Therapeutic Applications of Monte Carlo Calculations in Nuclear Medicine , 2002 .

[7]  S. Hauptmann,et al.  Uptake of radiolabeled anti-CEA antibodies in human colorectal primary tumors as a function of tumor mass , 1993, European Journal of Nuclear Medicine.

[8]  J. O’Donoghue,et al.  Implications of nonuniform tumor doses for radioimmunotherapy. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[9]  D. Goldenberg.  Advancing role of radiolabeled antibodies in the therapy of cancer , 2003, Cancer Immunology, Immunotherapy.

[10]  C S Chui,et al.  Implementation of a Monte Carlo dosimetry method for patient-specific internal emitter therapy. , 1997, Medical physics.

[11]  C S Chui,et al.  Radionuclide photon dose kernels for internal emitter dosimetry. , 1996, Medical physics.

[12]  Y. Erdi,et al.  Radiation Dose Assessment for I-131 Therapy of Thyroid Cancer Using I-124 PET Imaging. , 1999, Clinical positron imaging : official journal of the Institute for Clinical P.E.T.

[13]  R G Dale,et al.  Dose-rate effects in targeted radiotherapy. , 1996, Physics in medicine and biology.

[14]  S. Larson,et al.  Parametric images of antibody pharmacokinetics in Bi213-HuM195 therapy of leukemia. , 2001, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  Yuni Dewaraja,et al.  Update on hybrid conjugate-view SPECT tumor dosimetry and response in 131I-tositumomab therapy of previously untreated lymphoma patients. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[16]  S M Larson,et al.  Segmentation of lung lesion volume by adaptive positron emission tomography image thresholding , 1997, Cancer.

[17]  R. Paxton,et al.  Tumor uptake as a function of tumor mass: a mathematic model. , 1988, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[18]  Kazuhiko Yoshida,et al.  Effect of tumor size on monoclonal antibody uptake in a metastatic model , 1992, Journal of surgical oncology.

[19]  L. Marinelli,et al.  Dosage determination with radioactive isotopes. , 1948, Nucleonics.

[20]  N. Volkow,et al.  PET scanning of iodine-124-3F9 as an approach to tumor dosimetry during treatment planning for radioimmunotherapy in a child with neuroblastoma. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  K S Pentlow,et al.  Quantitative imaging of I-124 using positron emission tomography with applications to radioimmunodiagnosis and radioimmunotherapy. , 1991, Medical physics.

[22]  Maggie A Flower,et al.  RMDP: a dedicated package for 131I SPECT quantification, registration and patient-specific dosimetry. , 2003, Cancer biotherapy & radiopharmaceuticals.

[23]  V S Hertzberg,et al.  Relation between effective radiation dose and outcome of radioiodine therapy for thyroid cancer. , 1983, The New England journal of medicine.

[24]  D. Lee,et al.  Clinical significance of hepatic visualization on iodine-131 whole-body scan in patients with thyroid carcinoma. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[25]  Katherine S Panageas,et al.  Patient-specific, 3-dimensional dosimetry in non-Hodgkin's lymphoma patients treated with 131I-anti-B1 antibody: assessment of tumor dose-response. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[26]  Xiaowei Liu,et al.  3D absorbed dose calculations based on SPECT: evaluation for 111-In/90-Y therapy using Monte Carlo simulations. , 2003, Cancer biotherapy & radiopharmaceuticals.

[27]  Q. Duh,et al.  Association between Residual Thyroid Carcinoma and Diffuse Hepatic Uptake of 131I following Radioiodine Ablation in Postoperative Total Thyroidectomy Patients , 2001, World Journal of Surgery.

[28]  Charles A Wemple,et al.  Application of MINERVA Monte Carlo simulations to targeted radionuclide therapy. , 2003, Cancer biotherapy & radiopharmaceuticals.

[29]  P M Evans,et al.  Combining dosimetry for targeted radionuclide and external beam therapies using the biologically effective dose. , 2003, Cancer biotherapy & radiopharmaceuticals.

[30]  D. van Nostrand,et al.  Dosimetrically determined doses of radioiodine for the treatment of metastatic thyroid carcinoma. , 2002, Thyroid : official journal of the American Thyroid Association.

[31]  G Sgouros,et al.  Implementation and evaluation of patient-specific three-dimensional internal dosimetry. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[32]  M. Flower,et al.  Absorbed dose ratios for repeated therapy of neuroblastoma with I-131 mIBG. , 2003, Cancer biotherapy & radiopharmaceuticals.

[33]  George Sgouros,et al.  The three-dimensional internal dosimetry software package, 3D-ID , 2002 .

[34]  M G Stabin,et al.  MIRDOSE: personal computer software for internal dose assessment in nuclear medicine. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[35]  E. Gaitan,et al.  Frontiers in Thyroidology , 1986, Springer US.

[36]  G. Reischl,et al.  Evaluation of dosimetry of radioiodine therapy in benign and malignant thyroid disorders by means of iodine-124 and PET , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[37]  M. Sonenberg,et al.  The relation of radioiodine dosimetry to results and complications in the treatment of metastatic thyroid cancer. , 1962, The American journal of roentgenology, radium therapy, and nuclear medicine.

[38]  S. Larson,et al.  New strategies in radioimmunotherapy for lymphoma , 2003, Current oncology reports.

[39]  Kai Vetter,et al.  Treatment planning for molecular targeted radionuclide therapy. , 2002, Cancer biotherapy & radiopharmaceuticals.