Dosimetry of Bone-Seeking Radiopharmaceuticals for Palliative Therapy of Bone Metastases: A Simulation Study Using GATE Monte Carlo Code

Purpose: Radiopharmaceutical Therapy (RPT) is one of the effective methods for pain palliation of bone metastases. Bone marrow is a critical organ in bone structure whose absorbed dose should be kept below a certain threshold. The purpose of this study was to calculate and compare absorbed doses of bone-seeking radiopharmaceuticals used in the palliative treatment of bone metastases. Materials and Methods: In this study, the GATE Monte Carlo code was used to simulate a femur bone, which consists of bone marrow, endosteal layer, bone, and soft tissue phantom model. Absorbed doses of the SmEDTMP, SrCl2, Lu-EDTMP, Re-HEDP, and RaCl2 radiopharmaceuticals were calculated in the femur phantom compartments. Results: bone absorbed doses per disintegration from alpha particles of RaCl2 is approximately 24 times higher than absorbed doses from beta particles of SrCl2. Also, absorbed dose per disintegration from beta particles of SrCl2 in the bone is approximately 12, 6 and 1.5 times higher than Lu-EDTMP, Sm-EDTMP, and ReHEDP, respectively. Moreover, the bone and bone marrow absorbed dose from beta particles of Sm-EDTMP is approximately 2 times higher than Lu-EDTMP. Besides, absorbed dose per disintegration from beta particles of Re-HEDP in the bone marrow is approximately 40, 30, 7, and 4 times higher than RaCl2, SrCl2, LuEDTMP and Sm-EDTMP, respectively. Conclusion: Our results show that RaCl2 could be a more efficient radiopharmaceutical for radionuclide therapy of bone metastases. Also, Lu-EDTMP, due to low marrow toxicity and comparable bone absorbed dose with Sm-EDTMP, can be used for achieving bone pain palliation. Moreover, significantly high bone marrow absorbed dose of Re-HEDP should be considered for palliative therapy of metastatic bone patients.

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