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Overview of commercial treatment planning systems for targeted radionuclide therapy
Institution:1. University of Maryland School of Medicine, Department of Radiation Oncology, Baltimore, MD;2. University of Texas Southwestern Medical Center, Dallas, TX
Abstract:IntroductionTargeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or directly injected into the arteries that supply blood to liver tumour vasculature, indicated as Selective RT (SRT). The aim of this work is to offer a panoramic view on the increasing number of commercially-available TRT treatment planning systems (TPSs).Materials and methodsA questionnaire was sent to manufacturers' representatives. Academic software were not considered. Questions were grouped as follows: general information, clinical workflow, calibration procedure, image processing/reconstruction, image registration and segmentation tools, time-activity curve (TAC) fitting and absorbed dose calculation.ResultsAll software reported have CE-marking. TPSs were divided between SRT-dedicated software 4] and MRT 5] dosimetry software. In SRT, since no kinetic process is involved, absorbed dose calculation does not require TAC fitting, and image registration is not fully developed in all TPS. All software requires a radionuclide-specific calibration. In SRT, a relative image calibration can be obtained by scaling the counts to a known activity. Automated VOI contouring and rigid/deformable propagation between different acquisitions time-points is implemented in most TPSs, although DICOM export is rare. Different TAC fits are available depending on the number of time-points. Voxel S-value and Local deposition methods are the most frequent dosimetric approaches; dose-voxel kernel convolution and semi-Monte Carlo method are also available.ConclusionsAvailable TPSs allows performing personalized dosimetry in clinical practice. Individual variations in methodology/algorithms must be considered in the standardisation/harmonization processes.
Keywords:Targeted Radionuclide Therapy  Treatment planning systems  Dose calculation  Kernel  Dose volume histograms  BED"}  {"#name":"keyword"  "$":{"id":"pc_yYO6Hb7fHn"}  "$$":[{"#name":"text"  "_":"Biologically Effective Dose  DVH"}  {"#name":"keyword"  "$":{"id":"pc_xJE9FTdmt1"}  "$$":[{"#name":"text"  "_":"Dose-Volume Histogram  EBRT"}  {"#name":"keyword"  "$":{"id":"pc_qcfTuHpenW"}  "$$":[{"#name":"text"  "_":"External Beam Radiotherapy  FBP"}  {"#name":"keyword"  "$":{"id":"pc_2YVhLJmm4U"}  "$$":[{"#name":"text"  "_":"Filtered Back Projection  MRT"}  {"#name":"keyword"  "$":{"id":"pc_n09qiAsarC"}  "$$":[{"#name":"text"  "_":"Molecular Radiotherapy  OSEM"}  {"#name":"keyword"  "$":{"id":"pc_eMFjYognrS"}  "$$":[{"#name":"text"  "_":"Ordered Subset Expectation Maximization  SRT"}  {"#name":"keyword"  "$":{"id":"pc_rar4YROSzt"}  "$$":[{"#name":"text"  "_":"Selective Radiotherapy  TAC"}  {"#name":"keyword"  "$":{"id":"pc_3QwoR3Oy9X"}  "$$":[{"#name":"text"  "_":"Time-Activity Curve  TPS(s)"}  {"#name":"keyword"  "$":{"id":"pc_vcWy1PeRjt"}  "$$":[{"#name":"text"  "_":"Treatment Planning System(s)  TRT"}  {"#name":"keyword"  "$":{"id":"pc_WzrzueEpWH"}  "$$":[{"#name":"text"  "_":"Targeted Radionuclide Therapy  VOI(s)"}  {"#name":"keyword"  "$":{"id":"pc_EwKeiBfcKK"}  "$$":[{"#name":"text"  "_":"Volume(s) of Interest
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