Dosimetric methodology for 131I therapy for benign thyroid diseases |
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| Affiliation: | 1. Department of Nuclear Medicine, Nîmes University Hospital, Nîmes, France;2. Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PSE-SANTE/SDOS/LEDI, BP-17, 92262 Fontenay-aux-Roses, France;3. Centre de recherches en cancérologie de Toulouse, université Paul-Sabatier, UMR 1037 Inserm, Toulouse, France;1. Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada;2. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;3. Department of Radiology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;1. Department of nuclear medicine, Bordeaux university hospitals, hôpital Haut-Lévêque, 33604 Pessac, France;2. Department of internal medicine, thyroid oncology program, university of Kentucky, 40536 Lexington, KY, USA;3. Department of nuclear medicine, institut universitaire du cancer de Toulouse–Oncopole, 31059 Toulouse, France;4. Department of radiology, division of nuclear medicine and molecular imaging, university of Michigan, 48109 Ann Arbor, MI, USA;1. Service de médecine nucléaire, institut universitaire du cancer Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France;2. Service d’endocrinologie de l’hôpital Larrey, CHU de Toulouse, 24, chemin de Pouvourville - TSA 30030, 31059 Toulouse cedex 9, France;3. Service de médecine nucléaire, université de Bordeaux, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33604 Pessac, France;4. Department of Nuclear Medicine, La Timone University Hospital, European & Center for Research in Medical Imaging, Aix-Marseille University, 13005 Marseille, France;5. Service de Biophysique et médecine nucléaire de l’hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France;1. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SDOS/LEDI, PSE-SANTE/SESANE/LEPID, Fontenay-aux-Roses, 92262, France;2. Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Ionizing Dosimetry Unit, Avda. Complutense 40, 28040, Madrid, Spain |
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| Abstract: | Treatment with 131I is one of the standard treatments for benign thyroid disease. In most cases, the prescribed dose is specific for the same disease. Inspired by external radiotherapy, the emergence of personalized pre-therapeutic dosimetry in nuclear medicine departments makes it possible to adapt to the patient's diseases and physiology; more specific to its kinetics of iodine distribution. By personalizing the prescribed activity, dosimetry makes it possible to comply with the ALARA principle in metabolic radiotherapy while at the same time preserving the therapeutic objective. Post-treatment dosimetry permits to validate the methodology and, by recording the dose actually delivered to the organs surrounding the target volume, to contribute to the understanding of the dose-effect relationship. A re-reading of the MIRD formalism guidelines is important as this document lists the procedure to be followed in thyroid dosimetry. Defining the sensitivity, calculating the S factors, estimating the cumulative activity and residence times and then calculating the dose are the different steps presented. The need to switch from fixed dose prescription to personalized prescription seems to be evident. Several studies in progress as well as the emergence of new software compiling all the information essential for its implementation will permit nuclear medicine departments to involve themselves more easily into the process. |
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| Keywords: | Personalized dosimetry Radiodine therapy Benign thyroid disease Dosimétrie personnalisée Traitement à l’iode 131 Maladie bénigne de la thyroïde |
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