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Dosimetry in Radiopharmaceutical Therapy

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Radiopharmaceutical Therapy

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Abstract

The foundational principle of radiopharmaceutical therapy (RPT) is to deliver tissue-altering radiation to diseased tissue while minimizing damage to healthy tissue. The utility and efficacy of a targeted radiotherapeutic procedure arise from the interplay between the physiological distribution of a radiopharmaceutical, the emitted particles of the associated radionuclide, the subject’s anatomy, and radiobiologic factors. The characterization of this multifactorial paradigm is encapsulated in the field of internal dosimetry. Through dosimetry, we quantify the distribution and strength of the intervention in terms of radiation dose deposition. This information supports clinicians in predicting and optimizing treatment outcomes.

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Notes

  1. 1.

    Effective uptake/clearance considers the activity of the radionuclide (or proportional parameter, e.g., the activity concentration) and is a function of both radioactive decay and biological translocation mechanisms.

  2. 2.

    Biological uptake/clearance considers the activity of a radionuclide that has been decay-corrected back to the time of administration. Thus, biological uptake/clearance is only a function of biological translocation.

  3. 3.

    Alpha particles, beta particles, and monoenergetic electrons (Auger and conversion electrons) are considered weakly penetrating due to their short tissue ranges

  4. 4.

    Photons (X-rays, γ-rays) are considered penetrating radiations.

  5. 5.

    S-values can be usefully defined in several ways. MIRD Pamphlet 21 defines the S-value as the absorbed dose rate per unit activity in the specified source region. Due to the stochastic nature of decay and dose deposition, all interpretations should consider the S-value to be a mean value averaged over many interactions.

  6. 6.

    In dosimetry calculations, the rest of body represents a combination of all other tissues, in which the activity is assumed to be uniformly distributed. Tissues without pronounced uptake are often considered collectively as “rest of body” tissues, as it is impractical to segment (via imaging) or harvest (for ex vivo counting) every individual tissue.

  7. 7.

    Theranostics are discussed in detail in Chap. 22.

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Authors and Affiliations

  1. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Lukas M. Carter & Adam L. Kesner

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  1. Lukas M. Carter
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  2. Adam L. Kesner
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Correspondence to Adam L. Kesner .

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Editors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Lisa Bodei

  2. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jason S. Lewis

  3. Hunter College - CUNY, New York, NY, USA

    Brian M. Zeglis

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Carter, L.M., Kesner, A.L. (2023). Dosimetry in Radiopharmaceutical Therapy. In: Bodei, L., Lewis, J.S., Zeglis, B.M. (eds) Radiopharmaceutical Therapy. Springer, Cham. https://doi.org/10.1007/978-3-031-39005-0_8

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  • DOI: https://doi.org/10.1007/978-3-031-39005-0_8

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