Radiation Dosimetry Considerations of Locoregional Radionuclide Cancer Therapy

Wong, Franklin C. L.; Sparks, Richard B.

doi:10.1007/978-3-030-56267-0_6

Franklin C. L. Wong² &
Richard B. Sparks³

348 Accesses

Abstract

Radiation dosimetry allows for the estimation of potential efficacy and toxicity in locoregional radionuclide cancer therapy (LRCT). In order to evaluate and compare candidate radiopharmaceuticals, models that encompass the range of expected activity distributions in the tumor were examined to estimate the radiation-absorbed doses to tumor and to the tissues surrounding the tumor as a function of depth. These models were executed for the clinically relevant tumor/source volumes, and Monte Carlo radiation transport simulations were performed with 23 radionuclides that are commercially available and relevant in theranostics. This allows for the comparison of tumor dosimetry and depth dosimetry of the various available radionuclides to aid the clinician in the selection of the most appropriate nuclide for specific locoregional therapy cases. Empirical modeling of the volume-normalized results was also performed in order to provide the clinician with simple tools to quickly compare and evaluate the use of different radionuclides. Utility of these models is illustrated by providing an example of their use in an animal case utilizing LRCT.

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Patient-Specific Dosimetry, Radiobiology, and the Previously-Treated Patient

Simplified Methods of Dosimetry

Dosimetry in Radiopharmaceutical Therapy

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Authors and Affiliations

Department of Nuclear Medicine, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
Franklin C. L. Wong
CDE Dosimetry Services, Inc., Knoxville, TN, USA
Richard B. Sparks

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Franklin C. L. Wong
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Richard B. Sparks
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Correspondence to Franklin C. L. Wong .

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Department of Nuclear Medicine, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
Franklin C.L. Wong

Appendices

Appendix I Target dose (cGy/mCi) of Five-Sphere (0.4–250 ml) Model of 23 Radionuclides

Sph Vol in ml.
	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	6a-67	Tl-201	ln-111	Y-90	Sm-153	Ho-156	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga68	Cu-62	Rb-82
0.40	240000.0	3900000.0	12000000.0	260000.0	165000.0	100000.0	198000.0	55000.0	22700.0	24900.0	19900.0	260000.0	86700.0	98500.0	64400.0	11000.0	25000.0	768.0	6600.0	3260.0	4160.0	750.0	99.1
2.00	51000.0	880000.0	290000.0	54291.8	34400.0	25000.0	42282.5	13000.0	4756.0	5100.0	4460.5	66000.0	17977.0	22903.9	15499.8	2300.0	7700.0	164.0	1500.0	697.2	1012.1	210.0	28.7
10.00	12000.0	190000.0	63000.0	11350.7	699.0	6000.0	8794.7	3000.0	1006.3	1060.0	1044.6	15000.0	3684.9	4995.4	3434.6	480.0	2100.0	36.2	320.0	150.0	227.9	51.0	7.2
50.00	2700.0	40000.0	13000.0	2400.0	14100	1400.0	1800.0	730.0	220.0	220.0	260.0	3200.0	750.0	1000.0	730.0	99.0	500.0	8.3	70.0	33.0	50.0	11.0	1.6
250.00	640.0	8100.0	2700.0	520.0	287.0	340.0	360.0	190.0	50.0	49.0	67.0	670.0	150.0	220.0	150.0	21.0	120.0	2.1	16.0	7.5	11.0	25	0.4

Appendix II Fractional Depth dose of 23 Radionuclides in the 2 ml Sphere Model

Appendix III Target dose (cGy/mCi) of Five-Shell Model (Core of 0.4–250 ml) of 23 Radionuclides

Shell Model	core vol mL	Dist. (cm)	Rb-82	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	Ga-67	Tl-201	In-111	Y-90	Sm-153	Ho-166	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga-68	Cu-62
Core(0.457 cm)	0.4	0	51	15000	1400000	490000	45000	19400	42000	53000	17000	1700	1200	2900	110000	15000	36000	26000	2100	13000	62	2200	710	1800	370
Source Shell	0.4	0.025	84	600000	4100000	1200000	490000	364000	99000	280000	72000	55000	63000	42000	230000	160000	110000	64000	20000	22000	1850	7600	5500	3800	630
Core(0.782 cm)	2	0	12	4900	240000	86000	5800	2070	8600	7500	3200	330	230	680	23000	1800	6400	4800	260	3500	15	360	100	330	84
Source Shell	2	0.05	24	100000	1100000	320000	100000	70600	27000	66000	18000	9900	11000	8200	64000	34000	27000	17000	4200	6400	333	1900	1200	1000	180
Core(1.336 cm)	10	0	3	1800	52000	19000	1400	450	2100	1600	900	99	67	230	5200	400	1400	1100	61	920	5	84	26	76	20
Source Shell	10	0.05	9	38000	380000	120000	37000	25400	9700	24000	6500	3600	4000	3000	23000	12000	9800	6100	1500	2300	121	700	440	380	65
Core(1.8128 cm)	50	0	1	580	11000	3900	360	98	540	330	260	31	21	76	1100	86	300	230	15	220	2	20	7	17	5
Source Shell	50	0.05	3	13000	140000	41000	13000	8970	3400	8400	2300	1300	1400	1100	8100	4300	3500	2100	540	830	43	250	160	130	23
Core(3.908 cm)	250	0	0	180	2200	810	96	22	140	69	80	10	7	26	230	19	62	47	4	53	1	5	2	4	1
Source Shell	250	0.05	1	4700	47000	14000	4500	3120	1200	2900	820	440	490	380	2800	1500	1200	740	190	290	15	87	55	46	8

Appendix IV Fractional Depth dose of 23 Radionuclides in the 2 ml Shell Model to 15 cm

Appendix V Ranges (cm) of for Five-Sphere Models, at <50% and 10% Residual Dose Rate and 10% Cumulative Dose

Vol (ml)	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	Ga-67	Tl-201	In-111	Y-90	Sm-153	Ho-166	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga-68	Cu-62	Rb-82
	range (cm) <50% dose rate
0.4	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.025	0.075	0.025	0.025	0.025	0.025	0.025	0.075
2	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05
10	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05
50	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.5	0.05	0.05	0.05	0.05
250	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05	0.05
	range (cm) <10% dose rate
0.4	0.025	0.125	0.175	0.075	0.075	0.225	0.075	0.1	0.025	0.025	0.075	0.225	0.075	0.175	0.175	0.075	0.4	0.025	0.125	0.075	0.175	0.3	0.3
2	0.05	0.15	0.15	0.15	0.05	0.25	0.15	0.14	0.05	0.05	0.15	0.25	0.05	0.15	0.25	0.15	0.45	0.05	0.15	0.15	0.25	0.35	0.35
10	0.25	0.15	0.15	0.15	0.05	0.35	0.15	0.35	0.05	0.05	0.45	0.25	0.15	0.25	0.25	0.15	0.45	0.15	0.15	0.15	0.25	0.35	0.35
50	0.65	0.15	0.25	0.15	0.05	0.45	0.15	0.95	0.15	0.05	1.25	0.25	0.15	0.25	0.25	0.15	0.55	0.75	0.25	0.25	0.25	0.35	0.45
250	1.25	0.15	0.25	0.15	0.05	1.25	0.15	2.25	0.95	0.35	2.75	0.25	0.15	0.25	0.25	0.15	0.75	2.25	0.35	0.95	0.35	0.45	0.45
	range (cm) <10% culmulative RAD
0.4	0.175	0.125	0.125	0.025	0.025	0.175	0.025	0.175	0.025	0.025	0.225	0.175	0.025	0.125	0.125	0.025	0.3	0.125	0.075	0.025	0.125	0.225	0.225
2	0.45	0.05	0.05	0.05	0	0.35	0.05	0.46	0.15	0.05	0.55	0.15	0.05	0.15	0.15	0.05	0.45	0.45	0.15	0.24	0.15	0.25	0.35
10	0.75	0.05	0.05	0.35	0	0.65	0.05	0.8	0.65	0.35	0.85	0.15	0.05	0.15	0.15	0.15	0.55	0.85	0.35	0.55	0.25	0.35	0.35
50	0.95	0.05	0.15	0.75	0.05	0.95	0.05	1.25	0.95	0.85	1.75	0.15	0.05	0.15	0.15	0.65	0.65	1.75	0.85	0.95	0.45	0.45	0.45
250	1.25	0.05	0.15	1.75	0.25	2.25	0.05	2.75	2.75	2.25	2.75	0.15	0.45	0.15	0.15	1.25	0.95	3.25	1.75	2.25	0.95	0.65	0.65

Appendix VI Ranges (cm) of for Five-Shell Models, at <50% and 10% Residual Dose Rate and 10% Cumulative Dose

Core Vol (ml)	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	Ga-67	Tl-201	In-111	Y-90	Sm-153	Ho-166	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga-68	Cu-62	Rb-82
	range(cm) <50% dose rate
0.4	0.075	0.075	0.125	0.075	0.075	0.125	0.075	0.075	0.075	0.075	0.075	0.075	0.075	0.075	0.075	0.075	0.125	0.075	0.075	0.075	0.075	0.125	0.125
2	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.15	0.25	0.15
10	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.15	0.25	0.25
50	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.25	0.25	0.25
250	0.15	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.15	0.25	0.15	0.15	0.15	0.25	0.25	0.25
	range(cm) <10% dose rate
0.4	0.075	0.225	0.225	0.125	0.125	0.3	0.175	0.175	0.075	0.075	0.125	0.3	0.125	0.225	0.3	0.125	0.5	0.075	0.175	0.125	0.3	0.4	0.4
2	0.25	0.35	0.35	0.25	0.15	0.35	0.25	0.25	0.15	0.15	0.15	0.45	0.25	0.35	0.35	0.25	0.65	0.15	0.25	0.25	0.35	0.45	0.55
10	0.15	0.35	0.35	0.25	0.15	0.45	0.25	0.25	0.15	0.15	0.25	0.45	0.25	0.35	0.45	0.25	0.75	0.15	0.25	0.25	0.35	0.55	0.55
50	0.15	0.35	0.35	0.25	0.15	0.45	0.25	0.35	0.15	0.15	0.25	0.45	0.25	0.35	0.35	0.25	0.75	0.15	0.35	0.25	0.45	0.55	0.65
250	0.15	0.35	0.35	0.25	0.15	0.45	0.25	0.35	0.15	0.15	0.25	0.45	0.25	0.35	0.35	0.15	0.75	0.15	0.15	0.25	0.45	0.55	0.65
	range (cm) <10% culuminative RAD
0.4	0.025	0.175	0.175	0.075	0.075	0.225	0.125	0.175	0.025	0.025	0.075	0.225	0.96	0.175	0.175	0.075	0.3	0.075	0.125	0.075	0.175	0.225	0.3
2	0.25	0.15	0.25	0.15	0.05	0.35	0.15	0.35	0.05	0.05	0.35	0.25	0.15	0.25	0.25	0.15	0.55	0.15	0.15	0.15	0.25	0.35	0.35
10	0.35	0.15	0.25	0.15	0.05	0.45	0.15	0.55	0.15	0.05	0.55	0.25	0.15	0.25	0.25	0.15	0.55	0.35	0.25	0.15	0.25	0.45	0.45
50	0.55	0.25	0.25	0.15	0.05	0.55	0.15	0.75	0.25	0.15	0.75	0.35	0.15	0.25	0.25	0.15	0.65	0.65	0.25	0.35	0.35	0.45	0.45
250	0.65	0.25	0.25	0.15	0.05	0.75	0.15	0.95	0.55	0.25	0.95	0.35	0.15	0.25	0.25	0.15	0.75	0.85	0.35	0.55	0.35	0.45	0.55

Appendix VII Statistically Significant Regression of Volume-Normalized S-Values of the Five-Sphere Model

A common two-parameter equation: y = a + b* lnx with valid statistics was found by SigmaPlot Table Curve 2D. The volume-normalized S-values can be reliably predicted based on the volume (X) of the sphere for each radionuclide

TC2D Fit	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	Ga-67	Tl-201	In-111	Y-90	Sm-153	Ho-166	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga-68	Cu-62	Rb-82
a	47.8	961.5	1087.8	381.2	290.5	312.7	630.6	208.4	81.8	36.1	84.9	1305.1	526.3	1111.1	1178.5	245.9	962.7	36.1	570.9	509.4	1139.2	1577.0	1600.9
Pa	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
b	4.8	41.6	57.9	14.2	3.5	47.2	12.8	33.7	4.6	3.7	13.7	104.3	6.6	56.9	73.5	6.9	225.0	3.7	40.7	32.9	100.5	206.9	245.2
Pb	0.00	0.01	0.02	0.00	0.01	0.00	0.02	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.00	0.00	0.01	0.00	0.00	0.00	0.00	0.00
rSq Coef	0.96	0.93	0.89	0.97	0.92	0.99	0.88	0.95	0.94	0.90	0.94	0.93	0.90	0.92	0.93	0.99	1.00	0.90	0.98	0.96	0.99	0.97	0.98
F value	78.57	37.57	24.23	100.57	35.34	362.87	21.06	52.84	43.86	27.39	44.53	40.65	27.25	36.42	37.37	266.12	981.46	27.39	131.56	79.77	326.76	92.18	127.54

Appendix VIII Statistically Significant Regression of Depth Dose fraction of the Five-Sphere Model

Empirical curve fitting with SigmaPlot Table Curve 3D found three sets of equations that could reliably predict the normalized S-values of the five-sphere model of the 23 radionuclides, based on the distance from the sphere (X) and the volume of the sphere (y)

T1/2P (hr)	1443.36	1212	342.24	192.96	161.04	100.32	90.64	78.48	78.26	73.1	67.92	64	46.7	26.8	16.98	12.7	9.49	6.01	3.41	1.83	1.13	0.16	0.02
TC3D Fit	I-125	Sr-89	P-32	I-131	Lu-177	I-124	Re-186	Zr-89	Ga-67	Tl-201	In-111	Y-90	Sm-153	Ho-166	Re-188	Cu-64	Ga-66	Tc-99m	Cu-61	F-18	Ga-68	Cu-62	Rb-82
TC3D Eq#	82	2160	2160	82	82	82	2160	82	82	82	82	2160	83	2160	2160	82	82	82	82	82	82	83	83
A	0.024	−0.203	−0.227	0.013	0.005	0.012	−0.155	0.040	0.013	0.008	0.033	−0.293	−0.006	−0.214	−0.239	0.012	0.083	0.020	0.028	0.019	0.041	0.008	0.013
P	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.01	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
b	0.013	0.256	0.285	0.006	0.001	0.005	0.196	0.019	0.011	0.007	0.020	0.366	0.001	0.272	0.302	0.005	0.006	0.017	0.007	0.011	0.004	0.003	0.003
P	0.00	0.00	0.00	0.00	0.04	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.05	0.00	0.00
c	−0.031	−0.059	−0.056	−0.017	−0.006	−0.016	−0.068	−0.048	−0.019	−0.013	−0.042	−0.049	−0.010	−0.058	−0.054	−0.016	−0.071	−0.029	−0.032	−0.026	−0.041	−0.053	−0.057
P	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
d	−0.00004			−0.00002	−0.00001	−0.00002		−0.00007	−0.00003	−0.00002	−0.00006		0.00678			−0.00002	−0.00010	−0.00004	−0.00004	−0.00004	−0.00006	0.02452	0.02502
P	0.00			0.00	0.00	0.00		0.00	0.00	0.00	0.00		0.00			0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
e													0.00001									0.00004	0.00004
P													0.00									0.00	0.00
*rSq*	*0.98*	*0.89*	*0.88*	*0.99*	*1.00*	*0.99*	*0.92*	*0.96*	*0.99*	*0.99*	*0.97*	*0.85*	*1.00*	*0.89*	*0.87*	*0.99*	*0.93*	*0.98*	*0.96*	*0.98*	*0.94*	*0.99*	*0.99*
*F Value*	*1812*	*538*	*474*	*3772*	*10275*	*3492*	*770*	*1039*	*3829*	*7826*	*1217*	*369*	*8347*	*511*	*441*	*3492*	*583*	*1710*	*1093*	*2132*	*652*	*4934*	*5196*
Eqn 83 z=a+blnx+clny+d(lny)2+e(lny)3				rSq >0.99
Eqn 82 z=a+blnx+clny+d(lny)2				rSq >0.93
Eqn 2160 z=a+POWX(b,c)^*POWY(1,c)				rSq>0.85

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Wong, F.C.L., Sparks, R.B. (2021). Radiation Dosimetry Considerations of Locoregional Radionuclide Cancer Therapy. In: Wong, F.C. (eds) Locoregional Radionuclide Cancer Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-56267-0_6

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DOI: https://doi.org/10.1007/978-3-030-56267-0_6
Published: 09 December 2020
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-56266-3
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Radiation Dosimetry Considerations of Locoregional Radionuclide Cancer Therapy

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