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Practice Guideline
. 2013 Dec;54(12):2182-8.
doi: 10.2967/jnumed.113.122390. Epub 2013 Oct 15.

MIRD pamphlet No. 24: Guidelines for quantitative 131I SPECT in dosimetry applications

Yuni K Dewaraja  1 , Michael Ljungberg, Alan J Green, Pat B Zanzonico, Eric C Frey; SNMMI MIRD Committee; Wesley E Bolch, A Bertrand Brill, Mark Dunphy, Darrell R Fisher, Roger W Howell, Ruby F Meredith, George Sgouros, Barry W Wessels
Affiliations
Practice Guideline

MIRD pamphlet No. 24: Guidelines for quantitative 131I SPECT in dosimetry applications

Yuni K Dewaraja et al. J Nucl Med. 2013 Dec.

Abstract

The reliability of radiation dose estimates in internal radionuclide therapy is directly related to the accuracy of activity estimates obtained at each imaging time point. The recently published MIRD pamphlet no. 23 provided a general overview of quantitative SPECT imaging for dosimetry. The present document is the first in a series of isotope-specific guidelines that will follow MIRD 23 and focuses on one of the most commonly used therapeutic radionuclides, (131)I. The purpose of this document is to provide guidance on the development of protocols for quantitative (131)I SPECT in radionuclide therapy applications that require regional (normal organs, lesions) and 3-dimensional dosimetry.

Keywords: 131I; MIRD; SPECT/CT, dosimetry; quantitative SPECT.

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Conflict of interest statement

DISCLOSURE

No other potential conflict of interest relevant to this article was reported.

Figures

FIGURE 1
FIGURE 1
Images corresponding to 131I pointlike source measured in air at 20 cm with medium-energy (left) and high-energy (right) collimators. Images are shown on a logarithmic gray scale (individually normalized). System planar sensitivities for a 364-keV window were 319 cps/MBq for the medium-energy collimator and 82 cps/MBq for the high-energy collimator, but the fraction of unwanted penetration and scatter events was much higher with the medium-energy collimator than with the high-energy collimator, 85% versus 49%, based on Monte Carlo simulation.
FIGURE 2
FIGURE 2
Energy spectrum corresponding to a radioimmunotherapy patient imaged 2 d after administration of 2.8 GBq of 131I. Windows for TEW (310–332 keV and 405–427 keV) are shown by dashed lines, and the trapezoidal scatter estimate is indicated in the 332–405 keV photopeak window.
FIGURE 3
FIGURE 3
Measurement of RCs discussed in patient example 1. (A) Phantom set-up. (B) SPECT/CT image. (C) RC as function of OSEM iteration number. (D) RC as function of volume at 35 iterations. RCs that were determined with commercial OSEM reconstruction are also shown.
FIGURE 4
FIGURE 4
SPECT/CT imaging based tumor dosimetry in a non-Hodgkin lymphoma patient undergoing 131I radioimmunotherapy. (A) Inguinal tumor outline shown on superimposed SPECT/CT images. Tumor volumes at the 3 time points were 77, 63, and 39 mL. (B) Tumor time–activity curves. (C) Tumor-absorbed dose map, showing isodose contours in units of cGy. (D) Tumor dose–volume histogram.
FIGURE 5
FIGURE 5
SPECT/CT imaging–based biodistribution measurement in sarcoma patient undergoing radioimmunotherapy with 131I-L19SIP. (A) SPECT/CT images of upper thorax, with tumor indicated by arrows. (B) Time–activity concentration curves for tumor and normal organs.
See this image and copyright information in PMC

References

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