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. 2021 Oct;48(11):3365-3377.
doi: 10.1007/s00259-021-05345-9. Epub 2021 Apr 29.

EANM position paper on the role of radiobiology in nuclear medicine

An Aerts  1 , Uta Eberlein  2 , Sören Holm  3 , Roland Hustinx  4 , Mark Konijnenberg  5 , Lidia Strigari  6 , Fijs W B van Leeuwen  7 , Gerhard Glatting  8 , Michael Lassmann  9
Affiliations

EANM position paper on the role of radiobiology in nuclear medicine

An Aerts et al. Eur J Nucl Med Mol Imaging. 2021 Oct.

Abstract

With an increasing variety of radiopharmaceuticals for diagnostic or therapeutic nuclear medicine as valuable diagnostic or treatment option, radiobiology plays an important role in supporting optimizations. This comprises particularly safety and efficacy of radionuclide therapies, specifically tailored to each patient. As absorbed dose rates and absorbed dose distributions in space and time are very different between external irradiation and systemic radionuclide exposure, distinct radiation-induced biological responses are expected in nuclear medicine, which need to be explored. This calls for a dedicated nuclear medicine radiobiology. Radiobiology findings and absorbed dose measurements will enable an improved estimation and prediction of efficacy and adverse effects. Moreover, a better understanding on the fundamental biological mechanisms underlying tumor and normal tissue responses will help to identify predictive and prognostic biomarkers as well as biomarkers for treatment follow-up. In addition, radiobiology can form the basis for the development of radiosensitizing strategies and radioprotectant agents. Thus, EANM believes that, beyond in vitro and preclinical evaluations, radiobiology will bring important added value to clinical studies and to clinical teams. Therefore, EANM strongly supports active collaboration between radiochemists, radiopharmacists, radiobiologists, medical physicists, and physicians to foster research toward precision nuclear medicine.

Keywords: Biodosimetry; Biomarkers; Dosimetry; Radiobiology; Radionuclide therapy.

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Conflict of interest statement

M.L. has received research grants by IPSEN Pharma and Nordic Nanovector. A.A., G.G., M.K., S.H., R.H, and F.v.L. have no conflicts of interest to declare that are relevant to the content of this article. U.E., L.S. and R.H. have no conflicts of interest to declare. M.L. and R.H. are members of the EANM board. The other authors are members of the following EANM committees: Radiation Protection (G.G., S.H.); Dosimetry (U.E., M.K., L.S.); Translational Molecular Imaging & Therapy (A.A., F.v.L.).

Figures

Fig. 1
Fig. 1
Interaction of ionizing radiation with cellular matter, DNA, and much more. DNA and other cell elements as potential targets for ionizing radiation damage. Ionizing radiation also impacts cell signaling pathways like oxidative stress, cell death and survival pathways, premature aging, and inflammation, all of which moreover are highly interconnected. Also, aspects beyond the cellular boundaries must be considered, like intercellular communication, the tumor microenvironment, the immune system, and the abscopal effect. Image created using BioRender.com
Fig. 2
Fig. 2
Contributions of radiobiology to nuclear medicine. Radiobiology helps to understand patient- and tumor-specific radiosensitivities. In addition, radiobiology is fundamental to a mechanistic understanding of the therapeutic capacity of nuclear medicine agents and their potential short- and long-term toxicities, including the dose–effect relationships herein. Biological data will serve as input for dosimetry, together leading to a more accurate estimation of efficacy and adverse effects. Ideally, this will lead to patient-specific dosing schemes. Moreover, further fundamental knowledge about the biological mechanisms underlying tumor and healthy tissue responses will help in identifying predictive and prognostic biomarkers as well as biomarkers for treatment follow-up. In addition, it can form the basis for the development of combination therapies, including radiosensitizing and radioprotectant strategies. Image created using BioRender.com
See this image and copyright information in PMC

References

    1. Eberlein U, Bröer JH, Vandevoorde C, Santos P, Bardiès M, Bacher K, et al. Biokinetics and dosimetry of commonly used radiopharmaceuticals in diagnostic nuclear medicine – a review. Eur J Nucl Med Mol Imaging. 2011;38:2269–2281. doi: 10.1007/s00259-011-1904-z. - DOI - PMC - PubMed
    1. Chawla SC, Federman N, Zhang D, Nagata K, Nuthakki S, McNitt-Gray M, et al. Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review. Pediatr Radiol. 2010;40:681–686. doi: 10.1007/s00247-009-1434-z. - DOI - PMC - PubMed
    1. Bodei L, Mueller-Brand J, Baum RP, Pavel ME, Hörsch D, O'Dorisio MS, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2013;40:800–816. doi: 10.1007/s00259-012-2330-6. - DOI - PMC - PubMed
    1. Strigari L, Konijnenberg M, Chiesa C, Bardies M, Du Y, Gleisner KS, et al. The evidence base for the use of internal dosimetry in the clinical practice of molecular radiotherapy. Eur J Nucl Med Mol Imaging. 2014;41:1976–1988. doi: 10.1007/s00259-014-2824-5. - DOI - PubMed
    1. Jia X, Guo K, Gao R, Yu Y, Yang A. Radiosensitivity-related postirradiation hypothyroidism in Graves’ disease patients. Hormones (Athens) 2019;18:267–272. doi: 10.1007/s42000-019-00123-7. - DOI - PubMed