Personalized Dosimetry in the Context of Radioiodine Therapy for Differentiated Thyroid Cancer

Pacilio, Massimiliano; Conte, Miriam; Frantellizzi, Viviana; Feo, Maria Silvia De; Pisani, Antonio; Marongiu, Andrea; Nuvoli, Susanna; Rubini, Giuseppe; Spanu, Angela; Vincentis, Giuseppe De

doi:10.3390/diagnostics12071763

Cited by 12 publications

(7 citation statements)

References 141 publications

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“…There is an inherent risk of problems with diagnostic tests, such as hemorrhage, infection, and injury to adjacent structures ( 29 ). These hazards include imaging examinations, surgical treatments, and fine-needle aspiration (FNA) biopsies ( 30 ). Furthermore, radiation induced malfunction of the salivary glands and its long-term repercussions are possible side effects and problems of radioactive iodine ablation, a popular postoperative treatment for thyroid cancer ( 31 ).…”

Section: Overview Of Thyroid Cancermentioning

confidence: 99%

Advances in targeted therapy and biomarker research in thyroid cancer

Guo,

Sun,

Wei

et al. 2024

Front. Endocrinol.

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Driven by the intricacy of the illness and the need for individualized treatments, targeted therapy and biomarker research in thyroid cancer represent an important frontier in oncology. The variety of genetic changes associated with thyroid cancer demand more investigation to elucidate molecular details. This research is clinically significant since it can be used to develop customized treatment plans. A more focused approach is provided by targeted therapies, which target certain molecular targets such as mutant BRAF or RET proteins. This strategy minimizes collateral harm to healthy tissues and may also reduce adverse effects. Simultaneously, patient categorization based on molecular profiles is made possible by biomarker exploration, which allows for customized therapy regimens and maximizes therapeutic results. The benefits of targeted therapy and biomarker research go beyond their immediate clinical impact to encompass the whole cancer landscape. Comprehending the genetic underpinnings of thyroid cancer facilitates the creation of novel treatments that specifically target aberrant molecules. This advances the treatment of thyroid cancer and advances precision medicine, paving the way for the treatment of other cancers. Taken simply, more study on thyroid cancer is promising for better patient care. The concepts discovered during this investigation have the potential to completely transform the way that care is provided, bringing in a new era of personalized, precision medicine. This paradigm shift could improve the prognosis and quality of life for individuals with thyroid cancer and act as an inspiration for advances in other cancer types.

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Section: Overview Of Thyroid Cancermentioning

confidence: 99%

Advances in targeted therapy and biomarker research in thyroid cancer

Guo,

Sun,

Wei

et al. 2024

Front. Endocrinol.

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“…that of Benua and Leeper, in which absorbed dose limits to the bone marrow (2 Gy) and to the lung (30 Gy) are imposed. These limits have been deemed equivalent to a whole-body activity retention on the 48 h whole-body planar scan of 4.4 or 3.0 GBq, in the absence or presence of diffuse lung metastases, respectively [34,35]. Prospective results using this or other approaches have not been reported yet, to our knowledge.…”

Section: Of Thyroid Cancermentioning

confidence: 99%

Use of imaging-based dosimetry for personalising radiopharmaceutical therapy of cancer

Beauregard

2022

Cancer Imaging

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Theranostics – i.e., the combination of molecular imaging and radiopharmaceutical therapy of cancer targeting a common biological feature – is a rapidly expanding field owing the recent successes of novel radiopharmaceutical therapies, such as 177Lu-based prostate-specific membrane antigen radioligand therapy of prostate cancer and peptide receptor radionuclide therapy of neuroendocrine tumours. Despite the ongoing technical developments in imaging-based dosimetry, the existence of tumour absorbed dose-efficacy and organ absorbed dose-toxicity relationships, as well as the high interpatient variability in absorbed doses per unit activity, radiopharmaceutical therapies are still mostly administered in a fixed-activity, one-size-fits-all fashion. This is at odds with the principles of radiation oncology, where the absorbed doses to tissues are prescribed and their delivery is carefully planned and controlled for each individual patient to maximise the clinical benefits. There is a growing body of clinical evidence that dosimetry-based radiopharmaceutical therapy allows to safely optimise tumour irradiation, which translates into improved clinical outcomes. In this narrative review, we will present the reported prospective clinical experience to date on the use of imaging-based dosimetry to personalise radiopharmaceutical therapies.

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“…Over half of its emissions are γ rays, which have energies of 603 keV (61%), 511 keV (46%), and 1691 keV (11%), and energies of its β + emissions are high and long-range (11%, E max = 2138 keV) . The coincidences between the γ-ray and one or both annihilation photons are necessary to accurate quantitative imaging. − Hence, the surrogacy of another useful theranostic pair 123 I (83.3%, E γ = 159 keV)was investigated and led to the establishment of the 123 I SPECT image-based dosimetry method for DTC treatment, , despite its relatively short half-life (13 h) and limited availability …”

Section: Introductionmentioning

confidence: 99%

Theranostic Surrogacy of [¹²³I]NaI for Differentiated Thyroid Cancer Radionuclide Therapy

et al. 2023

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Precise dosimetry has gained interest for interpreting the response assessments of novel therapeutic radiopharmaceuticals, as well as for improving conventional radiotherapies such as the "one dose fits all" approach. Although radioiodine as sameelement isotope theranostic pairs has been used for differentiated thyroid cancer (DTC), there are insufficient studies on the determination of its dosing regimen for personalized medicine and on extrapolating strategies for companion diagnostic radiopharmaceuticals. In this study, DTC xenograft mouse models were generated after validating iodine uptakes via sodium iodine symporter proteins (NIS) through in vitro assays, and theranostic surrogacy of companion radiopharmaceuticals was investigated in terms of single photon emission computed tomography (SPECT) imaging and voxel-level dosimetry. Following a Monte Carlo simulation, the hypothetical energy deposition/dose distribution images were produced as [ 123 I]NaI SPECT scans with the use of 131 I ion source simulation, and dose rate curves were used to estimate absorbed dose. For the tumor, a peak concentration of 96.49 ± 11.66% ID/g occurred 2.91 ± 0.42 h after [ 123 I]NaI injection, and absorbed dose for 131 I therapy was estimated as 0.0344 ± 0.0088 Gy/MBq. The absorbed dose in target/off-target tissues was estimated by considering subject-specific heterogeneous tissue compositions and activity distributions. Furthermore, a novel approach was proposed for simplifying voxel-level dosimetry and suggested for determining the minimal/optimal scan time points of surrogates for pretherapeutic dosimetry. When two scan time points were set to T max and 26 h and the group mean half-lives were applied to the dose rate curves, the most accurate absorbed dose estimates were determined [−22.96, 2.21%]. This study provided an experimental basis to evaluate dose distribution and is expected hopefully to improve the challenging dosimetry process for clinical use.

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Personalized Dosimetry in the Context of Radioiodine Therapy for Differentiated Thyroid Cancer

Cited by 12 publications

References 141 publications

Advances in targeted therapy and biomarker research in thyroid cancer

Advances in targeted therapy and biomarker research in thyroid cancer

Use of imaging-based dosimetry for personalising radiopharmaceutical therapy of cancer

Theranostic Surrogacy of [¹²³I]NaI for Differentiated Thyroid Cancer Radionuclide Therapy

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Personalized Dosimetry in the Context of Radioiodine Therapy for Differentiated Thyroid Cancer

Cited by 12 publications

References 141 publications

Advances in targeted therapy and biomarker research in thyroid cancer

Advances in targeted therapy and biomarker research in thyroid cancer

Use of imaging-based dosimetry for personalising radiopharmaceutical therapy of cancer

Theranostic Surrogacy of [123I]NaI for Differentiated Thyroid Cancer Radionuclide Therapy

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Product

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Theranostic Surrogacy of [¹²³I]NaI for Differentiated Thyroid Cancer Radionuclide Therapy