124I PET-Based 3D-RD Dosimetry for a Pediatric Thyroid Cancer Patient: Real-Time Treatment Planning and Methodologic Comparison
124I PET-Based 3D-RD Dosimetry for a Pediatric Thyroid Cancer Patient: Real-Time Treatment Planning and Methodologic Comparison
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DOI：
10.2967/jnumed.109.066738
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发表时间：
2009-11-01
影响因子：
9.3
通讯作者：
Sgouros, George
中科院分区：
文献类型：
--
作者：
Hobbs, Robert F.;Wahl, Richard L.;Sgouros, George
我们采用患者特异性三维放射生物学剂量法（3D-RD）对一名11岁女孩分化型乳头状甲状腺癌、严重肺部累及脑转移进行I-131治疗计划。采用I-124 PET进行药代动力学研究。基于肺毒性约束的推荐给药活度的计算是实时进行的（即在数据采集间隔期间）。结果及时提供给医生，以影响治疗；这些估计值与传统剂量学方法进行了比较。在随后的回顾性分析中，将3D-RD计算扩展到包括额外的肿瘤剂量估计，并重新检查传统方法以揭示所观察到的差异的原因。与基于s值的方法相比，获得了更高的推荐给药活性和良好的临床结果。这种方法允许更积极的治疗，同时坚持患者特异性肺毒性限制。对传统方法进行回顾性分析并进行适当修正，得出与3D-RD一致的吸收剂量估计。
Patient-specific 3-dimensional radiobiologic dosimetry (3D-RD) was used for I-131 treatment planning for an 11-y-old girl with differentiated papillary thyroid cancer, heavy lung involvement, and cerebral metastases. I-124 PET was used for pharmacokinetics. Calculation of the recommended administered activity, based on lung toxicity constraints, was performed in real time (i.e., during the data-acquisition interval). The results were available to the physician in time to influence treatment; these estimates were compared with conventional dosimetry methodologies. In subsequent, retrospective analyses, the 3D-RD calculations were expanded to include additional tumor dose estimates, and the conventional methodologies were reexamined to reveal the causes of the differences observed. A higher recommended administered activity than by an S-value-based method with a favorable clinical outcome was obtained. This approach permitted more aggressive treatment while adhering to patient-specific lung toxicity constraints. A retrospective analysis of the conventional methodologies with appropriate corrections yielded absorbed dose estimates consistent with 3D-RD.