Invited Resubmission: Improved Organ Dose Determination and Imaging in 177Lu Targeted Radionuclide Therapy - towards a clinical solution.

点击翻译按钮获取中文摘要

With this grant we will develop a far more accurate way of processing medical images from patients receiving cancer therapy using radioactive materials that target their tumours, known as Targeted Radionuclide Therapy (TRT). These images, taken using a hospital SPECT (Single Photon Emission Computed Tomography) scanner, are typically quite blurry and it is often difficult to distinguish tumours from normal healthy tissue. Based on our previous findings, by modelling the SPECT scanner system on a computer we will create a range of corrections that improve the accuracy of the information from these images. Our collaboration has successfully shown that we can significantly improve this accuracy for a variety of simple models representing the human body. We now wish to use this work as the basis of an advanced technique which will provide the same improvements for data from more detailed models of the human body and ultimately for actual patients receiving cancer therapy. This information will be used to provide doctors with an accurate measurement of the radiation dose delivered to the tumours and critical organs in the patient's body.Using current commercial SPECT images, the uncertainties in dose estimation do not allow treatments to be optimised and consequently a significant proportion of patients do not receive the optimal therapy. Identification of these patients is problematic due to the current low accuracy of dose measurements. Having this improved dose information will help doctors to improve their therapies, potentially reducing side effects and hospital stays. This will improve the patients' therapy experience and also improve the efficacy of the therapies by allowing the doctors to optimise the treatment for each patient. Only by improving the accuracy of the images obtained from the SPECT scanner can we provide this information. Accurate dose information is considered very important in countries across Europe. Legislation is currently being written recommending accurate dosimetry for every patient receiving Targeted Radionuclide Therapy treatment. Our research will concentrate on improving the dose information for therapies using the isotope 177Lu. Recent work has shown that new treatments using this isotope can improve a patient's life expectancy by several years compared with other therapies, particularly for tumours affecting the hormonal and nervous systems. Our research will provide the basis for developing a commercial solution that will allow the techniques developed from this grant to be used in clinical departments performing cancer therapy with 177Lu. However, it can be extended to cover the complete range of isotopes commonly used for therapy and for images from different models of SPECT scanner. We have already approached two commercial companies who are interested in helping bring this research to market. This has the potential to provide a significant improvement in the outcome of an estimated 201,000 such therapies performed annually in Europe.