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First published online October 16, 2009, 10.2967/jnumed.109.066738
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Journal of Nuclear Medicine Vol. 50 No. 11 1844-1847
© 2009 by Society of Nuclear Medicine
doi: 10.2967/jnumed.109.066738

Basic Science Investigation

124I PET-Based 3D-RD Dosimetry for a Pediatric Thyroid Cancer Patient: Real-Time Treatment Planning and Methodologic Comparison

Robert F. Hobbs1, Richard L. Wahl1, Martin A. Lodge1, Mehrbod S. Javadi1, Steve Y. Cho1, David T. Chien1, Marge E. Ewertz2, Caroline E. Esaias1, Paul W. Ladenson2 and George Sgouros1

1 Department of Radiology, Johns Hopkins University, Baltimore Maryland; and 2 Department of Endocrinology, Johns Hopkins University, Baltimore, Maryland

Correspondence: For correspondence or reprints contact: George Sgouros, Department of Radiology, Johns Hopkins University, School of Medicine, CRB II 4M.61, 1550 Orleans St., Baltimore, MD 21231. E-mail: gsgouros{at}jhmi.edu

Patient-specific 3-dimensional radiobiologic dosimetry (3D-RD) was used for 131I treatment planning for an 11-y-old girl with differentiated papillary thyroid cancer, heavy lung involvement, and cerebral metastases. 124I 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.

Key Words: oncology • radiobiology/dosimetry • radionuclide therapy • 3D-RD • dosimetry • PET • thyroid • treatment planning

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.


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