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Toxicity to hematopoietically active bone marrow is a primary limitation of radionuclide therapy. Accurate patient-specific skeletal dosimetry is crucial to avoiding marrow toxicity and tumor underdosing. In current assessments of skeletal dose, deposition of particle energy is tracked within an infinite extent of trabecular spongiosa, with no allowance for particle escape to cortical bone. Paired-image radiation transport (shown here in a model constructed for the right proximal femur) provides a more realistic 3-dimensional geometry for particle transport at both macroscopic and microscopic levels of the skeletal site.

SEE PAGE 348.