@article {Buckley1518, author = {Susan E. Buckley and Sarah J. Chittenden and Frank H. Saran and Simon T. Meller and Glenn D. Flux}, title = {Whole-Body Dosimetry for Individualized Treatment Planning of 131I-MIBG Radionuclide Therapy for Neuroblastoma}, volume = {50}, number = {9}, pages = {1518--1524}, year = {2009}, doi = {10.2967/jnumed.109.064469}, publisher = {Society of Nuclear Medicine}, abstract = {The aims of this study were to examine the relationship between whole-body absorbed dose and hematologic toxicity and to assess the most accurate method of delivering a prescribed whole-body absorbed dose in 131I-metaiodobenzylguanidine (131I-MIBG) therapy for neuroblastoma. Methods: A total of 20 children (1{\textendash}12 y), 5 adolescents (13{\textendash}17 y), and 1 adult (20 y) with stage 3 or 4 neuroblastoma were treated to a prescribed whole-body absorbed dose, which in most cases was 2 Gy. Forty-eight administrations of 131I-MIBG were given to the 26 patients, ranging in activity from 1,759 to 32,871 MBq. For 30 administrations, sufficient data were available to assess the effect of whole-body absorbed dose on hematologic toxicity. Comparisons were made between the accuracy with which a whole-body absorbed dose could be predicted using a pretherapy tracer study and the patient{\textquoteright}s most recent previous therapy. The whole-body absorbed dose that would have been delivered if the administered activity was fixed (7,400 MBq) or determined using a weight-based formula (444 MBq{\textperiodcentered}kg-1) was also estimated. Results: The mean whole-body absorbed dose for patients with grade 4 Common Terminology Criteria for Adverse Events (CTCAE) neutropenia after therapy was significantly higher than for those with grade 1 CTCAE neutropenia (1.63 vs. 0.90 Gy; P = 0.05). There was no correlation between administered activity and hematologic toxicity. Absorbed whole-body doses predicted from previous therapies were within {\textpm}10\% for 70\% of the cases. Fixed-activity administrations gave the largest range in whole-body absorbed dose (0.30{\textendash}3.11 Gy). Conclusion: The results indicate that even in a highly heterogeneous and heavily pretreated patient population, a whole-body absorbed dose can be prescribed accurately and is a more accurate predictor of hematologic toxicity than is administered activity. Therefore, a whole-body absorbed dose can be used to deliver accurate and reproducible 131I-MIBG therapy on a patient-specific basis.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/50/9/1518}, eprint = {https://jnm.snmjournals.org/content/50/9/1518.full.pdf}, journal = {Journal of Nuclear Medicine} }