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EANM Dosimetry Committee guidelines for bone marrow and whole-body dosimetry

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Abstract

Introduction

The level of administered activity in radionuclide therapy is often limited by haematological toxicity resulting from the absorbed dose delivered to the bone marrow. The purpose of these EANM guidelines is to provide advice to scientists and clinicians on data acquisition and data analysis related to bone-marrow and whole-body dosimetry.

Materials and methods

The guidelines are divided into sections “Data acquisition” and “Data analysis”. The Data acquisition section provides advice on the measurements required for accurate dosimetry including blood samples, quantitative imaging and/or whole-body measurements with a single probe. Issues specific to given radiopharmaceuticals are considered. The Data analysis section provides advice on the calculation of absorbed doses to the whole body and the bone marrow. The total absorbed dose to the bone marrow consists of contributions from activity in the bone marrow itself (self-absorbed dose) and the cross-absorbed dose to the bone marrow from activity in bone, larger organs and the remainder of the body.

Conclusion

As radionuclide therapy enters an era where patient-specific dosimetry is used to guide treatments, accurate bone-marrow and whole-body dosimetry will become an essential element of treatment planning. We hope that these guidelines will provide a basis for the optimization and standardization of the treatment of cancer with radiopharmaceuticals, which will facilitate single- and multi-centre radionuclide therapy studies.

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Acknowledgments

This work was developed under the close supervision of the Dosimetry Committee of the EANM (M. Bardiès, C. Chiesa, G. Flux, M. Konijnenberg, M. Lassmann, M. Monsieurs, S.-E. Strand). In addition, the authors wish to acknowledge the contribution from S. Savolainen, past member of the EANM Dosimetry Committee.

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Authors and Affiliations

  1. Imagerie Médicale, ONIRIS - Ecole Nationale Vétérinaire, Agroalimentaire et d’Alimentation Nantes Atlantique, Atlanpole, La Chantrerie, BP 40706, 44307 CEDEX 3, Nantes, France

    Cecilia Hindorf

  2. Klinik für Nuklearmedizin, Universität Ulm, Ulm, Germany

    Gerhard Glatting

  3. Nuclear Medicine Division, Foundation IRCCS Istituto Nazionale Tumori, Milano, Italy

    Carlo Chiesa

  4. Department of Oncology, Lund University Hospital, Lund, Sweden

    Ola Lindén

  5. Joint Department of Physics, Royal Marsden Hospital & Institute of Cancer Research, London, UK

    Glenn Flux

Authors
  1. Cecilia Hindorf
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  2. Gerhard Glatting
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  3. Carlo Chiesa
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  4. Ola Lindén
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  5. Glenn Flux
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Corresponding author

Correspondence to Cecilia Hindorf.

Additional information

These guidelines summarize the views of the Dosimetry Committee of the EANM and reflects recommendation for which the EANM cannot be held responsible. The guidelines have been reviewed by the EANM Radionuclide Therapy Committee and the EANM Physics Committee and they have been brought to the attention of the National Societies of Nuclear Medicine. The recommendations should be taken in the context of good practice of nuclear medicine and do not substitute for national and international legal or regulatory provisions.

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Hindorf, C., Glatting, G., Chiesa, C. et al. EANM Dosimetry Committee guidelines for bone marrow and whole-body dosimetry. Eur J Nucl Med Mol Imaging 37, 1238–1250 (2010). https://doi.org/10.1007/s00259-010-1422-4

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