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Variations in the practice of molecular radiotherapy and implementation of dosimetry : results from a European survey

Sjögreen Gleisner, Katarina LU ; Spezi, Emiliano; Solny, Pavel; Gabina, Pablo Minguez LU ; Cicone, Francesco; Stokke, Caroline; Chiesa, Carlo; Paphiti, Maria; Brans, Boudewijn and Sandström, Mattias, et al. (2017) In EJNMMI Physics 4(1).
Abstract

Background: Currently, the implementation of dosimetry in molecular radiotherapy (MRT) is not well investigated, and in view of the Council Directive (2013/59/Euratom), there is a need to understand the current availability of dosimetry-based MRT in clinical practice and research studies. The aim of this study was to assess the current practice of MRT and dosimetry across European countries. Methods: An electronic questionnaire was distributed to European countries. This addressed 18 explicitly considered therapies, and for each therapy, a similar set of questions were included. Questions covered the number of patients and treatments during 2015, involvement of medical specialties and medical physicists, implementation of absorbed dose... (More)

Background: Currently, the implementation of dosimetry in molecular radiotherapy (MRT) is not well investigated, and in view of the Council Directive (2013/59/Euratom), there is a need to understand the current availability of dosimetry-based MRT in clinical practice and research studies. The aim of this study was to assess the current practice of MRT and dosimetry across European countries. Methods: An electronic questionnaire was distributed to European countries. This addressed 18 explicitly considered therapies, and for each therapy, a similar set of questions were included. Questions covered the number of patients and treatments during 2015, involvement of medical specialties and medical physicists, implementation of absorbed dose planning, post-therapy imaging and dosimetry, and the basis of therapy prescription. Results: Responses were obtained from 26 countries and 208 hospitals, administering in total 42,853 treatments. The most common therapies were 131I-NaI for benign thyroid diseases and thyroid ablation of adults. The involvement of a medical physicist (mean over all 18 therapies) was reported to be either minority or never by 32% of the responders. The percentage of responders that reported that dosimetry was included on an always/majority basis differed between the therapies and showed a median value of 36%. The highest percentages were obtained for 177Lu-PSMA therapy (100%), 90Y microspheres of glass (84%) and resin (82%), 131I-mIBG for neuroblastoma (59%), and 131I-NaI for benign thyroid diseases (54%). The majority of therapies were prescribed based on fixed-activity protocols. The highest number of absorbed-dose based prescriptions were reported for 90Y microsphere treatments in the liver (64% and 96% of responses for resin and glass, respectively), 131I-NaI treatment of benign thyroid diseases (38% of responses), and for 131I-mIBG treatment of neuroblastoma (18% of responses). Conclusions: There is a wide variation in MRT practice across Europe and for different therapies, including the extent of medical-physicist involvement and the implementation of dosimetry-guided treatments.

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keywords
Dosimetry, European survey, Molecular radiotherapy, Radionuclide therapy, Radiopharmaceutical therapy
in
EJNMMI Physics
volume
4
issue
1
publisher
Springer Open
external identifiers
  • scopus:85037365313
ISSN
2197-7364
DOI
10.1186/s40658-017-0193-4
language
English
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yes
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8d8e608b-0e65-4d99-94bb-c42ccce30732
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2018-01-11 14:10:25
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2018-04-22 04:34:53
@article{8d8e608b-0e65-4d99-94bb-c42ccce30732,
  abstract     = {<p>Background: Currently, the implementation of dosimetry in molecular radiotherapy (MRT) is not well investigated, and in view of the Council Directive (2013/59/Euratom), there is a need to understand the current availability of dosimetry-based MRT in clinical practice and research studies. The aim of this study was to assess the current practice of MRT and dosimetry across European countries. Methods: An electronic questionnaire was distributed to European countries. This addressed 18 explicitly considered therapies, and for each therapy, a similar set of questions were included. Questions covered the number of patients and treatments during 2015, involvement of medical specialties and medical physicists, implementation of absorbed dose planning, post-therapy imaging and dosimetry, and the basis of therapy prescription. Results: Responses were obtained from 26 countries and 208 hospitals, administering in total 42,853 treatments. The most common therapies were <sup>131</sup>I-NaI for benign thyroid diseases and thyroid ablation of adults. The involvement of a medical physicist (mean over all 18 therapies) was reported to be either minority or never by 32% of the responders. The percentage of responders that reported that dosimetry was included on an always/majority basis differed between the therapies and showed a median value of 36%. The highest percentages were obtained for <sup>177</sup>Lu-PSMA therapy (100%), <sup>90</sup>Y microspheres of glass (84%) and resin (82%), <sup>131</sup>I-mIBG for neuroblastoma (59%), and <sup>131</sup>I-NaI for benign thyroid diseases (54%). The majority of therapies were prescribed based on fixed-activity protocols. The highest number of absorbed-dose based prescriptions were reported for <sup>90</sup>Y microsphere treatments in the liver (64% and 96% of responses for resin and glass, respectively), <sup>131</sup>I-NaI treatment of benign thyroid diseases (38% of responses), and for <sup>131</sup>I-mIBG treatment of neuroblastoma (18% of responses). Conclusions: There is a wide variation in MRT practice across Europe and for different therapies, including the extent of medical-physicist involvement and the implementation of dosimetry-guided treatments.</p>},
  articleno    = {28},
  author       = {Sjögreen Gleisner, Katarina and Spezi, Emiliano and Solny, Pavel and Gabina, Pablo Minguez and Cicone, Francesco and Stokke, Caroline and Chiesa, Carlo and Paphiti, Maria and Brans, Boudewijn and Sandström, Mattias and Tipping, Jill and Konijnenberg, Mark and Flux, Glenn},
  issn         = {2197-7364},
  keyword      = {Dosimetry,European survey,Molecular radiotherapy,Radionuclide therapy,Radiopharmaceutical therapy},
  language     = {eng},
  month        = {12},
  number       = {1},
  publisher    = {Springer Open},
  series       = {EJNMMI Physics},
  title        = {Variations in the practice of molecular radiotherapy and implementation of dosimetry : results from a European survey},
  url          = {http://dx.doi.org/10.1186/s40658-017-0193-4},
  volume       = {4},
  year         = {2017},
}