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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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REVIEWS  MIBG IN THE DIAGNOSIS AND THERAPY OF PHEOCHROMOCYTHOMA AND PARAGANGLIOMAFREEfree


The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2013 June;57(2):161-70

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

Dosimetry in 131I-mIBG therapy: moving toward personalized medicine

Chiesa C. 1, Castellani R. 1, Mira M. 2, Lorenzoni A. 1, Flux G. D. 3

1 Department of Nuclear Medicine, Foundation IRCCS Istituto Nazionale per lo Studio la Cura dei Tumori Milan, Italy; 2 Post-graduate Health Physics School University of Milan, Milan, Italy; 3 Joint Department of Physics Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Downs Road Sutton, Surrey, SM2 PT, UK


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Internal dosimetry was developed as a basis for 131I-mIBG treatment at an early stage and has continued to develop for over the last 20 years. Whole-body dosimetry was introduced to prevent hematological toxicity. It will be the basis for a forthcoming European multicentre trial, in which the activity of a second administration is determined according to the results calculated from the first. Lesion dosimetry has also been performed in a small number of centres. The major goal of dosimetry now is to establish dose-effect correlation studies, which will be the basis for individualized treatment planning. The aim of this paper is to analyse previously published studies and to consider the potential for improvement in order to obtain a stronger predictive power of dosimetry. The intrinsic radiobiological limits of dosimetry are also illustrated. Due to the development and dissemination of methods of internal dosimetry and radiobiology over the last two decades, and to the increasing availability of quantitative 124I PET imaging, dosimetry could provide in the near future a more systematic basis for standardization and individualization of mIBG therapy. This will however require a number of multicentre trials which are performed under good instrumental and scientific methodology.

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carlo.chiesa@istitutotumori.mi.it