Dosimetry for 131I mIBG Therapy
In 131I-mIBG of paediatric neuroblastoma, the first dosimetric method introduced was whole-body dosimetry by Lashford et al. (J Clin Oncol 10(12):1889–96, 1992). This aims to prevent haematological toxicity. Despite its simplicity and level of approximation, this method is the basis for a forthcoming European multicentre trial, in which the activity of a second administration is planned according to the whole-body absorbed dose delivered in the first. Lesion dosimetry has also been performed, though in a small number of centres. The limited number of lesion dosimetry studies derives from the challenge of high activity quantitative imaging of I-131, incurring gamma camera saturation in peri-therapy imaging, and the need for children to remain steady during sequential camera scans. The major goal now is to establish absorbed dose-effect correlation studies, which will provide a fundamental basis for individualised treatment planning. Thanks to the improvement of methods for internal dosimetry and radiobiology over the last two decades and the increasing availability of quantitative 124I PET imaging, in the near future, we could have a more systematic basis for standardisation and individualisation of mIBG therapy.
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