Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives

<p dir="ltr">In light of widely expanding personalized medicine applications and their impact on clinical outcomes, it is naturally befitting to explore all the dimensional aspects of personalized radionuclide therapy (RNT). Adoption of absorbed radiation dose into clinical practice...

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Main Author: Rahaf Alsadi (19517740) (author)
Other Authors: Mehdi Djekidel (17733723) (author), Othmane Bouhali (8252544) (author), Jim O’ Doherty (19517743) (author)
Published: 2022
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_version_ 1864513506151235584
author Rahaf Alsadi (19517740)
author2 Mehdi Djekidel (17733723)
Othmane Bouhali (8252544)
Jim O’ Doherty (19517743)
author2_role author
author
author
author_facet Rahaf Alsadi (19517740)
Mehdi Djekidel (17733723)
Othmane Bouhali (8252544)
Jim O’ Doherty (19517743)
author_role author
dc.creator.none.fl_str_mv Rahaf Alsadi (19517740)
Mehdi Djekidel (17733723)
Othmane Bouhali (8252544)
Jim O’ Doherty (19517743)
dc.date.none.fl_str_mv 2022-07-14T09:00:00Z
dc.identifier.none.fl_str_mv 10.3389/fphy.2022.940677
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Towards_Routine_Clinical_Use_of_Dosimetry_in_177Lu_Lu-PSMA_Prostate_Cancer_Radionuclide_Therapy_Current_Efforts_and_Future_Perspectives/26889466
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Oncology and carcinogenesis
Health sciences
Health services and systems
dosimetry
177 lu
PSMA
prostate
cancer
dc.title.none.fl_str_mv Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">In light of widely expanding personalized medicine applications and their impact on clinical outcomes, it is naturally befitting to explore all the dimensional aspects of personalized radionuclide therapy (RNT). Adoption of absorbed radiation dose into clinical practice in the field of RNT has been hampered by difficulties such as evidence of dose-effect correlation, technical requirements in quantitative imaging of the radiopharmaceutical, heterogeneity of methods between not only centers, but also across software, hardware and radionuclides used. Additionally, standardized agreed upon definition of outcome measures is being debated whether it be solely related to toxicity, quality of life, survival or other measures. Many clinical RNT activity administrations are still based on empirical/fixed activities, or scaled based on parameters such as body surface area. Although still challenging, a tremendous amount of progress has been made to facilitate routine clinical dosimetry with discussions regarding standardization, harmonization and automated processing techniques. This has also been aided by the development and FDA approval of several companion diagnostics allowing within the theranostic paradigm not only a crude qualitative predictive biomarker but also an objective dosimetry based predictive therapeutic biomarker. This work aims to review the literature of [177Lu]Lu-PSMA RNT, focusing on clinical trials and studies, with the goal to summarize the range of dosimetry techniques and the range of doses calculated to organs and tissues of interest from these techniques. A dosimetry method for [177Lu]Lu-PSMA RNT should be reliable, reproducible and encompassing the knowledge gained from all clinical trials evaluating it. Its translation into clinical routine practice can be achieved with the confirmation that dose calculation represents good clinical efficacy and low treatment-related toxicity. Finally, some future perspectives on the future of [177Lu]Lu-PSMA RNT are made, especially in the rapidly emerging field of artificial intelligence (AI), where deep learning may be able to play a large role in the simplification of dosimetry calculations to aid in their clinical adoption.</p><h2>Other Information</h2><p dir="ltr">Published in: Frontiers in Physics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3389/fphy.2022.940677" target="_blank">https://dx.doi.org/10.3389/fphy.2022.940677</a></p>
eu_rights_str_mv openAccess
id Manara2_e2a9be4e7d8c17b1827efb4392422abf
identifier_str_mv 10.3389/fphy.2022.940677
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/26889466
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spelling Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future PerspectivesRahaf Alsadi (19517740)Mehdi Djekidel (17733723)Othmane Bouhali (8252544)Jim O’ Doherty (19517743)Biomedical and clinical sciencesClinical sciencesOncology and carcinogenesisHealth sciencesHealth services and systemsdosimetry177 luPSMAprostatecancer<p dir="ltr">In light of widely expanding personalized medicine applications and their impact on clinical outcomes, it is naturally befitting to explore all the dimensional aspects of personalized radionuclide therapy (RNT). Adoption of absorbed radiation dose into clinical practice in the field of RNT has been hampered by difficulties such as evidence of dose-effect correlation, technical requirements in quantitative imaging of the radiopharmaceutical, heterogeneity of methods between not only centers, but also across software, hardware and radionuclides used. Additionally, standardized agreed upon definition of outcome measures is being debated whether it be solely related to toxicity, quality of life, survival or other measures. Many clinical RNT activity administrations are still based on empirical/fixed activities, or scaled based on parameters such as body surface area. Although still challenging, a tremendous amount of progress has been made to facilitate routine clinical dosimetry with discussions regarding standardization, harmonization and automated processing techniques. This has also been aided by the development and FDA approval of several companion diagnostics allowing within the theranostic paradigm not only a crude qualitative predictive biomarker but also an objective dosimetry based predictive therapeutic biomarker. This work aims to review the literature of [177Lu]Lu-PSMA RNT, focusing on clinical trials and studies, with the goal to summarize the range of dosimetry techniques and the range of doses calculated to organs and tissues of interest from these techniques. A dosimetry method for [177Lu]Lu-PSMA RNT should be reliable, reproducible and encompassing the knowledge gained from all clinical trials evaluating it. Its translation into clinical routine practice can be achieved with the confirmation that dose calculation represents good clinical efficacy and low treatment-related toxicity. Finally, some future perspectives on the future of [177Lu]Lu-PSMA RNT are made, especially in the rapidly emerging field of artificial intelligence (AI), where deep learning may be able to play a large role in the simplification of dosimetry calculations to aid in their clinical adoption.</p><h2>Other Information</h2><p dir="ltr">Published in: Frontiers in Physics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3389/fphy.2022.940677" target="_blank">https://dx.doi.org/10.3389/fphy.2022.940677</a></p>2022-07-14T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.3389/fphy.2022.940677https://figshare.com/articles/journal_contribution/Towards_Routine_Clinical_Use_of_Dosimetry_in_177Lu_Lu-PSMA_Prostate_Cancer_Radionuclide_Therapy_Current_Efforts_and_Future_Perspectives/26889466CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/268894662022-07-14T09:00:00Z
spellingShingle Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
Rahaf Alsadi (19517740)
Biomedical and clinical sciences
Clinical sciences
Oncology and carcinogenesis
Health sciences
Health services and systems
dosimetry
177 lu
PSMA
prostate
cancer
status_str publishedVersion
title Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
title_full Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
title_fullStr Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
title_full_unstemmed Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
title_short Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
title_sort Towards Routine Clinical Use of Dosimetry in [177Lu]Lu-PSMA Prostate Cancer Radionuclide Therapy: Current Efforts and Future Perspectives
topic Biomedical and clinical sciences
Clinical sciences
Oncology and carcinogenesis
Health sciences
Health services and systems
dosimetry
177 lu
PSMA
prostate
cancer