放射性药物治疗中单时点剂量测定的现状、前景及未来方向:系统性综述

10 April 2025


Mohammad Hossein Sadeghi, Sedigheh Sina, Teik Hin Tan, Saw Huey Ong, Kuangyu Shi, Kitiwat Khamwan, Chai Hong Yeong

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摘要

The rise of image-based approaches has reshaped personalized dosimetry in radiopharmaceutical therapies, holding the promise of reducing organ toxicity and tailoring treatments to individual responses. However, implementing these strategies accurately demands numerous quantitative scans and complex data processing, posing significant clinical hurdles. Therefore, simplified methodologies like single-time point (STP) dosimetry have emerged, aiming to enhance efficiency in clinical dosimetry. STP dosimetry estimates absorbed doses in radiopharmaceutical therapy from a singular measurement of time-integrated activity (TIA) at a specific time point. Following the PRISMA guidelines, a systematic exploration was performed on PubMed, ScienceDirect, Scopus, and Web of Science. This review encompasses research concentrating on organ dosimetry in patients employing STP dosimetry from January 2012 to December 2023. Evaluation of these chosen articles exposes a variety of uses for STP dosimetry, outlining its theoretical bases, practical applications, and discussions regarding its vital role in achieving a balance between eliminating tumors and reducing exposure to healthy tissues. From this review, STP dosimetry offers a hopeful path in simplifying personalized dosimetry by decreasing imaging intervals without sacrificing its accuracy. This innovative approach holds potential for routine dosimetry in clinical settings, potentially revolutionizing the landscape of radiopharmaceutical therapy.

Keywords

Dosimetry; Nuclear medicine; Radiopharmaceutical; Single-time point.


参考资料

  1. The original order has been strictly preserved, extra web UI labels (like Article, PubMed, Google Scholar) have been removed, and standard APA rules have been applied (e.g., expanding up to 20 authors before using an ellipsis, sentence-case article titles, and En-dashes for page ranges).
  2. Stabin, M. G., Madsen, M. T., & Zaidi, H. (2019). Personalized dosimetry is a must for appropriate molecular radiotherapy. Medical Physics, 46(11), 4713–4716.
  3. Ljungberg, M., & Sjögreen Gleisner, K. (2016). Personalized dosimetry for radionuclide therapy using molecular imaging tools. Biomedicines, 4(4), Article 25.
  4. Chicheportiche, A., Sason, M., Krausz, Y., & Zidan, M. (2021). Simple model for estimation of absorbed dose by organs and tumors after PRRT from a single SPECT/CT study. EJNMMI Physics, 8(1), Article 1.
  5. Chicheportiche, A., Sason, M., Godefroy, J., Krausz, Y., Zidan, M., Oleinikov, K., Grozinsky-Glasberg, S., & Popova, E. (2023). Impact of single-time-point estimates of 177Lu-PRRT absorbed doses on patient management: Validation of a trained multiple-linear-regression model in 159 patients and 477 therapy cycles. Journal of Nuclear Medicine, 64(1), Article 122.
  6. Peters, S. M., Mink, M. C., Privé, B. M., de Bakker, M., de Lange, F., Muselaers, C. H., Mehra, N., Nagarajah, J., & Konijnenberg, M. W. (2023). Optimization of the radiation dosimetry protocol in Lutetium-177-PSMA therapy: Toward clinical implementation. EJNMMI Research, 13(1), Article 6.
  7. Gustafsson, J., & Taprogge, J. (2022). Theoretical aspects on the use of single-time-point dosimetry for radionuclide therapy. Physics in Medicine & Biology, 67(2), Article 025003.
  8. Madsen, M. T., Menda, Y., O’Dorisio, T. M., & O’Dorisio, M. S. (2018). Single time point dose estimate for exponential clearance. Medical Physics, 45(5), 2318–2324.
  9. Nautiyal, A., Michopoulou, S., & Guy, M. (2024). Dosimetry in Lu-177-DOTATATE peptide receptor radionuclide therapy: A systematic review. Clinical and Translational Imaging, 12(2), 157–175.
  10. Sandström, M., Freedman, N., Fröss-Baron, K., Kahn, T., & Sundin, A. (2020). Kidney dosimetry in 777 patients during 177Lu-DOTATATE therapy: Aspects on extrapolations and measurement time points. EJNMMI Physics, 7(1), Article 1.
  11. Hänscheid, H., Lapa, C., Buck, A. K., Lassmann, M., & Werner, R. A. (2018). Dose mapping after endoradiotherapy with 177Lu-DOTATATE/DOTATOC by a single measurement after 4 days. Journal of Nuclear Medicine, 59(1), 75–81.
  12. Willowson, K. P., Eslick, E., Ryu, H., Poon, A., Bernard, E. J., & Bailey, D. L. (2018). Feasibility and accuracy of single time point imaging for renal dosimetry following 177Lu-DOTATATE (‘Lutate’) therapy. EJNMMI Physics, 5(1), Article 1.
  13. Vergnaud, L., Giraudet, A. L., Moreau, A., Salvadori, J., Imperiale, A., Baudier, T., & Taïeb, D. (2022). Patient-specific dosimetry adapted to variable number of SPECT/CT time-points per cycle for 177Lu-DOTATATE therapy. EJNMMI Physics, 9(1), Article 37.
  14. Wang, C., Peterson, A. B., Wong, K. K., Roseland, M. E., Schipper, M. J., & Dewaraja, Y. K. (2023). Single-time-point imaging for dosimetry after [177Lu]Lu-DOTATATE: Accuracy of existing methods and novel data-driven models for reducing sensitivity to time-point selection. Journal of Nuclear Medicine, 64(9), 1463–1470.
  15. Jackson, P. A., Hofman, M. S., Hicks, R. J., Scalzo, M., & Violet, J. (2020). Radiation dosimetry in 177Lu-PSMA-617 therapy using a single posttreatment SPECT/CT scan: A novel methodology to generate time- and tissue-specific dose factors. Journal of Nuclear Medicine, 61(7), 1030–1038.
  16. Brosch-Lenz, J., Delker, A., Völter, F., Unterrainer, L. M., Kaiser, L., Bartenstein, P., & Todica, A. (2023). Toward single-time-point image-based dosimetry of 177Lu-PSMA-617 therapy. Journal of Nuclear Medicine, 64(5), 767–774.
  17. Hou, X., Brosch, J., Uribe, C., Desy, A., Böning, G., Beauregard, J. M., & Rahmim, A. (2021). Feasibility of single-time-point dosimetry for radiopharmaceutical therapies. Journal of Nuclear Medicine, 62(7), 1006–1011.
  18. Hardiansyah, D., Riana, A., Beer, A. J., & Glatting, G. (2023). Single-time-point estimation of absorbed doses in PRRT using a non-linear mixed-effects model. Zeitschrift für Medizinische Physik, 33(1), 70–81.
  19. Hardiansyah, D., Riana, A., Beer, A. J., & Glatting, G. (2023). Single-time-point dosimetry using model selection and nonlinear mixed-effects modelling: A proof of concept. EJNMMI Physics, 10(1), Article 1.
  20. Devasia, T. P., Dewaraja, Y. K., Frey, K. A., Wong, K. K., & Schipper, M. J. (2021). A novel time-activity information-sharing approach using nonlinear mixed models for patient-specific dosimetry with reduced imaging time points: Application in SPECT/CT after 177Lu-DOTATATE. Journal of Nuclear Medicine, 62(8), 1118–1125.
  21. Zhao, W., Esquinas, P. L., Frezza, A., Hou, X., Beauregard, J. M., & Celler, A. (2019). Accuracy of kidney dosimetry performed using simplified time activity curve modelling methods: A 177Lu-DOTATATE patient study. Physics in Medicine & Biology, 64(17), Article 175006.
  22. Gupta, A., Lee, M. S., Kim, J. H., Lee, D. S., & Lee, J. S. (2020). Preclinical voxel-based dosimetry in theranostics: A review. Nuclear Medicine and Molecular Imaging, 54(2), 86–97.
  23. Marsh, I. R., Grudzinski, J., Baiu, D. C., Besemer, A., Hernandez, R., Jeffery, J. J., Weichert, J. P., Otto, M., & Bednarz, B. P. (2019). Preclinical pharmacokinetics and dosimetry studies of 124I/131I-CLR1404 for treatment of pediatric solid tumors in murine xenograft models. Journal of Nuclear Medicine, 60(10), 1414–1420.
  24. Garrow, A. A., Andrews, J. P. M., Gonzalez, Z. N., Corral, C. A., Portal, C., Morgan, T. E. F., Walton, T., Wilson, I., Newby, D. E., & Lucatelli, C. (2020). Preclinical dosimetry models and the prediction of clinical doses of novel positron emission tomography radiotracers. Scientific Reports, 10(1), Article 15985.
  25. Stabin, M. G., Peterson, T. E., Holburn, G. E., & Emmons, M. A. (2006). Voxel-based mouse and rat models for internal dose calculations. Journal of Nuclear Medicine, 47(4), 655–659.
  26. Biglin, E. R., Price, G. J., Chadwick, A. L., Aitkenhead, A. H., Williams, K. J., & Kirkby, K. J. (2019). Preclinical dosimetry: Exploring the use of small animal phantoms. Radiation Oncology, 14(1), Article 1.
  27. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. International Journal of Surgery, 88, Article 105906.
  28. Garske, U., Sandström, M., Johansson, S., Sundin, A., Granberg, D., Eriksson, B., & Lundqvist, H. (2012). Minor changes in effective half-life during fractionated 177Lu-octreotate therapy. Acta Oncologica, 51(1), 86–96.
  29. Sundlöv, A., Gustafsson, J., Brolin, G., Mortensen, N., Hermann, R., Bernhardt, P., & Gleisner, K. S. (2018). Feasibility of simplifying renal dosimetry in 177Lu peptide receptor radionuclide therapy. EJNMMI Physics, 5(1), Article 1.
  30. Xue, S., Gafita, A., Dong, C., Zhao, Y., Tetteh, G., Menze, B. H., Eiber, M., Rominger, A., & Shi, K. (2022). Application of machine learning to pretherapeutically estimate dosimetry in men with advanced prostate cancer treated with 177Lu-PSMA I&T therapy. European Journal of Nuclear Medicine and Molecular Imaging, 49(12), 4064–4072.
  31. Peterson, A. B., Mirando, D. M., & Dewaraja, Y. K. (2023). Accuracy and uncertainty analysis of reduced time point imaging effect on time-integrated activity for 177Lu-DOTATATE PRRT in patients and clinically realistic simulations. EJNMMI Research, 13(1), Article 57.
  32. Alipour, R., Jackson, P., Bressel, M., Hogg, A., Callahan, J., Hicks, R. J., & Hofman, M. S. (2023). The relationship between tumour dosimetry, response, and overall survival in patients with unresectable neuroendocrine neoplasms (NEN) treated with 177Lu DOTATATE (LuTate). European Journal of Nuclear Medicine and Molecular Imaging, 50(10), 2997–3010.
  33. Del Prete, M., Arsenault, F., Saighi, N., Zhao, W., Buteau, F. A., Celler, A., & Beauregard, J. M. (2018). Accuracy and reproducibility of simplified QSPECT dosimetry for personalized 177Lu-octreotate PRRT. EJNMMI Physics, 5(1), Article 1.
  34. Kao, Y. H. (2023). A simplified general schema for rapid single time-point marrow predictive dosimetry. Nuclear Medicine Communications, 44(12), 1187–1188.
  35. Chen, G., Lu, Z., Jiang, H., Afshar-Oromieh, A., Rominger, A., Shi, K., & Mok, G. S. P. (2023). Lu-177-PSMA dosimetry for kidneys and tumors based on SPECT images at two imaging time points. Frontiers in Medicine, 10, Article 1246881.
  36. Mok, G. S. P., & Dewaraja, Y. K. (2021). Recent advances in voxel-based targeted radionuclide therapy dosimetry. Quantitative Imaging in Medicine and Surgery, 11(1), 483–489.
  37. Gear, J., Stokke, C., Terwinghe, C., Gnesin, S., Sandström, M., Tran-Gia, J., & Lassmann, M. (2023). EANM enabling guide: How to improve the accessibility of clinical dosimetry. European Journal of Nuclear Medicine and Molecular Imaging, 50(7), 1861–1868.
  38. Laforest, R., Ghai, A., Fraum, T. J., Oyama, R., Frye, J., Kaemmerer, H., & Dehdashti, F. (2023). First-in-human evaluation of safety and dosimetry of 64Cu-LLP2A for PET imaging. Journal of Nuclear Medicine, 64(2), 320–328.
  39. Gomes, C. V., Chen, Y., Rauscher, I., Xue, S., Gafita, A., Hu, J., & Shi, K. (2025). Characterization of effective half-life for instant single-time-point dosimetry using machine learning. Journal of Nuclear Medicine, 66(1), Article 4.

引用

Sadeghi, M.H., Sina, S., Tan, T.H. et al. Current Prospects and Future Directions of Single Time Point Dosimetry in Radiopharmaceutical Therapy: A Systematic Review. Nucl Med Mol Imaging 60, 64–78 (2026). https://doi.org/10.1007/s13139-025-00917-1

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