New article on Commercial Treatment Planning Systems for Targeted Radionuclide Therapy published in Physica Medica by Jill Tipping et al

by | Dec 23, 2021 | Blog, News, Research | 0 comments

Photo of Jill TippingCongratulations to our colleague Jill Tipping, Principal Clinical Scientist in Nuclear Medicine, at The Christie NHS Foundation Trust and PET-Academy, for publishing a new article in Physica Medica: European Journal of Medical Physics entitled Overview of Commercial Treatment Planning Systems for Targeted Radionuclide Therapy and co-authored with colleagues from IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy and Universite de Montpellier and Institut Regional du Cancer de Montpellier, France.

Read the Journal Article

The article presents a panoramic view of the increasing availability of commercial Treatment Planning Systems (TPS) using Targeted Radionuclide Therapy, with the intention to raise awareness of the various TPSs commercially available and to highlight their differences in design and architecture.

As a result of the study and amongst other recommendations, Jill et al ultimately hope that the medical physics community will be allowed to ‘…determine the range and choices available to allow a more productive and standardised use of TPSs’.

The full article features in Volume 92, P.52-61, 1st December 2021 issue of Physica Medica: European Journal of Medical Physics, which can be accessed on their website with an Elsevier subscription or as a one-off payable download.

The full article highlights, abstract and authors are presented below as displayed on the Physica Medica: European Journal of Medical Physics website.

Highlights

  • To implement the European directive a personalized treatment planning needs to be performed.
  • EU Medical Devices Regulation 2017/745 applies also to Treatment Planning Systems (TPSs) for targeted radionuclide therapy (TRT).
  • Several TPS are now commercially available for liver radioembolization and general-purpose TRT.
  • An overview of available TPSs is presented based on an ad hoc survey.

Abstract

Introduction

Targeted Radionuclide Therapy (TRT) is a branch of cancer medicine dealing with the therapeutic use of radioisotopes associated with biological vectors accumulating in the tumors/targets, indicated as Molecular Radiotherapy (MRT), or directly injected into the arteries that supply blood to liver tumour vasculature, indicated as Selective RT (SRT). The aim of this work is to offer a panoramic view on the increasing number of commercially available TRT treatment planning systems (TPSs).

Materials and methods

A questionnaire was sent to manufacturers’ representatives. Academic software was not considered. Questions were grouped as follows: general information, clinical workflow, calibration procedure, image processing/reconstruction, image registration and segmentation tools, time-activity curve (TAC) fitting and absorbed dose calculation.

Results

All software reported have CE-marking. TPSs were divided between SRT-dedicated software [4] and MRT [5] dosimetry software. In SRT, since no kinetic process is involved, absorbed dose calculation does not require TAC fitting, and image registration is not fully developed in all TPS. All software requires a radionuclide-specific calibration. In SRT, a relative image calibration can be obtained by scaling the counts to a known activity. Automated VOI contouring and rigid/deformable propagation between different acquisitions time-points is implemented in most TPSs, although DICOM export is rare. Different TAC fits are available depending on the number of time points. Voxel S-value and Local deposition methods are the most frequent dosimetric approaches; dose-voxel kernel convolution and semi-Monte Carlo method are also available.

Conclusions

Available TPSs allows performing personalized dosimetry in clinical practice. Individual variations in methodology/algorithms must be considered in the standardisation/harmonization processes.

Authors

Giuseppe Della Gala, Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Manuel Bardies, Departement de Medecine Nucleaire, Institut Regional du Cancer de Montpellier (ICM) and IRCM, UMR 1194 INSERM, Universite de Montpellier, Montpellier F-34298, France.

Jill Tipping, The Christie NHS Foundation Trust, Manchester, UK

Lidia Strigari, Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

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