Overview of commercial treatment planning systems for targeted radionuclide therapy. (December 2021)

• Record Type: Journal Article
• Authors: Della Gala, Giuseppe; Bardiès, Manuel; Tipping, Jill; Strigari, Lidia
• Is Part Of: Physica medica. Volume 92(2021)
• Page Start: 52
• Page End: 61
• Publication Date: 2021-12
• Subjects: Targeted Radionuclide Therapy -- Treatment planning systems -- Dose calculation -- Kernel -- Dose volume histograms; BED Biologically Effective Dose -- DVH Dose-Volume Histogram -- EBRT External Beam Radiotherapy -- FBP Filtered Back Projection -- MRT Molecular Radiotherapy -- OSEM Ordered Subset Expectation Maximization -- SRT Selective Radiotherapy -- TAC Time-Activity Curve -- TPS(s) Treatment Planning System(s) -- TRT Targeted Radionuclide Therapy -- VOI(s) Volume(s) of Interest; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2021.11.001
• Languages: English
• ISSNs: 1120-1797

Abstract

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 were 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.