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ICRU Report On Dosimetry-Guided Radiopharmaceutical Therapy

G Sgouros1*, K Sjogreen Gleisner2*, R Hobbs3*, Y Dewaraja4*, (1) Johns Hopkins Medical Institute, Ellicott City, MD, (2) Lund University, Lund, SE, (3) Johns Hopkins University, Baltimore, MD, (4) University of Michigan, Ann Arbor, MI

Presentations

TU-E-202-0 (Tuesday, 7/12/2022) 11:00 AM - 12:15 PM [Eastern Time (GMT-4)]

Room 202

Radiopharmaceutical therapy (RPT) is advancing rapidly as an important modality in the treatment of cancer. Recent therapeutic successes and regulatory approval of commercial radiopharmaceuticals is spurring development of new agents. However, comparisons of clinical results and optimization of RPT have been hindered by the absence of standardized practices for prescribing, reporting and recording of dosimetric quantities related to RPT. This session is dedicated to presenting the newly released ICRU Report 96, Dosimetry Guided Radiopharmaceutical Therapy. This report provides recommendations for standardized techniques and procedures and recommendations for prescribing, recording and reporting of dosimetry for radiopharmaceutical therapy. The session will focus on key concepts and terminology needed to implement dosimetry and treatment planning for RPT, the implementation of absorbed dose and equieffective dose (EQDX) in RPT treatment planning, and clinical examples of RPT for different tumor entities to illustrate the application of the recommendations. Highlights will include a new quantity, the standardized relative biological effectiveness (sRBEX), and new ICRU definitions of regions and geometric concepts to be used in RPT that reflect unique aspects of RPT relative to external beam radiotherapy. Finally, analogous to external beam radiation therapy, specific recommendations for ICRU reporting levels for RPT will be presented. This ICRU report is an important and useful reference for all practitioners in RPT and should facilitate comparisons of clinical results from different centers. The focus of dosimetry-guided RPT makes explicit the potential of RPT to target and control tumors while reducing normal tissue toxicity. This session is relevant for those wishing to learn about RPT, experts in the field who seek guidance on adopting international recommendations to raise their level of RPT practice to ICRU Level 2 or Level 3, and for those who are working to advance RPT as a front-line therapeutic modality.

Learning Objectives:
1) Understand the importance of dosimetry for RPT
2) Understand the relationship between dosimetry for external beam therapy, brachytherapy, and RPT
3) Learn the nomenclature and definitions for dosimetry in RPT
4) Understand the use of equieffective dose in RPT
5) Learn the Levels of RPT prescriptions, recording, and reporting
6) Learn how to implement ICRU Report 96 in the clinic

Funding Support, Disclosures, and Conflict of Interest: Funding Support RWH: NIH1S10OD026875-01,1R01CA245139; GS&RFH: NIH3R01CA116477,R01CA240779-01,R01CA157542; KSG: SwedishCancerSociety(180747,211754Pj01H), KampradsFoundation(BKS-2020-13); YKD: NIHR01CA240706, NIH R01EB022075, Varian. Disclosures and Conflicts of Interest RWH: Patents US 8,874,380 B2, US 9,623,262 B2, US 9,804,167, US 10,295,543; GS: Equity in RAPID, Advisory Board Member-OranoMed,ConvergentTherapeutics, Consultant-Bayer,Rayzebio,Precirix; RFH: Consultant-RAPID; KSG: Consultant-SpagoNanomedical, FusionPharmaceuticals; YKD: Consultant-MIM.

Handouts

Keywords

Radiation Dosimetry, Nuclear Medicine, Targeted Radiotherapy

Taxonomy

IM/TH- Radiopharmaceutical Therapy: General (most aspects)

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