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Abstract
Radiation dosimetry is necessary for optimising radiation-based medical procedures for individual patients but in the field of nuclear medicine there are few widely available or widely used tools for performing this kind of analysis. Those tools that are available tend to focus on one particular component of the dosimetry problem and integrating tools to form a complete system is left to the end-user.
A software system for performing individual, image-based dosimetry analysis of nuclear medicine studies has been developed and validated. The system consists of a suite of tools that use common file formats and data models. The tools can be integrated to form applications by means of a simple scripting system. One tool is a gamma camera simulator that can produce realistic images of dynamic activity distributions in planar or tomographic formats. Simulated imaging studies produced by this tool are used to validate the other tools in the system. In addition, the system implements a method of simulation assisted quantitation which is shown to achieve high accuracy in both software and physical phantom studies.
The system is applied to the dosimetry of I-131 Lipiodol, a therapeutic agent used to treat primary and secondary cancers of the liver. Simulation studies are used to validate the analytic methods used. Studies of a series of patients, treated over a period 10 years, are retrospectively analysed using a selection of methods appropriate to the available data.
The results of the analysis demonstrated a large range of lung doses from 1 to 10 Gy/GBq administered. The median absorbed dose in liver was 3 Gy (range 1 - 10 Gy) and the median absorbed dose in tumor was 19 Gy (range 5 - 84 Gy). The large individual variation reinforces the necessity of individualised dosimetry for treatment planning and follow up.