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Item Type Journal Article
Title Quality Assurance Considerations in Radiopharmaceutical Therapy Dosimetry Using PLANETDose: An International Atomic Energy Agency Study
Creator Kayal et al.
Author Gunjan Kayal
Author Nathaly Barbosa
Author Carlos Calderón Marín
Author Ludovic Ferrer
Author José-Alejandro Fragoso-Negrín
Author Darko Grosev
Author Santosh Kumar Gupta
Author Nur Rahmah Hidayati
Author Tumelo C. G. Moalosi
Author Gian Luca Poli
Author Parul Thakral
Author Virginia Tsapaki
Author Sébastien Vauclin
Author Alex Vergara-Gil
Author Peter Knoll
Author Robert F. Hobbs
Author Manuel Bardičs
Abstract Implementation of radiopharmaceutical therapy dosimetry varies depending on the clinical application, dosimetry protocol, software, and ultimately the operator. Assessing clinical dosimetry accuracy and precision is therefore a challenging task. This work emphasizes some pitfalls encountered during a structured analysis, performed on a single-patient dataset consisting of SPECT/CT images by various participants using a standard protocol and clinically approved commercial software. Methods: The clinical dataset consisted of the dosimetric study of a patient administered with [177Lu]Lu-DOTATATE at Tygerberg Hospital, South Africa, as a part of International Atomic Energy Agency-coordinated research project E23005. SPECT/CT images were acquired at 5 time points postinjection. Patient and calibration images were reconstructed on a workstation, and a calibration factor of 122.6?Bq/count was derived independently and provided to the participants. A standard dosimetric protocol was defined, and PLANETDose (version 3.1.1) software was installed at 9 centers to perform the dosimetry of 3 treatment cycles. The protocol included rigid image registration, segmentation (semimanual for organs, activity threshold for tumors), and dose voxel kernel convolution of activity followed by absorbed dose (AD) rate integration to obtain the ADs. Iterations of the protocol were performed by participants individually and within collective training, the results of which were analyzed for dosimetric variability, as well as for quality assurance and error analysis. Intermediary checkpoints were developed to understand possible sources of variation and to differentiate user error from legitimate user variability. Results: Initial dosimetric results for organs (liver and kidneys) and lesions showed considerable interoperator variability. Not only was the generation of intermediate checkpoints such as total counts, volumes, and activity required, but also activity-to-count ratio, activity concentration, and AD rate-to-activity concentration ratio to determine the source of variability. Conclusion: When the same patient dataset was analyzed using the same dosimetry procedure and software, significant disparities were observed in the results despite multiple sessions of training and feedback. Variations due to human error could be minimized or avoided by performing intensive training sessions, establishing intermediate checkpoints, conducting sanity checks, and cross-validating results across physicists or with standardized datasets. This finding promotes the development of quality assurance in clinical dosimetry.
Publication Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Volume 65
Issue 1
Pages 125-131
Date 2024-01-02
Journal Abbr J Nucl Med
Language eng
DOI 10.2967/jnumed.122.265340
ISSN 1535-5667
Short Title Quality Assurance Considerations in Radiopharmaceutical Therapy Dosimetry Using PLANETDose
Library Catalog PubMed
Extra PMID: 37884334 PMCID: PMC10755524
Tags first-last-coresponding, Humans, Liver, Neoplasms, original, PLANETDose, quality assurance, Radiometry, Radiopharmaceuticals, Scientific, Single Photon Emission Computed Tomography Computed Tomography, SPECT/CT, top, variability assessment
Date Added 2024/12/07 - 07:31:45
Date Modified 2024/12/15 - 11:17:30
Notes and Attachments Full Text (Attachment)
PubMed entry (Attachment)


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