TY - JOUR
T1 - Heterogeneity of absorbed dose distribution in kidney tissues and dose–response modelling of nephrotoxicity in radiopharmaceutical therapy with beta-particle emitters: A review
AU - Vargas, Clarita Saldarriaga
AU - Andersson, Michelle
AU - Bouvier-Capely, Céline
AU - Li, Wei Bo
AU - Madas, Balázs
AU - Covens, Peter
AU - Struelens, Lara
AU - Strigari, Lidia
N1 - Score=10
Funding Information:
The authors kindly thank the European Platform dedicated to low dose radiation risk research, MELODI (Multidisciplinary European Low Dose Initiative, https://melodi-online.eu/) for organizing the virtual workshop on “Effects of spatial and temporal variation in dose delivery” (17–20 November 2020) and motivating the preparation of this manuscript.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/4
Y1 - 2023/4
N2 - Absorbed dose heterogeneity in kidney tissues is an important issue in radiopharmaceutical therapy. The effect of absorbed dose heterogeneity in nephrotoxicity is, however, not fully understood yet, which hampers the implementation of treatment optimization by obscuring the interpretation of clinical response data and the selection of optimal treatment options. Although some dosimetry methods have been developed for kidney dosimetry to the level of microscopic renal substructures, the clinical assessment of the microscopic distribution of radiopharmaceuticals in kidney tissues currently remains a challenge. This restricts the anatomical resolution of clinical dosimetry, which hinders a thorough clinical investigation of the impact of absorbed dose heterogeneity. The potential of absorbed dose–response modelling to support individual treatment optimization in radiopharmaceutical therapy is recognized and gaining attraction. However, biophysical modelling is currently underexplored for the kidney, where particular modelling challenges arise from the convolution of a complex functional organization of renal tissues with the function-mediated dose distribution of radiopharmaceuticals. This article reviews and discusses the heterogeneity of absorbed dose distribution in kidney tissues and the absorbed dose–response modelling of nephrotoxicity in radiopharmaceutical therapy. The review focuses mainly on the peptide receptor radionuclide therapy with beta-particle emitting somatostatin analogues, for which the scientific literature reflects over two decades of clinical experience. Additionally, detailed research perspectives are proposed to address various identified challenges to progress in this field.
AB - Absorbed dose heterogeneity in kidney tissues is an important issue in radiopharmaceutical therapy. The effect of absorbed dose heterogeneity in nephrotoxicity is, however, not fully understood yet, which hampers the implementation of treatment optimization by obscuring the interpretation of clinical response data and the selection of optimal treatment options. Although some dosimetry methods have been developed for kidney dosimetry to the level of microscopic renal substructures, the clinical assessment of the microscopic distribution of radiopharmaceuticals in kidney tissues currently remains a challenge. This restricts the anatomical resolution of clinical dosimetry, which hinders a thorough clinical investigation of the impact of absorbed dose heterogeneity. The potential of absorbed dose–response modelling to support individual treatment optimization in radiopharmaceutical therapy is recognized and gaining attraction. However, biophysical modelling is currently underexplored for the kidney, where particular modelling challenges arise from the convolution of a complex functional organization of renal tissues with the function-mediated dose distribution of radiopharmaceuticals. This article reviews and discusses the heterogeneity of absorbed dose distribution in kidney tissues and the absorbed dose–response modelling of nephrotoxicity in radiopharmaceutical therapy. The review focuses mainly on the peptide receptor radionuclide therapy with beta-particle emitting somatostatin analogues, for which the scientific literature reflects over two decades of clinical experience. Additionally, detailed research perspectives are proposed to address various identified challenges to progress in this field.
KW - Absorbed dose heterogeneity
KW - Radiopharmaceutical therapy
KW - Kidney dosimetry
KW - Dose–response modelling
KW - Normal tissue complication probability (NTCP)
KW - Biophysical modelling
U2 - 10.1016/j.zemedi.2023.02.006
DO - 10.1016/j.zemedi.2023.02.006
M3 - Article
SN - 0939-3889
JO - Zeitschrift für Medizinische Physik
JF - Zeitschrift für Medizinische Physik
ER -