The internal dosimetry user group position statement on molecular radiotherapy

The Internal Dosimetry User Group (IDUG) is an independent, non-profit group of medical professionals dedicated to the promotion of dosimetry in molecular radiotherapy ( www.IDUG.org.uk ). The Ionising Radiation (Medical Exposure) Regulations 2017, IR(ME)R, stipulate a requirement for optimisation and verification of molecular radiotherapy treatments, ensuring doses to non-target organs are as low as reasonably practicable. For many molecular radiotherapy treatments currently undertaken within the UK, this requirement is not being fully met. The growth of this field is such that we risk digressing further from IR(ME)R compliance potentially delivering suboptimal therapies that are not in the best interest of our patients. For this purpose, IDUG proposes ten points of action to aid in the successful implementation of this legislation. We urge stakeholders to support these proposals and ensure national provision is sufficient to meet the criteria necessary for compliance, and for the future advancement of molecular radiotherapy within the UK.

Microspheres Used in Liver Radioembolization: From Conception to Clinical Effects

Inert microspheres, labeled with several radionuclides, have been developed during the last two decades for the intra-arterial treatment of liver tumors, generally called Selective Intrahepatic radiotherapy (SIRT). The aim is to embolize microspheres into the hepatic capillaries, accessible through the hepatic artery, to deliver high levels of local radiation to primary (such as hepatocarcinoma, HCC) or secondary (metastases from several primary cancers, e.g., colorectal, melanoma, neuro-endocrine tumors) liver tumors. Several types of microspheres were designed as medical devices, using different vehicles (glass, resin, poly-lactic acid) and labeled with different radionuclides, 90Y and 166Ho. The relationship between the microspheres’ properties and the internal dosimetry parameters have been well studied over the last decade. This includes data derived from the clinics, but also computational data with various millimetric dosimetry and radiobiology models. The main purpose of this paper is to define the characteristics of these radiolabeled microspheres and explain their association with the microsphere distribution in the tissues and with the clinical efficacy and toxicity. This review focuses on avenues to follow in the future to optimize such particle therapy and benefit to patients.

Prospective directions and problems of ensuring Radiation Safety in Radiation Medicine

The development of Radiation Medicine in the Russian Federation has resulted in the necessity to improve the regulatory and methodological support for ensuring Radiation Safety. Following the introduction of new diagnostics and therapy methods into practice, as well as the use of new radiopharmaceuticals, the actualization of radiation monitoring methods and the provision of radiological protection for patients, personnel and the public have become the most urgent tasks. Radionuclide therapy with new radiopharmaceuticals, which can be used in the day patient departments, is one of the promising directions in the development of Russian Radiation Medicine. The main tasks of ensuring Radiation Safety in the departments of radionuclide therapy are the regulation of radioactive waste management, the development of discharge criteria after the administration of radiopharmaceuticals and methods for Internal Dosimetry.