EANM Dosimetry Committee series on standard operational procedures for pre-therapeutic dosimetry I: blood and bone marrow dosimetry in differentiated thyroid cancer therapy.

Abstract

The purpose of the EANM Dosimetry Committee Series on "Standard Operational Procedures for Pre-therapeutic Dosimetry" (SOP) is to provide advice to scientists and clinicians on how to perform pre-therapeutic and/or therapeutic patient-specific absorbed dose assessments. This particular SOP gives advice on how to tailor the therapeutic activity to be administered for systemic treatment of differentiated thyroid cancer (DTC) such that the absorbed dose to the blood does not exceed 2 Gy (a widely accepted limit for bone marrow toxicity). The methodology of blood-based dosimetry has been developed in the 1960s and refined in a series of international multi-centre trials in the framework of the introduction of new diagnostic and therapeutic tools, e.g. recombinant human thyroid-stimulating hormone in the management of DTC. The intention is to guide the user through a series of measurements and calculations which the authors consider to be the best and most reproducible way at present.