S-values for radium-223 and absorbed doses estimates for 223RACL2 using three computational phantoms.

Radium-223 dichloride (223RaCl2), approved by FDA (Food and Drug Administration) in 2013 and in Brazil by ANVISA (Agência Nacional de Vigilância Sanitária) in 2016, offers a new therapeutic option for bone metastases from castration-resistant prostate cancer (CRPC). The advantages of radionuclide therapy for bone metastases include the simultaneous treatment of multiple lesions at the same time. The activity prescription is based on the patient's body weight, disregarding the absorbed dose limit of 2 Gy in the organ at risk: bone marrow. This study focuses on Internal Dosimetry for 223RaCl2 therapy aiming to apply biokinetic models described in the literature to estimate absorbed doses in the organs of interests, especially for the bone marrow. For this purpose, the present paper compares and validates the GATE Monte Carlo simulation with the Radioactive Decay Module (RDM) and calculates a set of S-values for Radium-223 radionuclide using male and female XCAT computational models. Moreover, a comparison of S-values for Radium-223 for three male computational models with different anatomies is also evaluated, Male (standard), Pat1 (lower body weight) and Pat2 (highest body weight). A comprehensive set of S-values was calculated for the Male model, 30 source-regions and 47 target-regions, and for Female model, 30 source-regions and 42 target-regions for Radium-223 and its decay scheme: Radon-219, Polonium-215, Lead-211, Bismuth- 211, Polonium-211 and Thallium-207. The new set of S-values will facilitate absorbed dose calculations for Radium-223 therapy. In addition, Absorbed Dose Evaluation for 223RaCl2 therapy was estimated for three different biodistributions described in the literature within three male computational models. For all biodistributions, the Pat2 phantom has a greatest absorbed dose within the red marrow, when compared with Male and Pat1.

Optimal theranostic SPECT imaging protocol for 223radium dichloride therapy.

223Radium dichloride image-based individual dosimetry requires an optimal acquisition and reconstruction protocol and proper image correction methods for theranostic applications. To assess this problem, radium-223 dichloride SPECT images were acquired from a Jaszczak simulator with a dual-headed gamma camera, LEHR collimator, 128 × 128 matrix, and total time of 32 minutes. A cylindrical PMMA phantom was used to calibrate the measurements performed with Jaszczak. The image quality parameters (noise coefficient, contrast, contrast-to-noise ratio and recovery coefficient) and septal penetration correction were calculated by MATLAB®. The best results for the investigated image quality parameters were obtained with an 89 keV energy window (24% wide) produced together with OSEM/MLEM reconstruction (8 subsets and 4 iterations) applying a Butterworth filter (order 10 and cutoff frequency of 0.48 cycles·cm-1). The successfully performed recovery coefficient parameter evaluation allows uptake correction for future patient dosimetry applications.