Physics aspects of setting up a multi-centre clinical trial involving internal dosimetry of radioiodine treatment of differentiated thyroid cancer
Abstract
The field of molecular radiotherapy is expanding rapidly, with the advent of many new radiotherapeutics for the treatment of common as well as for rare cancers. Treatment outcome is dependent on the absorbed doses delivered to target volumes and to healthy organs-at-risk, which are shown to vary widely from fixed administrations of activity. There have been significant developments in quantitative imaging and internal dosimetry in recent years, although clinical implementation of these methods has been slow in comparison with external beam radiotherapy, partly due to there being relatively few patients treated at single centres. Multi-centre clinical trials are therefore essential to acquire the data required to ensure best practice and to develop the personalised treatment planning that this area is well suited to, due to the unrivalled opportunity to image the therapeutic drug in vivo. Initial preparation for such trials requires a significant effort in terms of resources and trial design. Imaging systems in participating centres must be characterised and set up for quantitative imaging to allow for collation of data. Data transfer for centralised processing is usually necessary but is hindered in some cases by data protection regulations and local logistics. Recent multi-centre clinical trials involving radioiodine therapy have begun to establish the procedures necessary for quantitative SPECT imaging in a multi-centre setting using standard and anthropomorphic phantoms.…
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