Dosimetry to improve molecular radiotherapy outcomes
This article explores the critical role of dosimetry in enhancing outcomes for molecular radiotherapy (MRT), a treatment modality that delivers targeted radiation to cancer cells via radiopharmaceuticals. While MRT has grown significantly in the UK over the past two decades, current prescribing practices often rely on fixed activity or weight-based adjustments, which fail to account for patient-specific variations in radiopharmaceutical uptake. This one-size-fits-all approach contrasts with the NHS’s emphasis on personalised care.
Evidence shows that higher tumour doses correlate with improved survival and quality of life, as demonstrated in techniques like selective internal radiotherapy for liver cancer. Dosimetry enables precise activity modulation by mapping radiotracer kinetics through multi-timepoint imaging, optimising the therapeutic ratio between tumour control and normal tissue protection. Its importance is particularly pronounced in paediatric oncology, such as neuroblastoma treatment, where personalised dosimetry could significantly impact outcomes.
Despite regulatory directives mandating individualised dose planning, implementation remains inconsistent due to resource challenges. The article advocates for routine dosimetry as a cost-effective strategy that reduces complications and aligns MRT with external beam radiotherapy standards. Ultimately, widespread adoption promises better patient outcomes and ethical treatment optimisation.
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