Search

To The development of nuclear medicine in Indonesia can be seen by several factors, including the increasing number of patients who are diagnosed and treated utilizing nuclear medicine methods, the growing availability of locally manufactured radioisotopes for diagnosis and therapy, and the rising interest in performing dosimetry studies for radionuclide therapy. Since it is impossible to directly assess the organ dose in dosimetry studies for radionuclide therapy, image acquisition and quantification are utilized to explore how radiopharmaceuticals accumulate in the human body. The attenuation and calibration factors for the imaging instruments must be determined during the image quantification steps before the clinical procedures for the dosimetry research take place. The radioisotopes 153Sm, 131I, and 177Lu were used in this investigation because they have been proposed to contribute to cancer management in Indonesia. This study aims to evaluate at the effect of activity level on attenuation factors for image quantification. The experiment was carried out by acquiring images of 153Sm, 131I, and 177Lu at low (±2 mCi), medium (± 25 mCi), and high (± 50 mCi) activity. All radioisotopes were prepared in a 1 mL syringe and injected into the Mediso AnyScanS gamma camera equipped with Polymethyl methacrylate (PMMA) slab phantoms. The results reveal that the activity level does not affect the attenuation factors for 153Sm and 177Lu, which are around 0.12 ±0.008 cm-1 and 0.11 ± 0.003 cm-1, respectively. However, variability in 131I was high, around 0.07±0.037 cm-1. To summarize, the activity level has only a little impact on the attenuation factor for 153Sm and 177Lu, but for 131I, multi-energy adjustment is required to obtain an attenuation factor of around 0.095 ±0.005 cm-1. [ABSTRACT FROM AUTHOR]

In Indonesia, approximately 40 percent of radiotherapy patient treatment uses advanced radiation treatment technologies. These technologies have improved the quality of radiation treatment, especially in head and neck cases, for that reason the research aims to analyze the verification methods using SHANE Phantom to improve the accuracy and precision of dose delivery to radiotherapy patients. This study used a CT image of the SHANE Phantom from the IAEA project in the dosimetry audit program which included delineation of the target and OAR. The method of this study evaluated end-to-end test treatment radiation for Volumetric Arc Therapy (VMAT) technique, starting from the pre-treatment planning which cover the output factor (OF) and profile and picket fence test on MLC, and then continuing the treatment planning evaluate the result of the target and OAR. In the end, the post-treatment planning is by doing QA plan which uses the IBA MatrixFFF and Octavious 4D phantom. The parameter agreement of gamma index analysis is 3%/3 mm and 10% threshold. For the profile dose evaluation, the highest difference is 0.2 cm in the cross-plane of Eclipse. The evaluation of the treatment planning for SHANE phantom result in the target using eclipse are 66 Gy (D98%), 66.7 Gy (D95%), 70.6 Gy (D50%), and 72.5 Gy (D2%) while in Monaco, the difference is only 1–2 Gy for PTV. It is because the Monte Carlo algorithm account for inhomogeneous medium and considering scatter. Furthermore, the dose constraint in all of the OAR is lower than the IAEA recommendation, with the assessment using the maximum or mean doses depending on the organs. Meanwhile, the gamma index measurement is 96.1% (Monaco) on Octavius and 98.7% (Eclipse 1) on matrixFFF. It can be drawn that SHANE Phantom can be implemented for the evaluation of the VMAT technique. [ABSTRACT FROM AUTHOR]

[177Lu]Lu-DOTA-TATE has demonstrated an effective response in neuroendocrine tumor treatment. It positively impacts survival in peptide receptor radionuclide therapy (PRRT). Few studies have presented that performing personalized dosimetry for molecular radiotherapy patients in pre- and post-therapy may use available-commercial software, such as Planet Dose, Olinda 1.0, and Olinda 2.0. Recently, IDAC Dose 2.1 has been released as freeware. This study compares the absorbed dose estimation of the kidneys and whole liver using Planet Dose, Olinda 1.0, Olinda 2.0, and IDAC-Dose 2.1 in a neuroendocrine tumor (NET) patient. The absorbed dose in a series of patient data as a part of IAEA CRP E23005 was investigated for the target and organ at risk. The time point measurements for CT and SPECT evaluation were at 1, 4, 24, 48, and 96 h post-injection. The fusion of CT and SPECT images has been delineated as an at-risk organ. Absorbed dose estimation was conducted using Planet Dose to obtain the residence time. Furthermore, The statistical analysis was investigated from each software using the Kruskal-Wallis H test. The IDAC-Dose 2.1 result shows a higher absorbed dose estimation than other patients on the left kidney (3.73 Gy), right kidney (3.56 Gy), and whole liver (4.73 Gy). On the other hand, Planet Dose has an underestimated dose calculation result in the whole liver and right kidney. The statistical analysis using the Kruskal-Wallis H test shows no significant difference between commercial and free software in the dose calculation for personalized dosimetry. The free software IDAC-Dose 2.1 can be implemented in the nuclear medicine installation to estimate internal dosimetry. [ABSTRACT FROM AUTHOR]

Bonn Call for Action in 2012 is a joint statement of IAEA and WHO, which intended to foster global coordinated work to address issues arising in radiation protection in medical practices. The statement has been delivering a great impact on the organ dose assessment in practice in Indonesia. One of the statements has encouraged the establishment of organ dose assessment in nuclear medicine therapy that needs to be more developed. In Indonesia, the organ dose statement has been intensively promoted since 2013, when the organ dose assessment for the diagnostic procedure has been initiated, and continued with the radionuclide therapy procedures in 2014 and so on. This paper aimed for reviewing the works that have been done in organ dose assessment for nuclear medicine practices in Indonesia as the impact of the Bonn Call for Actions 2012, and the following stages which need to be performed. To evaluate the works, several published papers related to organ dose assessment have been reviewed and the analysis has been carried out. The result shows that for research purposes, organ dose assessment has been implemented. However, organ dose assessment is a part of optimization for the radiation protection of patients. It would be better if the research on organ dose for the patient in nuclear medicine will be more enhanced in clinical practice, especially when the new radiopharmaceutical will be administered to the patients either in diagnostic or therapeutic procedures. [ABSTRACT FROM AUTHOR]