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Ballester, F., Granero, D., Perez-Calatayud, J., Venselaar, J. L. M., & Rivard, M. J. (2010). Study of encapsulated Tm-170 sources for their potential use in brachytherapy. Med. Phys., 37(4), 1629–1637.
Abstract: Methods: The authors have assumed a theoretical Tm-170 cylindrical source encapsulated with stainless steel and typical dimensions taken from the currently available HDR Ir-192 brachytherapy sources. The dose-rate distribution was calculated for this source using the GEANT4 Monte Carlo (MC) code considering both photon and electron Tm-170 spectra. The AAPM TG-43 U1 brachytherapy dosimetry parameters were derived. To study general properties of Tm-170 encapsulated sources, spherical sources encapsulated with stainless steel and platinum were also studied. Moreover, the influence of small variations in the active core and capsule dimensions on the dosimetric characteristics was assessed. Treatment times required for a Tm-170 source were compared to those for Ir-192 and Yb-169 for the same contained activity. Results: Due to the energetic beta spectrum and the large electron yield, the bremsstrahlung contribution to the dose was of the same order of magnitude as from the emitted gammas and characteristic x rays. Moreover, the electron spectrum contribution to the dose was significant up to 4 mm from the source center compared to the photon contribution. The dose-rate constant Lambda of the cylindrical source was 1.23 cGy h(-1) U-1. The behavior of the radial dose function showed promise for applications in brachytherapy. Due to the electron spectrum, the anisotropy was large for r < 6 mm. Variations in manufacturing tolerances did not significantly influence the final dosimetry data when expressed in cGy h(-1) U-1. For typical capsule dimensions, maximum reference dose rates of about 0.2, 10, and 2 Gy min(-1) would then be obtained for Tm-170, Ir-192, and Yb-169, respectively, resulting in treatment times greater than those for HDR Ir-192 brachytherapy. Conclusions: The dosimetric characteristics of source designs exploiting the low photon energy of Tm-170 were studied for potential application in HDR-brachytherapy. Dose-rate distributions were obtained for cylindrical and simplified spherical Tm-170 source designs (stainless steel and platinum capsule materials) using MC calculations. Despite the high activity of Tm-170, calculated treatment times were much longer than for Ir-192.
Keywords: brachytherapy; cancer; dosimetry; prosthetics; radioisotopes; thulium
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Koolen, B. B., Vidal-Sicart, S., Benlloch, J. M., & Olmos, R. A. V. (2014). Evaluating heterogeneity of primary tumor 18 F-FDG uptake in breast cancer with a dedicated breast PET ( MAMMI): a feasibility study based on correlation with PET/CT. Nucl. Med. Commun., 35(5), 446–452.
Abstract: PurposeThe aim of the study was to evaluate the heterogeneity of primary tumor F-18-fluorodeoxyglucose (F-18-FDG) uptake in breast cancer patients using a dedicated breast PET.Patients and methodsA positron emission tomography/computed tomography (PET/CT) of the thorax was performed 60 min after administration of 180-240 MBq of F-18-FDG in patients with breast cancer. Subsequently, 110 min after injection, a scan was taken with a dedicated high-resolution breast PET [MAMmography with Molecular Imaging (MAMMI)]. Both procedures were performed with the patients in the prone position. Four-point scores were used to compare the intensity (0: none; 1: mild; 2: moderate; 3: high) and heterogeneity (0: none; 1: mild; 2: moderate; 3: high) of F-18-FDG uptake between PET/CT and MAMMI images.ResultsThirty-five patients in whom the primary tumor was visualized on both scans were included in this analysis. The mean primary tumor size was 35.1 mm (range 10-108 mm). The mean intensity score was similar on both devices (2.4 for PET/CT and 2.3 for MAMMI; P=0.439), but the mean heterogeneity score on MAMMI images was significantly higher (PET/CT 1.9 vs. MAMMI 2.3; P=0.005). MAMMI showed a higher heterogeneity score in 11 (31%) of 35 patients, especially in tumors with moderate or high intensity. Significantly higher heterogeneity scores on both PET/CT and MAMMI were seen in large tumors (P=0.005 and 0.014, respectively) and in tumors with high intensity scores (P=0.012 and P<0.001, respectively).ConclusionHeterogeneous tumor F-18-FDG uptake in breast cancer is frequently observed, particularly in large tumors with intense F-18-FDG uptake. It is more often seen on MAMMI PET than on conventional PET/CT. Although the observed heterogeneity should be proven histopathologically, this finding offers a rationale for F-18-FDG-guided biopsies.
Keywords: breast cancer; F-18-FDG; heterogeneity; MAMMI; PET
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Lozares, S., Tur, P., Ballester, F., Bundschuh, R. A., Gonzalez-Perez, V., Jaberi, R., et al. (2025). Head and neck and skin (HNS) GEC-ESTRO and BRAPHYQS working groups joint critical review of the use of Rhenium-188 in dermato-oncology. Clin. Transl. Radiat. Oncol., 53, 100991–9pp.
Abstract: Non-melanoma skin cancers are increasing globally, prompting the need for innovative, non-invasive treatment approaches. Radioactive rhenium (188Re) paste has emerged as an open-source radiation-based modality in dermato-oncology, offering a novel alternative to conventional radiotherapy and brachytherapy. In this review, a systematic literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for studies published over the past 20 years. Data were extracted from case series, pilot studies, and clinical trials, with particular emphasis on response rates, dosimetric parameters, and treatment-associated toxicity. Findings from approximately 240 patients demonstrated complete response rates ranging from 86 % to 100 % after one or two treatment applications, while dosimetric analyses revealed a rapid dose fall-off that effectively confines the therapeutic effect to a tissue depth of 2-3 mm, with most adverse effects being mild and transient. Notably, 188Re differs from conventional brachytherapy (specifically high-dose-rate modality) due to its open-source application and unique dosimetric profile. The use of 188Re in clinical practice mandates a highly specialized, multidisciplinary team, including radiation oncologists, nuclear medicine specialists, and experienced medical physicists, and strict quality assurance protocols, thereby limiting its application to carefully selected cases. Although 188Re therapy offers a promising alternative for the treatment of superficial skin cancers, its distinct clinical and dosimetric characteristics warrant further randomized studies with extended follow-up to validate its efficacy and refine patient selection criteria under rigorous multidisciplinary oversight.
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Roman, F. L., Abler, D., Kanellopoulos, V., Amoros, G., Davies, J., Dosanjh, M., et al. (2013). Hadron therapy information sharing prototype. J. Radiat. Res., 54, 56–60.
Abstract: The European PARTNER project developed a prototypical system for sharing hadron therapy data. This system allows doctors and patients to record and report treatment-related events during and after hadron therapy. It presents doctors and statisticians with an integrated view of adverse events across institutions, using open-source components for data federation, semantics, and analysis. There is a particular emphasis upon semantic consistency, achieved through intelligent, annotated form designs. The system as presented is ready for use in a clinical setting, and amenable to further customization. The essential contribution of the work reported here lies in the novel data integration and reporting methods, as well as the approach to software sustainability achieved through the use of community-supported open-source components.
Keywords: hadron therapy; proton therapy; data federation; web portal; eHealth; cancer informatics
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