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Radiation dosimetry for radioimmunotherapy. An overview of current capabilities and limitations

Background. The two major uncertainties associated with absorbed dose calculations involve: (1) measurement errors from assessment of radioactivity in specific organs and tissues by direct counting; and (2) application of standard anthropomorphic and biokinetic models for dose assessment. Uncertainties in direct counting result from the inherent difficulty of measuring radioactivity inside the body. Although the system recommended by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine provides a general framework and conceptual basis for the dosimetry of administered radiopharmaceuticals, it does not provide complete methods for assessing some of the more important quantities of interest in radioimmunotherapy, such as dose to tumors and descriptions of spatial dose distributions within tissues. Current MIRD anthropomorphic models are only crude representations of the human body. Generalized biokinetic models used in the MIRD system may vary considerably from the actual biokinetics of radiolabeled compounds in the body.