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Therapeutic Applications of Monte Carlo Calculations in Nuclear Medicine

2002 Edition, September 1, 2002

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Active, Most Current

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ISBN: 978-0-7503-0816-8
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Product Details:

  • Revision: 2002 Edition, September 1, 2002
  • Published Date: September 1, 2002
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 384
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


This book provides a review of the Monte Carlo method as it is applied in the field of therapeutic nuclear medicine. Driven in part by the remarkable increase in computing power and its ready and inexpensive availability, this is a relatively new yet rapidly expanding field. Likewise, although the use of radionuclides for therapy has origins dating back almost to the discovery of natural radioactivity itself, radionuclide therapy and, in particular, targeted radionuclide therapy has only recently emerged as a promising approach for therapy of cancer and, to a lesser extent, other diseases. An effort has, therefore, been made to place the reviews provided in this book in a broader context. The effort to do this is reflected by the inclusion of chapters that do not directly address Monte Carlo techniques, but rather provide an overview of issues that are closely related to therapeutic nuclear medicine and to the potential role of Monte Carlo in this field. A brief overview of each chapter is provided below.

Chapters 1, 2 and 6 review the fundamental theory of Monte Carlo, techniques that have been used in nuclear medicine dosimetry and Monte Carlo codes currently available for carrying out absorbed dose calculations. Unlike external radiotherapy or brachytherapy, the kinetics and biodistribution of internally administered radionuclides must be measured. Imaging is, therefore, an integral part of nuclear medicine dosimetry. As such, imaging considerations are incorporated in almost every chapter of the book. The contributions of Monte Carlo in nuclear medicine imaging are specifically reviewed in chapter 3. The anatomical input required for Monte Carlobased dose calculations may be provided either as idealized geometric representations of anatomy or as discrete, voxel-based representations that reflect the actual shape and composition of a human. Again, these considerations are present throughout the book, but chapters 5 and 13 focus on this specifically for the whole body and for the bone marrow, respectively, the latter being a particularly important and challenging portion of the anatomy. The role of Monte Carlo in providing a means for validating the overall scheme of imaging-based, patient-specific absorbed dose calculations is reviewed in chapter 12. Chapters 9, 14 and 15 examine specific implementations of the Monte Carlo approach in the special cases of microdosimetry, intravascular therapy and boron neutron capture synovectomy. Microdosimetry is becoming increasingly important as high linear energy transfer (LET) (see chapter 8) emissions are being considered for therapeutic use. In alpha-emitter therapy, for example, a small number of decays can substantially influence cell survival; the Monte Carlo method is therefore indispensable in simulating such a stochastic process and thereby understanding experimental cell survival studies and potentially translating such results into the clinic. Intravascular radiation therapy using radionuclides is a relatively new area of radionuclide therapy. The potential efficacy of this approach is heavily dependent upon the spatial distribution of absorbed dose relative to the anatomical distribution of the cells involved in restenosis. The absorbed dose distribution is, in turn, dependent upon the radionuclide emissions, the configuration of emitters and the heterogeneous environment that is traversed in going from the source region to the target regions. These aspects are best addressed by Monte Carlo calculations. Boron neutron capture therapy incorporates aspects of both external radiotherapy (the neutron beam) and systemic radionuclide therapy (the biodistribution and kinetics of boron-enriched compounds). In chapter 15, Monte Carlo is used to investigate the design of a neutron beam configuration that is optimized for synovectomy.

Conventional, non-Monte Carlo-based approaches to radionuclide dosimetry are described in chapters 4 and 7. Chapter 4, in particular, provides a review of the dose schema, developed by the Medical Internal Radionuclide Dose (MIRD) Committee, that is most widely implemented for radionuclide dosimetry. Chapter 7 describes the point-kernel methodology which has been used extensively in patient-specific absorbed dose calculations and which may be thought of as a precursor to a full Monte Carlo implementation of imaging-based patient-specific dosimetry. Chapters 10 and 11 briefly review two software packages that have been developed for carrying out radionuclide dosimetry in therapeutic nuclear medicine. The first, MABDOSE, facilitates implementation of the MIRD schema while also allowing for on-line Monte Carlo calculations that make it possible to incorporate idealized tumour geometries within the MIRD formalism. The second, 3D-ID, describes an imaging-based approach to patient-specific dosimetry.

Chapter 8 provides a comprehensive review of the radiobiology relevant to therapeutic nuclear medicine. This chapter is essential in understanding the biological aspects critical to the design of successful radionuclide therapy for cancer. It serves as a reminder that regardless of how precisely the distribution of ionizing energy density (i.e., absorbed dose) is estimated, this information will predict biologic response only if the pertinent biologic considerations are also incorporated.

Finally, we would like to thank all of the contributors for their invaluable hard work and for keeping to a very tight schedule. The topic of this book is rapidly evolving and the editors felt it important to minimize the time required to get this book into press. That this problem was so very well overcome speaks of the commitment and dedication of the contributors. We found compilation of this book to be a rewarding and educational experience and hope that the reader is left with the same experience.