Dosimetry related to SPECT and PET applications

Nuclear medicine methods permit the in vivo measurement of physiological and metabolic functions. For this purpose metabolically active molecules are labelled with radionuclides. After the injection, these radiopharmaceuticals can be detected from outside the body with appropriate detectors such as conventional gamma cameras, single photon emission computerized tomographs (SPECT), or positron emission tomographs (PET). As with any application of ionizing radiation the benefits of nuclear medicine (the diagnosis and treatment of disease) must be balanced against the risks of the procedures. Risks in nuclear medicine are evaluated through dosimetry, the calculation of the radiation dose estimates, in which the energy deposited by the radiation in human tissues is quantitated. The first step of dosimetry is the determination of the biodistribution, i.e. the spatial and temporal distribution of the radiopharmaceutical within the body. When a new radiopharmaceutical is introduced such data are first derived from ex vivo experiments in animals. Further evaluations of the biokinetics and dosimetry are carried out via quantitative measurements in humans using the nuclear medicine imaging equipment, applying whole-body planar and tomographic methods. Based on the knowledge of the biodistribution and using the framework introduced by the MIRD committee as well as by the ICRP, the radiation dose to single organs and to the total body can be calculated. The purpose of this paper is to review methods for measuring radiopharmaceutical biodistributions in humans and for calculating the appropriate radiation dose quantities.