To go further in the optimization of treatment planning in selective internal radiation therapy (SIRT), radiobiological aspects can be accounted for with the OEDIPE software and used to design fractionation protocols. Dosimetry was performed using data from 99mTc-MAA evaluations of 10 patients treated for hepatic metastases with SIRT. The maximal injectable activity (MIA) was calculated, using a tolerance criterion on BEDmean,healthyliver equal to 54 Gy2.5, for different fractionation protocols, varying the number of fractions, the repartition of activity and the time delay between fractions. OEDIPE was also used to calculate BEDmean and the EUD to the tumoral liver (TL) that would be delivered with those MIAs. Compared with a single-injection protocol, the MIA is increased on average by 23% ± 3%, 36% ± 5% and 45% ± 7% for fractionation protocols with 2, 3 and 4 equal fractions, respectively, while BEDmean,TL is increased by 15% ± 2%, 23% ± 4% and 29% ± 5%. EUDTL, calculated for one evaluation, is increased by 51%, 115% and 159% using 2, 3 and 4 equal fractions, respectively. For this evaluation, the optimal activity repartition for two-fraction protocols is (3/4 − 1/4) for time delays of less than 4 days, (2/3 − 1/3) for time delays between 4 and 6 days and (1/2 − 1/2) for time delays superior to 6 days. Finally, this study confirmed that OEDIPE can be regarded as a tool for treatment planning optimization and fractionation protocol design in SIRT.

For targeted radionuclide therapies, treatment planning usually consists of the administration of standard activities without accounting for the patient-specific activity distribution, pharmacokinetics and dosimetry to organs at risk. The OEDIPE software is a user-friendly interface which has an automation level suitable for performing personalized Monte Carlo 3D dosimetry for diagnostic and therapeutic radionuclide administrations. Mean absorbed doses to regions of interest (ROIs), isodose curves superimposed on a personalized anatomical model of the patient and dose-volume histograms can be extracted from the absorbed dose 3D distribution. Moreover, to account for the differences in radiosensitivity between tumoral and healthy tissues, additional functionalities have been implemented to calculate the 3D distribution of the biologically effective dose (BED), mean BEDs to ROIs, isoBED curves and BED-volume histograms along with the Equivalent Uniform Biologically Effective Dose (EUD) to ROIs. Finally, optimization tools are available for treatment planning optimization using either the absorbed dose or BED distributions. These tools enable one to calculate the maximal injectable activity which meets tolerance criteria to organs at risk for a chosen fractionation protocol. This paper describes the functionalities available in the latest version of the OEDIPE software to perform personalized Monte Carlo dosimetry and treatment planning optimization in targeted radionuclide therapies.

The measurement performances of in vivo monitoring vehicles were studied considering an increase in the radiological background in areas where the population is not evacuated after a nuclear accident. The study focused on 137Cs and 131I Detection Limits (DLs) and corresponding doses, for adults and one-year-old children. These DLs for ground contamination were obtained experimentally using a grid of point sources. Then, the DLs and doses were calculated using the experimental data and a safety factor for two accident scenarios. For these scenarios the 137Cs DL corresponds to a committed effective dose of 0.02 mSv. The 131I DL corresponds to committed equivalent thyroid doses of 3 mSv (adult) and 30 mSv (one-year-old child). To guarantee a 45 mSv thyroid equivalent dose assessment for the child the surface activity of 131I + 132I + 133I should be below 1.6 MBq/m2. This study shows that the vehicles can operate in a contaminated area where the population is not evacuated. However, in such a case, the contamination level outside and inside the vehicle should be kept stable to guarantee efficient body counting.

Les mesures spectrométriques par anthroporadiamétrie, utilisées pour la surveillance des travailleurs exposés à des risques de contamination interne, permettent une estimation rapide et fiable de la nature des radionucléides incorporés ainsi que de leur activité. Les étalonnages typiques des systèmes de comptage dédiés aux mesures in vivo reposent sur l’utilisation de fantômes physiques d’un réalisme anatomique limité. Ce travail met en évidence l’intérêt des nouvelles technologies de l’infographie, en proposant de nouvelles représentations 3D graphiques afin d’optimiser la dosimétrie interne et de la surveillance des travailleuses du nucléaire par anthroporadiamétrie. Une librairie de modèles thoraciques féminins aux formats Mesh et NURBS (non uniform rational B-splines) a ainsi été développée et a permis la correction des coefficients d’étalonnages expérimentalement obtenus à l’aide du mannequin masculin Livermore. La variation de l’efficacité de comptage avec la morphologie du fantôme a ensuite été mise en équation. Cette équation permet d’éviter la création laborieuse d’un fantôme équivalent travailleuse et de s’affranchir des simulations Monte Carlo très coûteuses en temps. Après validation à l’aide de données simulées, cette équation a été utilisée pour déduire, à partir des mesures expérimentales Livermore, les efficacités de comptage pour toute travailleuse surveillée par anthroporadiamétrie

In case of accidental exposure to radiation, it is necessary to establish as soon as possible a dosimetry report for each victim. In most cases, this report is based on medical images of the victim, enabling the construction of a personalized realistic numerical model, also called a voxel phantom. Unfortunately it is not always possible to perform the medical imaging of the victim since the technology may be unavailable or to avoid additional exposure to radiation. In such cases, the commonly used method is to represent the victim with a numerical model like the “Reference Man”, a voxelized phantom representative of the average male individual. The treatment accuracy depends on the diagnosis precision and, consequently, on the similarity of the phantom and/to the victim. A precise dosimetry evaluation requires a personalised and realistic phantom whose biometric characteristics match the victim; such model is often unavailable. The Case-Based Reasoning (CBR) is a problem solving method for the conception of intelligent systems. It imitates the analysis, understanding and reconstruction of the human intelligence. The ReEPh project (Research of Equivalent Phantom) proposes to use the CBR principles to retrieve from a set of phantoms, the most adapted one to the irradiated victim. For this study, the ReEPh platform retrieves, stores and compares existing phantoms to a victim. A graphic interface enables the user to compare victim’s characteristics to the ones of the most similar phantoms available in the database. This defines a similarity index presenting the equivalence between the victim and the suggested phantom. Moreover, a confidence index is also assessed to define the uncertainty implied by the RaPC choice procedure.