The case for modernizing biodistribution reporting in nuclear medicine

Radiopharmaceutical dosimetry (RD) is an integral part of nuclear imaging and therapy, but current standards for documenting and reporting compound travel patterns inside the human body—biodistribution—in dosimetry-related studies do not exist. 

A March 30 Journal of Nuclear Medicine article argues all publication of RD estimates need to include the associated biodistribution characterizations used to create them.

“Biodistribution data is already collected in every dosimetry case, and its standard documentation may help us understand the value and limitations of our RD, identify errors, resolve discrepancies, and enable the reproducibility of results,” wrote corresponding author Adam Kesner, PhD, and assistant attending of nuclear imaging physics at Memorial Sloan Kettering Cancer Center, and colleagues.

In imaging, accurate and replicable dosimetry is critical because the tracer dose can vary widely across radiopharmaceuticals, and understanding individual risk is important to ensure optimal imaging and regulation compliance.

The pair of authors writes the biodistribution summary should provide accounting for “100 percent of the activity modeled in the presented osimetry calculations.”

This includes time-integrated activity coefficients for all patients involved in the study, including organ uptake, remainder-of-body uptake and assumed waste, according to Kesner et al. This information can be formatted as a table and included in the body, appendix or supplementary data portions of published articles, they add.

“Ultimately [RD documentation] may improve the current generally poor acceptance of dosimetry procedures by clinicians,” wrote Kesner et al. “We are now at an opportune time when changing our reporting practices is practical and can lay the groundwork for a more robust and dynamic field in the coming decades.”