The two types of correction of absorbed dose estimates for internal emitters.
BACKGROUND
Two types of correction for absorbed dose (D) estimates are described for clinical applications of internal emitters. The first is appropriate for legal and scientific reasons involving phantom-based estimates; the second is patient-specific and primarily intended for radioimmunotherapy (RIT).


METHODS
The Medical Internal Radiation Dose (MIRD) relationship (D) = S A is used, where S is a geometric matrix factor and A is the integral of source organ activities. Internal consistency of the data and the size of organ systems in the humanoid phantom must be assured in both types of estimation.


RESULTS
The first dose estimate correction (I) is one whereby computations refer to one or another standard (e.g., MIRD-type) phantom. In this case the S value remains as given, but the measured patient A data must be standardized. The correction factor is the phantom's ratio of organ mass to whole-body mass divided by the same ratio for the volunteer or patient. The second dose estimate correction (II) is patient-specific. While the A value is unchanged for this application, a correction term is provided for the phantom-derived S matrix. The dominant (nonpenetrating radiation) component of this correction factor can be obtained via the ratio of the patient to phantom organ masses. In both corrections, we recommend that true organ sizes, necessary in each method of estimation, be determined in a separate sequence of anatomic images.


CONCLUSIONS
In both dose estimation corrections, true sizes of the patient's or volunteer's internal organs must be obtained. Correction due to organ mass size can be severalfold and is probably the dominant uncertainty in the internal emitter absorbed dose calculation process.
Williams
Lawrence E
LE
Division of Radiology, City of Hope National Medical Center, Duarte, California 91010, USA. lwilliams@coh.org
Liu
An
A
Yamauchi
Dave M
DM
Lopatin
George
G
Raubitschek
Andrew A
AA
Wong
Jeffrey Y C
JY
D000042:Absorption; D006801:Humans; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D016499:Radioimmunotherapy / Q000379:methods*