Introduction, Radiobiology I-II, Chemistry, and Dosimetry I-II (from the Radiopharmaceutical Therapy Curriculum Series)
Topics Covered:
Introduction to Radiopharmaceutical Therapy and Curriculum Overview
—Ana Kiess, MD, PhD
Radiobiology I (PK, Biodistribution, Dose Rate, Subcellular Targeting, Molecular and Cellular Effects of Beta/Alpha, Deterministic and Stochastic Effects, Toxicities)
—Ana Kiess, MD, PhD
Chemistry of Radiopharmaceutical Therapies for Medical Use
—Freddy E. Escorcia, MD, PhD
Dosimetry I - Dosimetry Methods and Individual Dose Planning, Uncertainties
—Yuni Dewaraja, PhD
Dosimetry II / Radiobiology II - Bioeffect Modeling, Tumor Dose-Response, Toxicities, Alpha Emitters
—Robert Francois Hobbs, PhD
For presentation descriptions, please see the Program tab.
This activity is available from July 19, 2024, through 11:59 p.m. Eastern time on July 4, 2026.
The content was originally presented and recorded on May 31, 2024 in the Beyond the Beam: A Radiation Oncology Curriculum for Radiopharmaceutical Therapy webinar series, a 15-hour in-depth curriculum designed specifically for radiation oncology residents and practicing radiation oncologists who are planning or participating in a radiopharmaceutical therapy (RPT) clinical program. Learn more about the full curriculum.
Target Audience
The activity is designed to meet the interests of radiation oncologists, radiation physicists, dosimetrists, radiation therapists, diagnostic radiologists, radiation biologists, medical oncologists and radiation oncology residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Discuss the relevant principles of physics, chemistry and radiobiology for radiopharmaceutical therapies (RPTs).
- Identify clinical indications and therapy-specific management for RPTs that are currently approved for clinical use.
- Identify barriers and logistical steps for implementing RPT use in one's own practice.
- Explain the main steps that need to be performed for RPT dose estimation.
- Describe how dosimetry guided treatment can be used to enhance the efficacy of RPT while keeping toxicity at an acceptable level.
- Determine if the imaging requirements associated with RPT dosimetry can be reduced.
- Explain and perform BED calculations using the Medical Internal Radiation Dosimetry (MIRD) formalism or dose rate functions.
- Convert RPT doses to EBRT values, yet understand the challenges and limitations in those conversions.
- Discuss the challenges of alphaRPT dosimetry.
Introduction, Radiobiology I and Chemistry
In this session, presenters introduce the curriculum, radiopharmaceutical therapies (RPTs) in general, radiobiology of RPTs, and chemistry of RPTs. This includes discussion of pharmacokinetics, biodistribution, dose rate, subcellular targeting, molecular and cellular effects of beta/alpha emitters, deterministic and stochastic effects, and toxicities.
Dosimetry I - Dosimetry Methods and Individual Dose Planning, Uncertainties
This presentation introduces methods for performing organ-level and voxel-level radiopharmaceutical therapy (RPT) dosimetry. The reference model-based MIRD formulism as well as direct Monte Carlo based methods for highly patient specific dose estimation using the patient’s SPECT and CT images as the input are discussed. The main steps of the dosimetry calculation including serial imaging, activity quantification, image registration, segmentation, time-activity fitting, and absorbed dose estimation are introduced together with the main sources of uncertainty. How individualized dosimetry before, during and after therapy can enhance RPT are covered. Methods for simplifying the dosimetry protocol to make it practical for clinical implementation are discussed including recently available AI-based tools.
Dosimetry II / Radiobiology II – Bioeffect Modeling, Tumor Dose-Response, Toxicities, Alpha Emitters
In this presentation, basic bio-effect modeling based on the linear-quadratic model is introduced. A large focus is on the biological effective dose (BED), how it is calculated, why it should be more utilized in RPT than in external beam (EBRT), and why it is a better correlate with outcome than absorbed dose. The presentation explores the theoretical comparison of EBRT and RPT doses and the limitations of that translation, especially with regard to normal organ toxicity threshold determination in RPT. Finally, the particularities and challenges of alphaRPTs are explored, including low count rate imaging, radioactive daughters, sub-organ dosimetry, the relative biological effect (RBE), and stochastic energy deposition.
- Ana Kiess, MD, PhD, is employed by Johns Hopkins University. Dr. Kiess receives grant/research funding from Bayer and serves in an uncompensated consultant role with Novartis/AAA.
- Freddy E. Escorcia, MD, PhD, is employed by the National Cancer Institute.
- Yuni Dewaraja, PhD, is employed by University of Michigan Medicine. Dr. Dewaraja receives compensation from MIM Software and grant/research funding from GE Healthcare.
- Robert F. Hobbs, PhD, is employed by Johns Hopkins Medical Institute. Dr. Hobbs receives honoraria from Novartis/AAA and Varian. Dr. Hobbs receives compensation from Vivos. Dr. Hobbs owns the copyright for RAPID Dosimetry. Dr. Hobbs serves as Chair of the Radiopharmaceutical Therapy Subcommittee with AAPM.
The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.
ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification.
Available Credit
- 4.00 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this for a maximum of 4.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 4.00 Certificate of AttendanceThis activity was designated for 4.00 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
Nonmember: $379
Member: $249
Member-in-training: $69
Student/Grad Student/PGY: $69
Postdoctoral Fellow: $69
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date.
Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.
The course and its materials will only be available on the ASTRO website until July 4, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.