Adaptive biokinetic modelling of iodine-131 in thyroid cancer treatments: implications on individualised internal dosimetry

Nowadays therapies involving radioiodine (I-131) represent 84% of the total metabolic treatments in Europe, according to the last report of the European Association of Nuclear Medicine in relation to treatment planning for molecular radiotherapy. Last recommendations of the European Council, i.e. 2013/59/ Euroatom, mandates that metabolic treatments should be planned according to the radiation doses delivered to individual patients, analogous to external beam radiotherapy. In this work, we present a novel biokinetic model for 1-131 that allows on to obtain realistic activity distributions for particular patients with thyroid cancer in absence of metastasis. Other models existing in the literature present either a too simple metabolic description to obtain realistic results or a too complex one for adapting the model to individual patients, and many of these models are not indicated for metabolic treatments. The individualisation of activity distribution is obtained by an optimisation method that adjusts our model to a set of experimental measurements. Significant differences in terms of absorbed doses are observed between our model and the standard generalist models, especially in terms of red marrow absorbed dose.