EANM practical guidance on uncertainty analysis for molecular radiotherapy absorbed dose calculations.

A framework is proposed for modelling the uncertainty in the measurement processes constituting the dosimetry chain that are involved in internal absorbed dose calculations. The starting point is the basic model for absorbed dose in a site of interest as the product of the cumulated activity and a dose factor. In turn, the cumulated activity is given by the area under a time-activity curve derived from a time sequence of activity values. Each activity value is obtained in terms of a count rate, a calibration factor and a recovery coefficient (a correction for partial volume effects). The method to determine the recovery coefficient and the dose factor, both of which are dependent on the size of the volume of interest (VOI), are described. Consideration is given to propagating estimates of the quantities concerned and their associated uncertainties through the dosimetry chain to obtain an estimate of mean absorbed dose in the VOI and its associated uncertainty. This approach is demonstrated in a clinical example

The evidence base for the use of internal dosimetry in the clinical practice of molecular radiotherapy

Molecular radiotherapy (MRT) has demonstrated unique therapeutic advantages in the treatment of an increasing number of cancers. As with other treatment modalities, there is related toxicity to a number of organs at risk. Despite the large number of clinical trials over the past several decades, considerable uncertainties still remain regarding the optimization of this therapeutic approach and one of the vital issues to be answered is whether an absorbed radiation dose-response exists that could be used to guide personalized treatment. There are only limited and sporadic data investigating MRT dosimetry. The determination of dose-effect relationships for MRT has yet to be the explicit aim of a clinical trial. The aim of this article was to collate and discuss the available evidence for an absorbed radiation dose-effect relationships in MRT through a review of published data. Based on a PubMed search, 92 papers were found. Out of 79 studies investigating dosimetry, an absorbed dose-effect correlation was found in 48. The application of radiobiological modelling to clinical data is of increasing importance and the limited published data on absorbed dose-effect relationships based on these models are also reviewed. Based on National Cancer Institute guideline definition, the studies had a moderate or low rate of clinical relevance due to the limited number of studies investigating overall survival and absorbed dose. Nevertheless, the evidence strongly implies a correlation between the absorbed doses delivered and the response and toxicity, indicating that dosimetry-based personalized treatments would improve outcome and increase survival

Comparison of Empiric Versus Dosimetry-Guided Radioiodine Therapy: The Devil Is in the Details.

International audienc

Solar Influence on Global and Regional Climates

The literature relevant to how solar variability influences climate is vast—but much has been based on inadequate statistics and non-robust procedures. The common pitfalls are outlined in this review. The best estimates of the solar influence on the global mean air surface temperature show relatively small effects, compared with the response to anthropogenic changes (and broadly in line with their respective radiative forcings). However, the situation is more interesting when one looks at regional and season variations around the global means. In particular, recent research indicates that winters in Eurasia may have some dependence on the Sun, with more cold winters occurring when the solar activity is low. Advances in modelling ‘‘top-down’’ mechanisms, whereby stratospheric changes influence the underlying troposphere, offer promising explanations of the observed phenomena. In contrast, the suggested modulation of low-altitude clouds by galactic cosmic rays provides an increasingly inadequate explanation of observations