ArticleAnnals of nuclear medicine2026
A cohort electron blood self-dose fraction and its propagated uncertainty for ¹²⁴I PET pre-therapy dosimetry in radioiodine therapy of differentiated thyroid cancer.
Article in Annals of nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePre-therapy blood-marrow dosimetry for ¹³¹I treatment of differentiated thyroid cancer (DTC) requires serial imaging and blood sampling, limiting clinical adoption. When blood data are unavailable, operators fall back to fixed or imaging-only prescribing, usually without an explicit uncertainty bound. We characterise the cohort electron blood self-dose fraction (β
methodsRetrospective single-centre analysis of 18 pre-therapy ¹²⁴I PET courses in 15 DTC patients with paired serial venous blood-counting, all prepared by thyroid-hormone withdrawal. Time-activity curves were fitted in the ¹³¹I therapy frame following the EANM Standard Operational Procedure, separating D
resultsThe cohort β fraction was 84.3 ± 4.8% across 18 courses (mean ± SD; median 85.4%; 95% CI 82.0-86.7%), and 84.4 ± 4.6% over the 15 patients. The β fraction decreased with body weight (- 0.113 pp/kg, p = 0.019), although not significantly when reduced to one value per patient (p = 0.118); the association is therefore exploratory. Substitution gave a per-patient 1-σ uncertainty on the imaging-only D
conclusionsA cohort β fraction of 84.3 ± 4.8% is proposed as a fall-back reference for blood-free prescribing in DTC radioiodine therapy. Because the estimator's error is multiplicative on the estimate, a prescribing cap must come from the lower tail of that error, giving approximately 1.0-1.2 Gy in this cohort. No 95% coverage is demonstrated at this sample size, and the cap is offered as an exploratory observation requiring local confirmation rather than a validated threshold. The decomposition is imaging-modality agnostic for ¹³¹I clearance studies and therefore potentially applicable to low-dose ¹³¹I SPECT, although no SPECT data were analysed here.
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