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EMPIR project established clinical procedures that allow use of traceable methodologies for molecular radiotherapy across Europe

Molecular Radiotherapy

Cancer cases are rising in Europe, creating an increasing need for more effective treatment options. Molecular radiotherapy (MRT) uses radioactive medication to target tumour tissue. Molecular radiotherapy can be used to treat many cancer types and is generally well tolerated as diseased cells are targeted effectively. This also may reduce any side effects that may occur with other cancer treatments.

EURAMET projects

The EC Directive 20143/59/EURATOM, Article 56 was introduced across EU states to create uniform guidelines for the individual dose planning for nuclear medicine treatments. The EMRP project ‘Metrology for molecular radiotherapy’  (HLT11,  MetroMRT) and EMPIR project ‘Metrology for clinical implementation of dosimetry in molecular radiotherapy’ (15HLT06, MRTDosimetry) developed the required metrology needed to accurately determine the individual doses for molecular radiotherapy using quantitative imaging instruments. These instruments include SPECT (single-photon emission computed tomography) and PET (positron emission tomography) scans, that both use imaging of tissue after administering radioactivity to assess the function of tissue and organs. However, healthcare providers across Europe need further guidance to establish traceability for these measurement techniques in clinical practice.

As part of EURAMET’s ‘Support for Impact’ call in 2019, the EMPIR project ‘Protocols for clinical impact in molecular radiotherapy’ (19SIP01, PINICAL-MRT) was funded. The project coordinated the practical implementations of the measurement technologies developed in the two previous projects. This included generating good practice guides, training workshops and practical protocols for the commission and validation of molecular radiotherapy dosimetry calculations.

Project outputs

The project was able to successfully establish traceable practices within clinical centres. Throughout the project, 15 lectures were delivered as part of training courses that helped to train 1500 medical professionals including medical physicists, physicians and technologists. These training courses were held by various organisations such as the European School for Medical Physics Experts Nuclear Medicine Dosimetry, or the UK Internal Dosimetry Users Group. Additionally, 8 international and national workshops were held with more than 1000 participants, which further helped to reach the metrology community.  

The project outputs were able to contribute to a variety of international standards, including the new practice guidelines for quantitative SPECT-CT for the European Association of Nuclear Medicine (EANM). Project partners have also been able to provide input for new EARL accreditation service for SPECT/CT systems.

All practical guides were published in an open access repository, including the good practice guide ‘Preparation of Radioactive Phantoms with an Activity Traceable to National Standards’ that was prepared by the UK’s national metrology institute National Physical Laboratory (NPL).

The project coordinator Andrew Robinson (NPL) comments on the success of the PINICAL-MRT project:

“Within the PINICAL-MRT project we have been able to disseminate the underlying metrology for MRT develop in previous EMRP and MEPIR projects through multiple routes. The close collaboration between clinical physicists and metrologists in this project has produced a range of guidance and training that we hope will allow nuclear medicine clinics to address the unique measurement challenges in delivering MRT.”

This EMPIR project is co-funded by the European Union's Horizon 2020 research and innovation programme and the EMPIR Participating States.

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