Dosimétrie clinique en médecine nucléaire thérapeutique : statut et perspectives

Abstract

There is a contradiction between the European regulations on patient radiation protection and the marketing authorisations for therapeutic radiopharmaceuticals. On the one hand, it is mandatory to “programme target volume exposures on a case-by-case basis”, on the other hand, radiopharmaceuticals are marketed on the basis of fixed activity delivery. Some countries are currently trying to resolve this contradiction, and various scientific or professional associations have proposed their views on how to implement therapeutic nuclear medicine dosimetry in clinical routine. Apart from the consequences of inconsistent European legislation, various factors limit the wide dissemination of clinical dosimetry. The lack of human and material resources and the absence of reimbursement are reasons frequently given. In addition, it is necessary to make progress in understanding the phenomena that lead to cell death in this particular irradiation context. The development of clinical dosimetry must accompany that of clinical radiobiology.