This project is with the Division of Nuclear Medicine of the Dept. of Radiology at the NIH Clinical Center.

Uncertainty characterization and propagation for emerging Nuclear Medicine targeted therapy.

The resurgence of the use of radiotracers for cancer therapy is poised to benefit from two recent innovations in image instrumentation such as voxelized detection, total body PET imaging, faster and more quantitative SPECT tomography. There are also new radiolabeled agents with high diagnostic and therapeutic potential that can be paired by virtue of their co-localization on the same specific target. Such pairs are referred to as “theranostic”: having a diagnostic arm with positron or single-photon emitting labels suitable for imaging, and a therapeutic arm that uses the same ligand but attached instead the alpha or beta emitting isotopes used for treatment. Such developments are already allowing better quantification, monitoring and control of cancer cells ablation for prostate and neuroendocrine malignancies as well as other lesions and metastasis and promises the same for other targets that have eluded detection and/or other type of therapies. Still, as with any therapeutic intervention, a critical need for such procedures is establishing dose-response predictability. For radioisotope based targeted therapy, one challenge is designing methods that deliver the required accuracy for the image-derived quantities that guide treatment decisions.  These values are extracted from diagnostic images and other devices using automatic, semi-automatic or fully operator-guided procedures all of which have uncertainties that propagate and impact the accuracy of the end-point quantities used for treatment decisions. Therefore, for reproducible, accurate and reliable treatments, it is essential to identify, measure and manage all sources of uncertainty. This summer’s internship projects will focus on one or more aspects of this challenge.