Imaging-Guided Dosimetry Across Beta-, Alpha-, and Auger-Emitter Radiopharmaceutical Therapies

Radiopharmaceutical therapy (RPT) is expanding from established treatments such as iodine-131 for thyroid disease and yttrium-90 radioembolization to lutetium-177 radioligand therapies and emerging alpha- and Auger-emitter approaches. Across these applications, molecular and post-therapy imaging can support patient selection, treatment planning, verification of radiopharmaceutical distribution, absorbed-dose estimation, cycle-to-cycle adaptation, and response assessment. PET/CT, SPECT/CT, planar imaging, and complementary non-imaging measurements therefore have an increasingly important role in moving RPT from empirical or fixed-activity administration toward more individualized care. However, quantitative imaging and dosimetry remain highly variable across radionuclides, institutions, equipment, software platforms, and clinical indications. Differences in calibration, acquisition timing, reconstruction, corrections, segmentation, kinetic modeling, and absorbed-dose calculation can affect reported results and limit comparison between studies. The technical challenges also vary by therapy: iodine-131 presents high-energy photon and dead-time considerations; yttrium-90 may require bremsstrahlung SPECT or low-count PET; lutetium-177 enables post-therapy SPECT but still requires validated and harmonized protocols; and alpha-emitter therapies pose particular difficulties because of low administered activities, limited imageable emissions, decay-chain effects, and possible daughter redistribution. Intensive multi-time-point protocols may also be difficult to implement in routine practice. There is therefore a need for accurate, practical, and resource-conscious methods, together with quality assurance, common reporting standards, and multicenter validation. Moreover, the expanding range of therapies creates a fragmented evidence base: methods developed for one radionuclide or disease are not always transferable to another. Bridging technical validation with clinical utility is essential if imaging and dosimetry are to influence treatment decisions rather than remain primarily research procedures.This Research Topic aims to bring together technical, clinical, and translational evidence on how quantitative imaging and dosimetry can verify, personalize, and evaluate RPT. It will emphasize reproducible approaches that can progress from single-center proof-of-concept studies to routine and multicenter implementation. By linking imaging-derived activity and absorbed dose with treatment decisions, toxicity, response, and outcomes, the collection will help identify where quantitative methods add clinical value, which uncertainties are acceptable, and how workflows can be adapted across radionuclides, diseases, equipment, and healthcare settings. It will also foster shared terminology, transparent reporting, and collaboration among physicians, physicists, radiochemists, engineers, and data scientists.We welcome original, methodological, clinical, preclinical, multicenter, review, and technology-focused contributions addressing:o quantitative PET, SPECT, planar, hybrid, or non-imaging measurements before, during, or after therapy; o calibration, acquisition, reconstruction, corrections, segmentation, kinetic modeling, and uncertainty analysis; o organ-, lesion-, and voxel-level dosimetry, including single-time-point and multi-time-point approaches; o patient selection, pre-therapy planning, treatment verification, adaptive treatment, and response assessment; o preclinical validation of quantitative imaging or dosimetry methods with clear clinical translation potential; o applications involving iodine-131, lutetium-177, yttrium-90, radium-223, actinium-225, lead-212, terbium-161, holmium-166, rhenium isotopes, and other beta-, alpha-, or Auger-emitting therapies; o quality assurance, harmonization, multicenter benchmarking, software validation, automation, and artificial intelligence specifically supporting quantitative RPT; o dose-response and dose-toxicity relationships, workflow feasibility, health economics, radiation safety, and implementation in resource-diverse settings. Submissions should have a clear connection to imaging, dosimetry, treatment verification, or quantitative clinical decision-making in RPT. Purely diagnostic imaging studies or radiopharmaceutical-development papers without a therapy-quantification component fall outside the central focus. Topic editors: Konstantinos Zeimpekis, Christos Sachpekidis, Thiago Viana Miranda Lima Source: https://www.frontiersin.org/research-topics/85844/imaging-guided-dosimetry-across-beta--alpha--and-auger-emitter-radiopharmaceutical-therapies