Comparison of Whole-Body Dosimetry Measurements in I-131 Therapy Using Ceiling-Mounted Geiger-Muller Detectors and Gamma Camera Scans: An Agreement Analysis

Background: In I-131 therapies internal dosimetry is crucial for determining the mean absorbed dose to organs at risk, particularly the bone marrow, which has a dose constraint of 2 Gy. Traditionally, multicompartmental models have been used for bone marrow dosimetry, necessitating whole-body absorbed-dose assessments. However, noninvasive techniques, such as gamma camera scans or ceiling-mounted Geiger-Muller (GM) counters, can estimate the aforementioned. This study was aimed to evaluate the agreement between whole-body mean absorbed dose using gamma camera scans and ceiling-mounted GM in patients with thyroid carcinoma undergoing I-131 therapy.Methods: This study included 31 patients with thyroid cancer who were treated with I-131. The whole-body time-integrated activity (TIA) and mean absorbed dose were estimated using the elimination curves obtained with gamma camera scans and ceiling-mounted GM. In addition, statistical analysis was performed on the data to determine the Coefficient Correlation Coefficient and the Bland-Altman limits of agreement for both parameters, as well as for the elimination curves' effective half-life.Results: The study revealed correlations of 0.562 and 0.586 between whole-body TIA and mean absorbed dose, respectively. The Bland-Altman limits of agreement were found to be below -3.75% and within 12.75% of the bone marrow dose constraint of 2 Gy. The nonparametric evaluation revealed that whole-body TIA and mean absorbed dose medians from GM were lower than those from gamma camera scans (p < 0.001). Effective half-life estimation mean was significantly lower in the GM than in the gamma camera of 13 and 23 h.Conclusions: Although GM calculates the whole-body absorbed dose with margins of error within clinical acceptance, underestimation of the effective half-life makes it an unacceptable substitute method for gamma cameras in clinical practice. Further research should be conducted to evaluate single-point GM measurement substitutions in time-activity curves.