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In Russian medicine two radiopharmaceuticals are currently used for radionuclide therapy of bone metastases: ⁸⁹Sr-chloride and ¹⁵³Sm-oxabifor. The first one has many side effects, so its use is limited. The second one is available only in clinics, its transportation to which does not take much time. Currently, the third radiopharmaceutical ¹⁸⁸Re-solerene is undergoing clinical trials. Due to the generator method of obtaining ¹⁸⁸Re, this radiopharmaceutical should become available for use in many regions of our country. Therefore, there is a need for a comparative analysis of the characteristics of these radiopharmaceuticals, including on the basis of mathematical modeling.

The article discusses the features of mathematical modeling the kinetics of osteotropic radiopharmaceutical drugs in the human body with bone metastases. Based on the four-compartment model, a complex of modeling and calculation of pharmacokinetic and dosimetric characteristics of radiopharmaceuticals for radionuclide therapy of bone metastases was developed and tested. Using clinical data, the transport constants of the model were identified and the individual characteristics of Russian radiopharmaceuticals labeled ⁸⁹Sr, 153Sm and ¹⁸⁸Re were calculated (effective half-lives, maximum activity in the compartments and the times of their achievement, absorbed doses to bone tissue and metastases, endosteal bone layer, red bone marrow, blood, kidneys and bladder). The time activity dependencies for all compartments of the model are obtained and analyzed. A comparative analysis of the pharmacokinetics and dosimetry of three radiopharmaceuticals (⁸⁹Sr-chloride, ¹⁵³Sm-oxabiphore, ¹⁸⁸Re-solerene) was carried out.

From a comparative analysis of the pharmacokinetic and dosimetric characteristics of these radiopharmaceutical drugs, it follows that the best of them for widespread use in many regions of our country should be ¹⁸⁸Re-solerene, taking into account the generator method of obtaining ¹⁸⁸Re in a hospital.

When determining therapeutic absorbed doses in the process of radioiodine therapy, the method of individual dosimetric planning is increasingly used in Russian medicine. However, for the successful implementation of this method, it is necessary to have appropriate software that allows modeling the pharmacokinetics of radioiodine in the patient’s body and calculate the necessary therapeutic activity of a radiopharmaceutical drug to achieve the planned therapeutic absorbed dose in the thyroid gland.

Purpose of the work: development of a software package for pharmacokinetic modeling and calculation of individual absorbed doses in radioiodine therapy based on a five-chamber model of radioiodine kinetics using two mathematical optimization methods. The work is based on the principles and methods of RFLP pharmacokinetics (chamber modeling). To find the minimum of the residual functional in identifying the values of the transport constants of the model, the Hook – Jeeves method and the simulated annealing method were used. Calculation of dosimetric characteristics and administered therapeutic activity is based on the method of calculating absorbed doses using the functions of radioiodine activity in the chambers found during modeling. To identify the parameters of the model, the results of radiometry of the thyroid gland and urine of patients with radioiodine introduced into the body were used.

A software package for modeling the kinetics of radioiodine during its oral intake has been developed. For patients with diffuse toxic goiter, the transport constants of the model were identified and individual pharmacokinetic and dosimetric characteristics (elimination half-lives, maximum thyroid activity and time to reach it, absorbed doses to critical organs and tissues, administered therapeutic activity) were calculated. The activity-time relationships for all cameras in the model are obtained and analyzed. A comparative analysis of the calculated pharmacokinetic and dosimetric characteristics calculated using two mathematical optimization methods was performed. Evaluation completed the stunning-effect and its contribution to the errors in calculating absorbed doses. From a comparative analysis of the pharmacokinetic and dosimetric characteristics calculated in the framework of two optimization methods, it follows that the use of a more complex mathematical method for simulating annealing in a software package does not lead to significant changes in the values of the characteristics compared to the simple Hook – Jeeves method. Errors in calculating absorbed doses in the framework of these mathematical optimization methods do not exceed the spread of absorbed dose values from the stunning-effect.

Radiopharmaceuticals with iodine radioisotopes are now widely used in imaging and non-imaging methods of nuclear medicine. When evaluating the results of radionuclide studies of the structural and functional state of organs and tissues, parallel modeling of the kinetics of radiopharmaceuticals in the body plays an important role. The complexity of such modeling lies in two opposite aspects. On the one hand, excessive simplification of the anatomical and physiological characteristics of the organism when splitting it to the compartments that may result in the loss or distortion of important clinical diagnosis information, on the other – excessive, taking into account all possible interdependencies of the functioning of the organs and systems that, on the contrary, will lead to excess amount of absolutely useless for clinical interpretation of the data or the mathematical model becomes even more intractable. Our work develops a unified approach to the construction of mathematical models of the kinetics of radiopharmaceuticals with iodine isotopes in the human body during diagnostic and therapeutic procedures of nuclear medicine. Based on this approach, three- and four-compartment pharmacokinetic models were developed and corresponding calculation programs were created in the C⁺⁺ programming language for processing and evaluating the results of radionuclide diagnostics and therapy. Various methods for identifying model parameters based on quantitative data from radionuclide studies of the functional state of vital organs are proposed. The results of pharmacokinetic modeling for radionuclide diagnostics of the liver, kidney, and thyroid using iodine-containing radiopharmaceuticals are presented and analyzed. Using clinical and diagnostic data, individual pharmacokinetic parameters of transport of different radiopharmaceuticals in the body (transport constants, half-life periods, maximum activity in the organ and the time of its achievement) were determined. It is shown that the pharmacokinetic characteristics for each patient are strictly individual and cannot be described by averaged kinetic parameters. Within the framework of three pharmacokinetic models, “Activity–time” relationships were obtained and analyzed for different organs and tissues, including for tissues in which the activity of a radiopharmaceutical is impossible or difficult to measure by clinical methods. Also discussed are the features and the results of simulation and dosimetric planning of radioiodine therapy of the thyroid gland. It is shown that the values of absorbed radiation doses are very sensitive to the kinetic parameters of the compartment model. Therefore, special attention should be paid to obtaining accurate quantitative data from ultrasound and thyroid radiometry and identifying simulation parameters based on them. The work is based on the principles and methods of pharmacokinetics. For the numerical solution of systems of differential equations of the pharmacokinetic models we used Runge–Kutta methods and Rosenbrock method. The Hooke–Jeeves method was used to find the minimum of a function of several variables when identifying modeling parameters.