Nuclear energy, nuclear technologies, and radiological protection -- Vocabulary

This document contains the terms, definitions, notes to entry and examples corresponding to the frequently used concepts which apply to diagnostic and therapeutic nuclear medicine. It comprises the minimum essential information for each nuclear medicine concept represented by a single term. It provides the reader with the information required to approach this multidisciplinary speciality, such as medical, radiopharmacy and medical physics point of view. It is intended to facilitate communication and promote common understanding.

Énergie nucléaire, technologies nucléaires et protection radiologique -- Vocabulaire

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Published
Publication Date
22-Nov-2020
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5060 - Close of voting Proof returned by Secretariat
Start Date
29-Oct-2020
Completion Date
28-Oct-2020
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INTERNATIONAL ISO
STANDARD 12749-6
First edition
2020-11
Nuclear energy, nuclear technologies,
and radiological protection —
Vocabulary —
Part 6:
Nuclear medicine
Énergie nucléaire, technologies nucléaires et protection
radiologique — Vocabulaire —
Partie 6: Médecine nucléaire
Reference number
ISO 12749-6:2020(E)
ISO 2020
---------------------- Page: 1 ----------------------
ISO 12749-6:2020(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2020

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting

on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address

below or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2020 – All rights reserved
---------------------- Page: 2 ----------------------
ISO 12749-6:2020(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction ..................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ...................................................................................................................................................................................... 1

3 Terms and definitions ..................................................................................................................................................................................... 1

3.1 Basic terms related to nuclear medicine .......................................................................................................................... 1

3.2 Terms related to diagnostic nuclear medicine ............................................................................................................ 2

3.3 Terms related to therapeutic nuclear medicine ......................................................................................................... 3

3.4 Terms related to radiopharmacy ............................................................................................................................................. 4

3.5 Terms related to medical equipment ................................................................................................................................... 5

3.6 Terms related to medical studies ............................................................................................................................................ 6

Annex A (informative) Methodology used in the development of the vocabulary ................................................8

Bibliography .............................................................................................................................................................................................................................16

Index .................................................................................................................................................................................................................................................17

© ISO 2020 – All rights reserved iii
---------------------- Page: 3 ----------------------
ISO 12749-6:2020(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards

bodies (ISO member bodies). The work of preparing International Standards is normally carried out

through ISO technical committees. Each member body interested in a subject for which a technical

committee has been established has the right to be represented on that committee. International

organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.

ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of

electrotechnical standardization.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of ISO documents should be noted. This document was drafted in accordance with the

editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/ directives).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of

any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www .iso .org/ patents).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to the

World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www .iso .org/

iso/ foreword .html.

This document was prepared by Technical Committee ISO/TC 85, Nuclear energy, nuclear technologies,

and radiological protection.
A list of all parts in the ISO 12749 series can be found on the ISO website.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www .iso .org/ members .html.
iv © ISO 2020 – All rights reserved
---------------------- Page: 4 ----------------------
ISO 12749-6:2020(E)
Introduction

This document provides terms and definitions for nuclear medicine, the medical discipline whereby

radionuclides as unsealed sources are administered to patients, in order to carry out diagnostic exams,

therapeutic treatments for various pathologies and to monitor the evolution of the disease.

This multidisciplinary activity is fundamentally made up of medical, radiopharmaceutical and medical

physics components, although it also relies on nuclear science, biology, biochemistry, radiochemistry,

nuclear chemistry, electronics, electro-mechanics, computing, metrology of ionizing radiation and

dosimetry. It involves tasks relating to support, research and development as well as staff training,

which are all carried out intensively in this field.

The specific areas of most relevance to nuclear medicine are oncology, cardiology, endocrinology and

neurology. However, its reaches practically every medical specialty.

The professional and technical staff who work in nuclear medicine are highly specialized, carrying out

their activities in highly complex facilities, using a large range of equipment, within a strict healthcare

and radiological regulatory setting.

These activities produce a large amount of documentation such as reports, publications, legal

documents and teaching texts, all of which require the use of precise, coherent and unambiguous terms

and definitions. Therefore, it becomes essential to harmonize the terminology used by all of the above-

mentioned sectors and professions.

Conceptual arrangement of terms and definitions is based on concepts systems that show corresponding

relationships among nuclear medicine concepts. Such arrangement provides users with a structured

view of the nuclear medicine sector and will facilitate common understanding of all related concepts,

see also Annex A. Besides, concept systems and conceptual arrangement of terminological data will be

helpful to any kind of user because it will promote clear, accurate and useful communication.

© ISO 2020 – All rights reserved v
---------------------- Page: 5 ----------------------
INTERNATIONAL STANDARD ISO 12749-6:2020(E)
Nuclear energy, nuclear technologies, and radiological
protection — Vocabulary —
Part 6:
Nuclear medicine
1 Scope

This document contains the terms, definitions, notes to entry and examples corresponding to the

frequently used concepts which apply to diagnostic and therapeutic nuclear medicine.

It comprises the minimum essential information for each nuclear medicine concept represented by a

single term. It provides the reader with the information required to approach this multidisciplinary

speciality, such as medical, radiopharmacy and medical physics point of view. It is intended to facilitate

communication and promote common understanding.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.

ISO and IEC maintain terminological databases for use in standardization at the following addresses:

— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
3.1 Basic terms related to nuclear medicine
3.1.1
nuclear medicine

field of medicine in which unsealed radioactive sources, namely radiopharmaceuticals (3.4.3), are used

for diagnosis or therapy
3.1.1.1
diagnostic nuclear medicine

scientific and clinical discipline in which radiopharmaceuticals, administered by different routes, are

used for diagnostic purposes

Note 1 to entry: Diagnostic nuclear medicine is mainly carried out through imaging but may also be measurements

of the global or regional function of an organ.

Note 2 to entry: Diagnostic nuclear medicine also includes quantitative imaging and patient monitoring for the

follow-up of both the disease progression and the treatment response.
3.1.1.2
therapeutic nuclear medicine

scientific and clinical discipline in which radiopharmaceuticals are administered for therapeutic

purposes
© ISO 2020 – All rights reserved 1
---------------------- Page: 6 ----------------------
ISO 12749-6:2020(E)
3.1.2
theranostics
theragnostics

treatment strategy based on personalized medicine, which allows selecting the most appropriate

therapy according to the diagnostic images

Note 1 to entry: In nuclear medicine, the specific targeted diagnostic test and therapy can be made sequentially

with the same radiolabelled molecule (i.e. radiopharmaceutical) or with the same molecule and different label

radionuclides or with different molecules with similar physiological properties.

EXAMPLE Personalized treatment of a patient with a positive somatostatin receptor image (neuroendocrine

tumour) by a radiopharmaceutical composed of somatostatin analogs peptide labelled with an emitter suitable

for molecular radiotherapy.
3.1.3
radiopharmacy

branch of pharmacy, that deals with the preparation, characterization and quality of radioactive drugs

in nuclear medicine procedures

EXAMPLE The final stage or the preparation of the pharmaceutical and/or activity dispensing is carried out

from commercial products in a hospital radiopharmacy or in centralized radiopharmacies and then delivered to

a hospital radiopharmacy.
3.1.4
administered activity

activity (in MBq) of radiopharmaceutical that has been administred to the patient for diagnostic or

therapeutic purposes
3.1.5
uptake

accumulation of administered activity to a particular organ or tissue at a particular time after

administration

[SOURCE: NATIONAL COUNCIL ON RADIATION PROTECTION AND MEASUREMENTS. NCRP Composite

Glossary. NCRP, Bethesda, 2011]
3.2 Terms related to diagnostic nuclear medicine
3.2.1
diagnostic nuclear medicine
(See 3.1.1.1)
3.2.2
nuclear medicine imaging
imaging performed after administration of a radiopharmaceutical

Note 1 to entry: Imaging is considered a non-invasive diagnostic technique, as opposed to a biopsy or exploratory

surgery.

Note 2 to entry: PET and SPECT are the main type of nuclear medicine imaging, providing information about how

certain tissues and organs are functioning. It is complementary to anatomical imaging, such as X-ray imaging.

3.2.3
molecular imaging

imaging allowing the visualization, characterization, and measurement of biological processes at the

molecular and cellular levels in humans and other living systems

Note 1 to entry: Nuclear medicine imaging (3.2.2) is one of the modalities of molecular imaging.

[SOURCE: Mankoff DA. A definition of molecular imaging. J. Nucl. Med. 2007 Jun;48(6):18N, 21N,

modified.]
2 © ISO 2020 – All rights reserved
---------------------- Page: 7 ----------------------
ISO 12749-6:2020(E)
3.2.4
quantitative imaging
extraction and use of numerical/statistical features from medical images

Note 1 to entry: The chief method used in quantitative imaging is to delineate a region of interest on the image

and determine the mean uptake in this region, but many other features can be extracted.

[SOURCE: Abramson RG, Burton KR, Yu JP, et al. Methods and challenges in quantitative imaging

biomarker development. Academic Radiology 2015 Jan, 22(1):25-32].
3.2.5
diagnostic reference level
DRL

level used in medical imaging to indicate whether, in routine conditions, the activity of a

radiopharmaceutical administered in a specified radiological procedure is unusually high or unusually

low for that procedure

Note 1 to entry: In diagnostic nuclear medicine, DRL is a level of activity for typical examinations for groups of

standardized patients.
[SOURCE: IAEA SAFETY STANDARDS SERIES No. GSR Part 3 (2014), modified.]
3.2.6
standard uptake value
SUV

value equal to the radio of the image derived r adioactivity concentration (in kBq/ml) to the whole

body concentration (in kBq/kg)
Note 1 to entry: Mainly used in PET imaging, but also in SPECT imaging.

Note 2 to entry: There are other definitions of the SUV when substituting the body weight with the lean body

weight or the body surface area. In addition, from a region of interest, several SUV values can be extracted (such

as the maximum, the mean SUV-value, etc.).
3.3 Terms related to therapeutic nuclear medicine
3.3.1
therapeutic nuclear medicine
(See 3.1.1.2)
3.3.2
radiotherapy
radiation therapy

therapy that uses ionizing radiation to kill cells and shrink pathological tissues

Note 1 to entry: Radiation may be delivered by a machine outside the body (external-beam radiation therapy),

or it may come from radioactive material placed in the body near cancer cells (brachytherapy) or from

radiopharmaceutical administered to the patient (molecular radiotherapy).
3.3.3
molecular radiotherapy

radiation therapy that uses a radiopharmaceutical to kill pathological cells and tissues by the effect of

ionizing radiation
3.3.3.1
metabolic radiotherapy

molecular radiotherapy using selective irradiation of a target zone by a radiopharmaceutical

administered to the patient and that participates in the metabolism of tumour cells

EXAMPLE The most widely used form of molecular radiotherapy is for the treatment of thyroid pathologies

(thyroid cancer and hyperthyroidism). Called radioiodine therapy, this treatment consists of an oral

administration of iodine-131, which will primarily concentrate in the thyroid to kill diseased cells.

© ISO 2020 – All rights reserved 3
---------------------- Page: 8 ----------------------
ISO 12749-6:2020(E)
3.3.3.2
radioimmunotherapy
RIT

molecular radiotherapy based on a personalized cancer treatment that combines radiation therapy

with the precise targeting ability of immunotherapy

Note 1 to entry: In immunotherapy, scientists create monoclonal antibodies in a laboratory that mimic cellular

activity in the body’s immune system and are designed to recognize and bind to the antigen of a specific cancer cell.

Note 2 to entry: In RIT, the monoclonal antibody is paired with a radioactive material. When injected into the

patient’s bloodstream, the antibody travels to and binds to the cancer cells, allowing a high dose of radiation to

be deli
...

FINAL
INTERNATIONAL ISO/FDIS
DRAFT
STANDARD 12749-6
ISO/TC 85
Nuclear energy, nuclear technologies,
Secretariat: AFNOR
and radiological protection —
Voting begins on:
2020-09-02 Vocabulary —
Voting terminates on:
Part 6:
2020-10-28
Nuclear medicine
Énergie nucléaire, technologies nucléaires et protection
radiologique — Vocabulaire —
Partie 6: Médicine nucléaire
RECIPIENTS OF THIS DRAFT ARE INVITED TO
SUBMIT, WITH THEIR COMMENTS, NOTIFICATION
OF ANY RELEVANT PATENT RIGHTS OF WHICH
THEY ARE AWARE AND TO PROVIDE SUPPOR TING
DOCUMENTATION.
IN ADDITION TO THEIR EVALUATION AS
Reference number
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO-
ISO/FDIS 12749-6:2020(E)
LOGICAL, COMMERCIAL AND USER PURPOSES,
DRAFT INTERNATIONAL STANDARDS MAY ON
OCCASION HAVE TO BE CONSIDERED IN THE
LIGHT OF THEIR POTENTIAL TO BECOME STAN-
DARDS TO WHICH REFERENCE MAY BE MADE IN
NATIONAL REGULATIONS. ISO 2020
---------------------- Page: 1 ----------------------
ISO/FDIS 12749-6:2020(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2020

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting

on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address

below or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii © ISO 2020 – All rights reserved
---------------------- Page: 2 ----------------------
ISO/FDIS 12749-6:2020(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction ..................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ...................................................................................................................................................................................... 1

3 Terms and definitions ..................................................................................................................................................................................... 1

3.1 Basic terms related to nuclear medicine .......................................................................................................................... 1

3.2 Terms related to diagnostic nuclear medicine ............................................................................................................ 2

3.3 Terms related to therapeutic nuclear medicine ......................................................................................................... 3

3.4 Terms related to radiopharmacy ............................................................................................................................................. 4

3.5 Terms related to medical equipment ................................................................................................................................... 5

3.6 Terms related to medical studies ............................................................................................................................................ 6

Annex A (informative) Methodology used in the development of the vocabulary ................................................9

Bibliography .............................................................................................................................................................................................................................17

Alphabetical index .............................................................................................................................................................................................................18

© ISO 2020 – All rights reserved iii
---------------------- Page: 3 ----------------------
ISO/FDIS 12749-6:2020(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards

bodies (ISO member bodies). The work of preparing International Standards is normally carried out

through ISO technical committees. Each member body interested in a subject for which a technical

committee has been established has the right to be represented on that committee. International

organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.

ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of

electrotechnical standardization.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of ISO documents should be noted. This document was drafted in accordance with the

editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/ directives).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of

any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www .iso .org/ patents).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to the

World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www .iso .org/

iso/ foreword .html.

This document was prepared by Technical Committee ISO/TC 85, Nuclear energy, nuclear technologies,

and radiological protection.
A list of all parts in the ISO 12749 series can be found on the ISO website.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www .iso .org/ members .html.
iv © ISO 2020 – All rights reserved
---------------------- Page: 4 ----------------------
ISO/FDIS 12749-6:2020(E)
Introduction

This document provides terms and definitions for nuclear medicine, the medical discipline whereby

radioisotopes as unsealed sources are administered to patients, in order to carry out diagnostic exams,

therapeutic treatments for various pathologies and to monitor the evolution of the disease.

This multidisciplinary activity is fundamentally made up of medical, radiopharmaceutical and medical

physics components, although it also relies on nuclear science, biology, biochemistry, radiochemistry,

nuclear chemistry, electronics, electro-mechanics, computing, metrology of ionizing radiation and

dosimetry. It involves tasks relating to support, research and development as well as staff training,

which are all carried out intensively in this field.

The specific areas of most relevance to nuclear medicine are oncology, cardiology, endocrinology and

neurology. However, its reaches practically every medical specialty.

The professional and technical staff who work in nuclear medicine are highly specialized, carrying out

their activities in highly complex facilities, using a large range of equipment, within a strict healthcare

and radiological regulatory setting.

These activities produce a large amount of documentation such as reports, publications, legal

documents and teaching texts, all of which require the use of precise, coherent and unambiguous terms

and definitions. Therefore, it becomes essential to harmonize the terminology used by all of the above-

mentioned sectors and professions.

Conceptual arrangement of terms and definitions is based on concepts systems that show corresponding

relationships among nuclear medicine concepts. Such arrangement provides users with a structured

view of the nuclear medicine sector and will facilitate common understanding of all related concepts,

see also Annex A. Besides, concept systems and conceptual arrangement of terminological data will be

helpful to any kind of user because it will promote clear, accurate and useful communication.

© ISO 2020 – All rights reserved v
---------------------- Page: 5 ----------------------
FINAL DRAFT INTERNATIONAL STANDARD ISO/FDIS 12749-6:2020(E)
Nuclear energy, nuclear technologies, and radiological
protection — Vocabulary —
Part 6:
Nuclear medicine
1 Scope

This document contains the terms, definitions, notes to entry and examples corresponding to the

frequently used concepts which apply to diagnostic and therapeutic nuclear medicine.

It comprises the minimum essential information for each nuclear medicine concept represented by a

single term. It provides the reader with the information required to approach this multidisciplinary

speciality, such as medical, radiopharmacy and medical physics point of view. It is intended to facilitate

communication and promote common understanding.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.

ISO and IEC maintain terminological databases for use in standardization at the following addresses:

— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
3.1 Basic terms related to nuclear medicine
3.1.1
nuclear medicine

field of medicine in which unsealed radioactive sources, namely radiopharmaceuticals (3.4.3), are used

for diagnosis or therapy
3.1.1.1
diagnostic nuclear medicine

scientific and clinical discipline in which radiopharmaceuticals, administered by different routes, are

used for diagnostic purposes

Note 1 to entry: Diagnostic nuclear medicine is mainly carried out through imaging but may also be measurements

of the global or regional function of an organ.

Note 2 to entry: Diagnostic nuclear medicine also includes quantitative imaging and patient monitoring for the

follow-up of both the disease progression and the treatment response.
3.1.1.2
therapeutic nuclear medicine

scientific and clinical discipline in which radiopharmaceuticals are administered for therapeutic

purposes
© ISO 2020 – All rights reserved 1
---------------------- Page: 6 ----------------------
ISO/FDIS 12749-6:2020(E)
3.1.2
theragnostics
theranostics

treatment strategy based on personalized medicine, that allows selecting the most appropriate therapy

according to the diagnostic images

Note 1 to entry: In nuclear medicine, the specific targeted diagnostic test and therapy can be made sequentially

with the same radiolabelled molecule (i.e. radiopharmaceutical) or with the same molecule and different label

radionuclides or with different molecules with similar physiological properties.

EXAMPLE Personalized treatment of a patient with a positive somatostatin receptor image (neuroendocrine

tumor) by a radiopharmaceutical composed of somatostatin analogs peptide labelled with an emitter suitable for

molecular radiotherapy.
3.1.3
radiopharmacy

branch of pharmacy, which deals with the preparation, characterization and quality of radioactive

drugs in nuclear medicine procedures

EXAMPLE The final stage or the preparation of the pharmaceutical and/or activity dispensing is carried out

from commercial products in a hospital radiopharmacy or in centralized radiopharmacies and then delivered to

a hospital radiopharmacy.
3.1.4
administered activity

activity (in Bq) of radiopharmaceutical that has been dispensed to the patient for diagnostic or

therapeutic purposes

Note 1 to entry: The activity of radiopharmaceuticals is measured in megabecquerels.

3.1.5
uptake

accumulation of administered activity to a particular organ or tissue at a particular time after

administration

[SOURCE: NATIONAL COUNCIL ON RADIATION PROTECTION AND MEASUREMENTS. NCRP Composite

Glossary. NCRP, Bethesda, 2011]
3.2 Terms related to diagnostic nuclear medicine
3.2.1
diagnostic nuclear medicine
(See 3.1.1.1)
3.2.2
nuclear medicine imaging
imaging performed after administration of a radiopharmaceutical

Note 1 to entry: Imaging is considered a non-invasive diagnostic technique, as opposed to a biopsy or exploratory

surgery.

Note 2 to entry: PET and SPECT are the main type of nuclear medicine imaging providing information about how

certain tissues and organs are functioning. It is complementary to anatomical imaging, such as X-ray imaging.

3.2.3
molecular imaging

imaging allowing the visualization, characterization, and measurement of biological processes at the

molecular and cellular levels in humans and other living systems

Note 1 to entry: Nuclear medicine imaging (3.2.2) is one of the modalities of molecular imaging.

2 © ISO 2020 – All rights reserved
---------------------- Page: 7 ----------------------
ISO/FDIS 12749-6:2020(E)

[SOURCE: Mankoff DA. A definition of molecular imaging. J. Nucl. Med. 2007 Jun;48(6):18N, 21N,

modified.]
3.2.4
quantitative imaging
extraction and use of numerical/statistical features from medical images

Note 1 to entry: The chief method used in quantitative imaging is to delineate a region of interest on the image

and determine the mean uptake in this region, but many other features can be extracted.

[SOURCE: Abramson RG, Burton KR, Yu JP, et al. Methods and challenges in quantitative imaging

biomarker development. Academic Radiology 2015 Jan, 22(1):25-32].
3.2.5
diagnostic reference level
DRL

level used in medical imaging to indicate whether, in routine conditions, the activity of a

radiopharmaceutical administered in a specified radiological procedure is unusually high or unusually

low for that procedure

Note 1 to entry: In diagnostic nuclear medicine, DRL is a level of activity for typical examinations for groups of

standardized patients.
[SOURCE: IAEA SAFETY STANDARDS SERIES No. GSR Part 3 (2014), modified.]
3.2.6
standard uptake value
SUV

value equal to the radio of the image derived r adioactivity concentration (in kBq/ml) to the whole

body concentration (in kBq/kg)
Note 1 to entry: Mainly used in PET imaging, but also in SPECT imaging.

Note 2 to entry: There are other definitions of the SUV when substituting the body weight with the lean body

weight or the body surface area. In addition, from a region of interest, several SUV values can be extracted (such

as the maximum, the mean SUV-value, etc.).
3.3 Terms related to therapeutic nuclear medicine
3.3.1
therapeutic nuclear medicine
(See 3.1.1.2)
3.3.2
radiotherapy
radiation therapy

therapy that uses ionizing radiation to kill cells and shrink pathological tissues

Note 1 to entry: Radiation may be delivered by a machine outside the body (external-beam radiation therapy),

or it may come from radioactive material placed in the body near cancer cells (brachytherapy) or from

radiopharmaceutical administered to the patient (molecular radiotherapy).
3.3.3
molecular radiotherapy

radiation therapy that uses a radiopharmaceutical to kill pathological cells and tissues by the effect of

ionizing radiation
© ISO 2020 – All rights reserved 3
---------------------- Page: 8 ----------------------
ISO/FDIS 12749-6:2020(E)
3.3.3.1
metabolic radiotherapy

molecular radiotherapy using selective irradiation of a target zone by a radiopharmaceutical

participating in the metabolism of tumor cells administered to the patient

EXAMPLE The most widely used form of molecular radiotherapy is for the treatment of thyroid pathologies

(thyroid cancer and hyperthyroidism). Called radioiodine therapy, this treatment consists of an oral

administration of iodine-131, which will primarily concentrate in the thyroid to kill diseased cells.

3.3.3.2
radioimmunotherapy
RIT

molecular radiotherapy based on a personalized cancer treatment that combines radiation therapy

with the precise targeting ability of immunotherapy, a treatment that mimics cellular activity in the

body’s immune system

Note 1 to entry: In immunotherapy, scientists create monoclonal antibodies in a laboratory that are designed to

recognize and bind to the antigen of a specific cancer c
...

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