Implementing targeted alpha therapy: safety, dosimetry, and regulatory essentials

Targeted alpha therapy (TAT) creates dense local irradiation with alpha particles (range of few cell diameters). Radium-223 has strongest clinical foundation; other alpha emitters are under study. Routine use limited by supply, dosimetry, organ toxicity (renal, salivary, marrow)…

• Alpha-particle dosimetry faces unique challenges, including daughter-nuclide redistribution and small-scale (MIRD, voxel) dosimetry.
• Quantitative imaging, Monte Carlo transport, and voxel dosimetry are entering workflows; artificial-intelligence applications remain aspirational.
• Safe clinical TAT requires controlling internal contamination, manufacturing standardization, and adherence to jurisdiction-specific regulations.

Automated summary

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