Radiation Dosimetry for Lu-PSMA I&T in Metastatic Castration-Resistant Prostate Cancer
Standard
Radiation Dosimetry for Lu-PSMA I&T in Metastatic Castration-Resistant Prostate Cancer : Absorbed Dose in Normal Organs and Tumor Lesions. / Okamoto, Shozo; Thieme, Anne; Allmann, Jakob; D'Alessandria, Calogero; Maurer, Tobias; Retz, Margitta; Tauber, Robert; Heck, Matthias M; Wester, Hans-Juergen; Tamaki, Nagara; Fendler, Wolfgang P; Herrmann, Ken; Pfob, Christian H; Scheidhauer, Klemens; Schwaiger, Markus; Ziegler, Sibylle; Eiber, Matthias.
in: J NUCL MED, Jahrgang 58, Nr. 3, 03.2017, S. 445-450.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Radiation Dosimetry for Lu-PSMA I&T in Metastatic Castration-Resistant Prostate Cancer
T2 - Absorbed Dose in Normal Organs and Tumor Lesions
AU - Okamoto, Shozo
AU - Thieme, Anne
AU - Allmann, Jakob
AU - D'Alessandria, Calogero
AU - Maurer, Tobias
AU - Retz, Margitta
AU - Tauber, Robert
AU - Heck, Matthias M
AU - Wester, Hans-Juergen
AU - Tamaki, Nagara
AU - Fendler, Wolfgang P
AU - Herrmann, Ken
AU - Pfob, Christian H
AU - Scheidhauer, Klemens
AU - Schwaiger, Markus
AU - Ziegler, Sibylle
AU - Eiber, Matthias
N1 - © 2017 by the Society of Nuclear Medicine and Molecular Imaging.
PY - 2017/3
Y1 - 2017/3
N2 - Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy is increasingly used in metastatic castration-resistant prostate cancer. We aimed to estimate the absorbed doses for normal organs and tumor lesions using 177Lu-PSMA I&T (I&T is imaging and therapy) in patients undergoing up to 4 cycles of radioligand therapy. Results were compared with pretherapeutic Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBEDCC)] (68Ga-PSMA-HBED-CC) PET. Methods: A total of 34 cycles in 18 patients were analyzed retrospectively. In 15 patients the first, in 9 the second, in 5 the third, and in 5 the fourth cycle was analyzed, respectively. Whole-body scintigraphy was performed at least between 30-120 min, 24 h, and 6-8 d after administration. Regions of interest covering the whole body, organs, and up to 4 tumor lesions were drawn. Organ and tumor masses were derived from pretherapeutic 68Ga-PSMA-HBED-CC PET/CT. Absorbed doses for individual cycles were calculated using OLINDA/EXM. SUVs from pretherapeutic PET were compared with absorbed doses and with change of SUV. Results: The mean whole-body effective dose for all cycles was 0.06 ± 0.03 Sv/GBq. The mean absorbed organ doses were 0.72 ± 0.21 Gy/GBq for the kidneys; 0.12 ± 0.06 Gy/GBq for the liver; and 0.55 ± 0.14 Gy/GBq for the parotid, 0.64 ± 0.40 Gy/GBq for the submandibular, and 3.8 ± 1.4 Gy/GBq for the lacrimal glands. Absorbed organ doses were relatively constant among the 4 different cycles. Tumor lesions received a mean absorbed dose per cycle of 3.2 ± 2.6 Gy/GBq (range, 0.22-12 Gy/GBq). Doses to tumor lesions gradually decreased, with 3.5 ± 2.9 Gy/GBq for the first, 3.3 ± 2.5 Gy/GBq for the second, 2.7 ± 2.3 Gy/GBq for the third, and 2.4 ± 2.2 Gy/GBq for the fourth cycle. SUVs of pretherapeutic PET moderately correlated with absorbed dose (r = 0.44, P < 0.001 for SUVmax; r = 0.43, P < 0.001 for SUVmean) and moderately correlated with the change of SUV (r = 0.478, P < 0.001 for SUVmax, and r = 0.50, P < 0.001 for SUVmean). Conclusion: Organ- and tumor-absorbed doses for 177Lu-PSMA I&T are comparable to recent reports and complement these with information on an excellent correlation between the 4 therapy cycles. With the kidneys representing the critical organ, a cumulative activity of 40 GBq of 177Lu-PSMA I&T appears to be safe and justifiable. The correlation between pretherapeutic SUV and absorbed tumor dose emphasizes the need for PSMA-ligand PET imaging for patient selection.
AB - Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy is increasingly used in metastatic castration-resistant prostate cancer. We aimed to estimate the absorbed doses for normal organs and tumor lesions using 177Lu-PSMA I&T (I&T is imaging and therapy) in patients undergoing up to 4 cycles of radioligand therapy. Results were compared with pretherapeutic Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBEDCC)] (68Ga-PSMA-HBED-CC) PET. Methods: A total of 34 cycles in 18 patients were analyzed retrospectively. In 15 patients the first, in 9 the second, in 5 the third, and in 5 the fourth cycle was analyzed, respectively. Whole-body scintigraphy was performed at least between 30-120 min, 24 h, and 6-8 d after administration. Regions of interest covering the whole body, organs, and up to 4 tumor lesions were drawn. Organ and tumor masses were derived from pretherapeutic 68Ga-PSMA-HBED-CC PET/CT. Absorbed doses for individual cycles were calculated using OLINDA/EXM. SUVs from pretherapeutic PET were compared with absorbed doses and with change of SUV. Results: The mean whole-body effective dose for all cycles was 0.06 ± 0.03 Sv/GBq. The mean absorbed organ doses were 0.72 ± 0.21 Gy/GBq for the kidneys; 0.12 ± 0.06 Gy/GBq for the liver; and 0.55 ± 0.14 Gy/GBq for the parotid, 0.64 ± 0.40 Gy/GBq for the submandibular, and 3.8 ± 1.4 Gy/GBq for the lacrimal glands. Absorbed organ doses were relatively constant among the 4 different cycles. Tumor lesions received a mean absorbed dose per cycle of 3.2 ± 2.6 Gy/GBq (range, 0.22-12 Gy/GBq). Doses to tumor lesions gradually decreased, with 3.5 ± 2.9 Gy/GBq for the first, 3.3 ± 2.5 Gy/GBq for the second, 2.7 ± 2.3 Gy/GBq for the third, and 2.4 ± 2.2 Gy/GBq for the fourth cycle. SUVs of pretherapeutic PET moderately correlated with absorbed dose (r = 0.44, P < 0.001 for SUVmax; r = 0.43, P < 0.001 for SUVmean) and moderately correlated with the change of SUV (r = 0.478, P < 0.001 for SUVmax, and r = 0.50, P < 0.001 for SUVmean). Conclusion: Organ- and tumor-absorbed doses for 177Lu-PSMA I&T are comparable to recent reports and complement these with information on an excellent correlation between the 4 therapy cycles. With the kidneys representing the critical organ, a cumulative activity of 40 GBq of 177Lu-PSMA I&T appears to be safe and justifiable. The correlation between pretherapeutic SUV and absorbed tumor dose emphasizes the need for PSMA-ligand PET imaging for patient selection.
KW - Absorption, Radiation
KW - Aged
KW - Dipeptides
KW - Heterocyclic Compounds, 1-Ring
KW - Humans
KW - Male
KW - Metabolic Clearance Rate
KW - Neoplasm Metastasis
KW - Organ Sparing Treatments
KW - Organ Specificity
KW - Positron-Emission Tomography
KW - Prostatic Neoplasms, Castration-Resistant
KW - Radiopharmaceuticals
KW - Radiotherapy Dosage
KW - Retrospective Studies
KW - Tissue Distribution
KW - Treatment Outcome
KW - Whole-Body Counting
KW - Journal Article
U2 - 10.2967/jnumed.116.178483
DO - 10.2967/jnumed.116.178483
M3 - SCORING: Journal article
C2 - 27660138
VL - 58
SP - 445
EP - 450
JO - J NUCL MED
JF - J NUCL MED
SN - 0161-5505
IS - 3
ER -