scholarly journals Practical kidney dosimetry in peptide receptor radionuclide therapy using [177Lu]Lu-DOTATOC and [177Lu]Lu-DOTATATE with focus on uncertainty estimates

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Peter Frøhlich Staanum ◽  
Anders Floor Frellsen ◽  
Marie Louise Olesen ◽  
Peter Iversen ◽  
Anne Kirstine Arveschoug
Keyword(s):  
Radionuclide Therapy ◽  
Absorbed Dose ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
University Hospital ◽  
Ct Scans ◽  
Post Injection ◽  
Total Uncertainty ◽  
Peptide Receptor ◽  
Uncertainty Estimates

Abstract Background Kidney dosimetry after peptide receptor radionuclide therapy using 177Lu-labelled somatostatin analogues is a procedure with multiple steps. We present the SPECT/CT-based implementation at Aarhus University Hospital and evaluate the uncertainty of the various steps in order to estimate the total uncertainty and to identify the major sources of uncertainty. Absorbed dose data from 115 treatment fractions are reported. Results The total absorbed dose with uncertainty is presented for 59 treatments with [177Lu]Lu-DOTATOC and 56 treatments with [177Lu]Lu-DOTATATE. For [177Lu]Lu-DOTATOC the mean and median specific absorbed dose (dose per injected activity) is 0.37 Gy/GBq and 0.38 Gy/GBq, respectively, while for [177Lu]Lu-DOTATATE the median and mean are 0.47 Gy/GBq and 0.46 Gy/GBq, respectively. The uncertainty of the procedure is estimated to be about 13% for a single treatment fraction, where the absorbed dose calculation is based on three SPECT/CT scans 1, 4 and 7 days post-injection, while it increases to about 19% if only a single SPECT/CT scan is performed 1 day post-injection. Conclusions The specific absorbed dose values obtained with the described procedure are comparable to those from other treatment sites for both [177Lu]Lu-DOTATOC and [177Lu]Lu-DOTATATE, but towards the lower end of the range of reported values. The estimated uncertainty is also comparable to that from other reports and judged acceptable for clinical and research use, thus proving the kidney dosimetry procedure a useful tool. The greatest reduction in uncertainty can be obtained by improved activity determination, partial volume correction and additional SPECT/CT scans.

scholarly journals Intraindividual comparison of [177Lu]Lu-DOTA-EB-TATE and [177Lu]Lu-DOTA-TOC

2021 ◽  
Author(s):  
Heribert Hänscheid ◽  
Philipp E. Hartrampf ◽  
Andreas Schirbel ◽  
Andreas K. Buck ◽  
Constantin Lapa
Keyword(s):  
Radionuclide Therapy ◽  
Therapeutic Agent ◽  
Somatostatin Receptor ◽  
Absorbed Dose ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogue ◽  
Target Tissue ◽  
Peptide Receptor ◽  
Intraindividual Comparison ◽  
Administered Activity

Abstract Purpose The radiolabelled somatostatin analogue [177Lu]Lu-DOTA-EB-TATE binds to albumin via Evans blue, thereby increasing the residence time in the blood and potentially allowing more therapeutic agent to be absorbed into the target tissue during peptide receptor radionuclide therapy. It was tested in selected patients whether the substance is superior to [177Lu]Lu-DOTA-TOC. Methods Activity kinetics in organs and tumours after [177Lu]Lu-DOTA-EB-TATE and [177Lu]Lu-DOTA-TOC were compared intraindividually in five patients with progressive somatostatin receptor-positive disease scheduled for radionuclide therapy. Results In comparison to [177Lu]Lu-DOTA-TOC, tumour doses per administered activity were higher for [177Lu]Lu-DOTA-EB-TATE in 4 of 5 patients (median ratio: 1.7; range: 0.9 to 3.9), kidney doses (median ratio: 3.2; range: 1.6 to 9.8) as well as spleen doses (median ratio: 4.7; range 1.2 to 6.2) in all patients, and liver doses in 3 of 4 evaluable patients (median ratio: 4.0; range: 0.7 to 4.9). The tumour to critical organs absorbed dose ratios were higher after [177Lu]Lu-DOTA-TOC in 4 of 5 patients. Conclusions Prior to a treatment with [177Lu]Lu-DOTA-EB-TATE, it should be assessed individually whether the compound is superior to established substances.

Neuroradiological and Neuropathological Changes After 177Lu-Octreotate Peptide Receptor Radionuclide Therapy of Refractory Esthesioneuroblastoma

2018 ◽  
Vol 15 (6) ◽  
pp. 100-109 ◽  
Author(s):  
Julia R Schneider ◽  
Deborah R Shatzkes ◽  
Stephen C Scharf ◽  
Tristan M Tham ◽  
Kay O Kulason ◽  
...  
Keyword(s):  
Radionuclide Therapy ◽  
Therapeutic Option ◽  
Somatostatin Receptor ◽  
Malignant Neoplasm ◽  
Peptide Receptor Radionuclide Therapy ◽  
Olfactory Neuroblastoma ◽  
Somatostatin Analogues ◽  
Symptomatic Improvement ◽  
Peptide Receptor ◽  
Molecular Alterations

Abstract BACKGROUND AND IMPORTANCE Olfactory neuroblastoma, also known as esthesioneuroblastoma (ENB), is a malignant neoplasm with an unpredictable behavior. Currently, the widely accepted treatment is inductive chemotherapy, with or without surgery, followed by radiotherapy. Since data on genetics and molecular alterations of ENB are lacking, there is no standard molecularly targeted therapy. However, ENB commonly expresses the somatostatin receptor (SSTR) that is also expressed by neuroendocrine tumors. Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogues, such as 177Lu-octreotate, is an effective treatment for the latter. We present the complex neuroradiological and neuropathological changes associated with 177Lu-octreotate treatment of a patient with a highly treatment-resistant ENB. CLINICAL PRESENTATION A 60-yr-old male presented with an ENB that recurred after chemotherapy, surgery, stereotactic radiosurgery, and immunotherapy. Pathology revealed a Hyams grade 3 ENB and the tumor had metastasized to lymph nodes. Tumor SSTR expression was seen on 68Ga-octreotate positron emission tomography (PET)/computed tomography (CT), suggesting that PRRT may be an option. He received 4 cycles of 177Lu-octreotate over 6 mo, with a partial response of all lesions and symptomatic improvement. Four months after the last PRRT cycle, 2 of the lesions rapidly relapsed and were successfully resected. Three months later, 68Ga-octreotate PET/CT and magnetic resonance imaging indicate no progression of the disease. CONCLUSION We describe imaging changes associated with 177Lu-octreotate PRRT of relapsing ENB. To our knowledge, this is the first report describing neuropathological changes associated with this treatment. PRRT is a promising therapeutic option to improve the disease control, and potentially, the survival of patients with refractory ENB.

Altered Biodistribution of Somatostatin Analogues After First Cycle of Peptide Receptor Radionuclide Therapy

2011 ◽  
Vol 29 (19) ◽  
pp. e579-e581 ◽  
Author(s):  
Sofie Van Binnebeek ◽  
Christophe M. Deroose ◽  
Kristof Baete ◽  
Christelle Terwinghe ◽  
Bert Vanbilloen ◽  
...  
Keyword(s):  
Radionuclide Therapy ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Peptide Receptor

scholarly journals Calculation of absorbed dose due to the 90Y-DOTATOC peptide receptor radionuclide therapy by MCNP5/X

2018 ◽  
Vol 33 (4) ◽  
pp. 380-385
Author(s):  
Marija Jeremic ◽  
Milovan Matovic ◽  
Suzana Pantovic ◽  
Dragoslav Nikezic ◽  
Dragana Krstic
Keyword(s):  
Radionuclide Therapy ◽  
Somatostatin Receptors ◽  
Computer Software ◽  
Absorbed Dose ◽  
Peptide Receptor Radionuclide Therapy ◽  
Beta Radiation ◽  
Bremsstrahlung Radiation ◽  
Peptide Receptor ◽  
Beta Emitters ◽  
Good Expression

Strong beta emitters, like 90Y, 177Lu labelled peptide, are used for treatment of neuroendocrine tumours where there is a good expression of somatostatin receptors. In this work, MCNP5/X computer software and ORNL human phantoms were used to calculate absorbed dose due to 90Y labelled DOTATOC in the peptide receptor radionuclide therapy. Tumour was considered as a sources of beta radiation and represented as a sphere with diameter of 1-4 cm and 5 cm in liver, pancreas, and lungs. Results are expressed as absorbed dose per unit of cumulated activity, S ? value in units mGy?(MBq?s)?1. The far largest dose is in tumour itself, then in organ which contains the tumour. Doses in other organs, where the metastasis are the most frequent, due to the bremsstrahlung radiation, are much smaller and could be neglected. The largest dose, 8.66?10?3 mGy?(MBq?s)?1 was obtained for tumour with size of 3 cm.

Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues: ten years experience

2008 ◽  
Vol 62 (8) ◽  
pp. 524 ◽  
Author(s):  
Lisa Bodei ◽  
Chiara M. Grana ◽  
Mirco Bartolomei ◽  
Silvia M. Baio ◽  
Maribel Lopera Sierra ◽  
...  
Keyword(s):  
Radionuclide Therapy ◽  
Peptide Receptor Radionuclide Therapy ◽  
Somatostatin Analogues ◽  
Peptide Receptor

scholarly journals Dosimetry after peptide receptor radionuclide therapy: impact of reduced number of post-treatment studies on absorbed dose calculation and on patient management

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Alexandre Chicheportiche ◽  
Simona Ben-Haim ◽  
Simona Grozinsky-Glasberg ◽  
Kira Oleinikov ◽  
Amichay Meirovitz ◽  
...  
Keyword(s):  
Radionuclide Therapy ◽  
Patient Management ◽  
Absorbed Dose ◽  
Dose Calculation ◽  
Peptide Receptor Radionuclide Therapy ◽  
Post Treatment ◽  
Peptide Receptor
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