UNLABELLED: Radioimmunotherapy (RIT) using (131)I-tositumomab has been used successfully to treat relapsed or refractory B-cell non-Hodgkin's lymphoma (NHL). Our approach to treatment planning has been to determine limits on radiation absorbed dose to critical nonhematopoietic organs. This study demonstrates the feasibility of using CT to adjust for actual organ volumes in calculating organ-specific absorbed dose estimates. METHODS: Records of 84 patients who underwent biodistribution studies after a trace-labeled infusion of (131)I-tositumomab for RIT (January 1990 and April 2003) were reviewed. Serial planar gamma-camera images and whole-body NaI probe counts were obtained to estimate (131)I-antibody source-organ residence times as recommended by the MIRD Committee. The source-organ residence times for standard man or woman were adjusted by the ratio of the MIRD phantom organ mass to the CT-derived organ mass. RESULTS: The mean radiation absorbed doses (in mGy/MBq) for our data using the MIRD model were lungs = 1.67; liver = 1.03; kidneys = 1.08; spleen = 2.67; and whole body = 0.3; and for CT volume-adjusted organ volumes (in mGy/MBq) were lungs = 1.30; liver = 0.92; kidneys = 0.76; spleen = 1.40; and whole body = 0.22. We determined the following correlation coefficients between the 2 methods for the various organs: lungs, 0.49 (P = 0.0001); liver, 0.64 (P = 0.004); kidneys, 0.45 (P = 0.0004); spleen, 0.22 (P = 0.0001); and whole body, 0.78 (P = 0.0001), for the residence times. For therapy, patients received mean (131)I administered activities of 19.2 GBq (520 mCi) after adjustment for CT-derived organ mass compared with 16.0 GBq (433 mCi) that would otherwise have been given had therapy been based only using standard MIRD organ volumes-a statistically significant difference (P = 0.0001). CONCLUSION: We observed large variations in organ masses among our patients. Our treatments were planned to deliver the maximally tolerated radiation dose to the dose-limiting normal organ. This work provides a simplified method for calculating patient-specific radiation doses by adjusting for the actual organ mass and shows the value of this approach in treatment planning for RIT.
UNLABELLED: Radioimmunotherapy (RIT) using (131)I-tositumomab has been used successfully to treat relapsed or refractory B-cell non-Hodgkin's lymphoma (NHL). Our approach to treatment planning has been to determine limits on radiation absorbed dose to critical nonhematopoietic organs. This study demonstrates the feasibility of using CT to adjust for actual organ volumes in calculating organ-specific absorbed dose estimates. METHODS: Records of 84 patients who underwent biodistribution studies after a trace-labeled infusion of (131)I-tositumomab for RIT (January 1990 and April 2003) were reviewed. Serial planar gamma-camera images and whole-body NaI probe counts were obtained to estimate (131)I-antibody source-organ residence times as recommended by the MIRD Committee. The source-organ residence times for standard man or woman were adjusted by the ratio of the MIRD phantom organ mass to the CT-derived organ mass. RESULTS: The mean radiation absorbed doses (in mGy/MBq) for our data using the MIRD model were lungs = 1.67; liver = 1.03; kidneys = 1.08; spleen = 2.67; and whole body = 0.3; and for CT volume-adjusted organ volumes (in mGy/MBq) were lungs = 1.30; liver = 0.92; kidneys = 0.76; spleen = 1.40; and whole body = 0.22. We determined the following correlation coefficients between the 2 methods for the various organs: lungs, 0.49 (P = 0.0001); liver, 0.64 (P = 0.004); kidneys, 0.45 (P = 0.0004); spleen, 0.22 (P = 0.0001); and whole body, 0.78 (P = 0.0001), for the residence times. For therapy, patients received mean (131)I administered activities of 19.2 GBq (520 mCi) after adjustment for CT-derived organ mass compared with 16.0 GBq (433 mCi) that would otherwise have been given had therapy been based only using standard MIRD organ volumes-a statistically significant difference (P = 0.0001). CONCLUSION: We observed large variations in organ masses among our patients. Our treatments were planned to deliver the maximally tolerated radiation dose to the dose-limiting normal organ. This work provides a simplified method for calculating patient-specific radiation doses by adjusting for the actual organ mass and shows the value of this approach in treatment planning for RIT.
Authors: Manuela Matesan; Darrell R Fisher; Roger Wong; Ajay K Gopal; Damian J Green; Brenda M Sandmaier; William Bensinger; John M Pagel; Johnnie Orozco; Oliver W Press; Ryan D Cassaday; Eric Hutchinson; Michelle Wanner; Sujit Pal; Carolyn Thostenson; Joseph G Rajendran Journal: J Nucl Med Date: 2020-03-13 Impact factor: 10.057
Authors: Christian Koenecke; Michael Hofmann; Oliver Bolte; Peter Gielow; Elke Dammann; Michael Stadler; Anke Franzke; Anne Rose Boerner; Matthias Eder; Arnold Ganser; Wolfram Knapp; Bernd Hertenstein Journal: Int J Hematol Date: 2008-05 Impact factor: 2.490
Authors: Ajay K Gopal; Ted A Gooley; Joseph G Rajendran; John M Pagel; Darrell R Fisher; David G Maloney; Frederick R Appelbaum; Ryan D Cassaday; Andrew Shields; Oliver W Press Journal: Biol Blood Marrow Transplant Date: 2014-02-12 Impact factor: 5.742
Authors: Naoya Hattori; Ajay K Gopal; Andrew T Shields; Darrell R Fisher; Ted Gooley; John M Pagel; Oliver W Press; Joseph G Rajendran Journal: Nucl Med Commun Date: 2012-12 Impact factor: 1.690
Authors: Jane N Winter; David J Inwards; Stewart Spies; Gregory Wiseman; David Patton; William Erwin; Alfred W Rademaker; Bing Bing Weitner; Stephanie F Williams; Martin S Tallman; Ivana Micallef; Jayesh Mehta; Seema Singhal; Andrew M Evens; Michael Zimmer; Arturo Molina; Christine A White; Leo I Gordon Journal: J Clin Oncol Date: 2009-03-02 Impact factor: 44.544