Gwennaëlle Marin1, Bruno Vanderlinden2, Ioannis Karfis3, Thomas Guiot4, Zena Wimana5, Nick Reynaert6, Stefaan Vandenberghe7, Patrick Flamen8. 1. Department of Medical Physics, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium; Medical Imaging and Signal Processing (MEDISIP), Department of Electronics and Information Systems (ELIS), Faculty of Engineering and Architecture (FEA), Ghent University (UGent), 185 De Pintelaan, 9000 Gent, Belgium. Electronic address: gwennaelle.marin@bordet.be. 2. Department of Medical Physics, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: bruno.vanderlinden@bordet.be. 3. Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: ioannis.karfis@bordet.be. 4. Department of Medical Physics, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: thomas.guiot@bordet.be. 5. Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: zena.wimana@bordet.be. 6. Department of Medical Physics, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: nick.reynaert@bordet.be. 7. Medical Imaging and Signal Processing (MEDISIP), Department of Electronics and Information Systems (ELIS), Faculty of Engineering and Architecture (FEA), Ghent University (UGent), 185 De Pintelaan, 9000 Gent, Belgium. Electronic address: stefaan.vandenberghe@ugent.be. 8. Department of Nuclear Medicine, Institut Jules Bordet-Université Libre de Bruxelles (ULB), 121 boulevard de Waterloo, 1000 Brussels, Belgium. Electronic address: patrick.flamen@bordet.be.
Abstract
PURPOSE: Peptide receptor radionuclide therapy with 177Lu-DOTATATE has become a standard treatment modality in neuroendocrine tumours (NETs). No consensus has yet been reached however regarding the absorbed dose threshold for lesion response, the absorbed dose limit to organs-at-risk, and the optimal fractionation and activity to be administered. This is partly due to a lack of uniform and comparable dosimetry protocols. The present article details the development of an organ-at-risk dosimetry procedure, which could be implemented and used routinely in a clinical context. METHODS: Forty-seven patients with NETs underwent 177Lu-DOTATATE therapy. Three SPECT/CT images were acquired at 4, 24 and 144-192 h post-injection. Three blood samples were obtained together with the SPECT/CT acquisitions and 2 additional samples were obtained around 30 min and 1 h post-injection. A bi-exponential fit was used to compute the source organ time-integrated activity coefficients. Coefficients were introduced into OLINDA/EXM software to compute organ-at-risk absorbed doses. Median values for all patients were computed for absorbed dose coefficient D/A0 and for late effective half-life T1/2eff for kidneys, spleen and red marrow. RESULTS: Dosimetry resulted in a median[interquartile range] of 0.78[0.35], 1.07[0.58] and 0.028[0.010] Gy/GBq for D/A0 and of 55[9], 71[9] and 52[18] h for T1/2eff for kidneys, spleen and red marrow respectively. CONCLUSIONS: A dosimetry procedure for organs-at-risk in 177Lu-DOTATATE therapy based on serial SPECT/CT images and blood samples can be implemented routinely in a clinical context with limited patient burden. The results obtained were in accordance with those of other centres.
PURPOSE: Peptide receptor radionuclide therapy with 177Lu-DOTATATE has become a standard treatment modality in neuroendocrine tumours (NETs). No consensus has yet been reached however regarding the absorbed dose threshold for lesion response, the absorbed dose limit to organs-at-risk, and the optimal fractionation and activity to be administered. This is partly due to a lack of uniform and comparable dosimetry protocols. The present article details the development of an organ-at-risk dosimetry procedure, which could be implemented and used routinely in a clinical context. METHODS: Forty-seven patients with NETs underwent 177Lu-DOTATATE therapy. Three SPECT/CT images were acquired at 4, 24 and 144-192 h post-injection. Three blood samples were obtained together with the SPECT/CT acquisitions and 2 additional samples were obtained around 30 min and 1 h post-injection. A bi-exponential fit was used to compute the source organ time-integrated activity coefficients. Coefficients were introduced into OLINDA/EXM software to compute organ-at-risk absorbed doses. Median values for all patients were computed for absorbed dose coefficient D/A0 and for late effective half-life T1/2eff for kidneys, spleen and red marrow. RESULTS: Dosimetry resulted in a median[interquartile range] of 0.78[0.35], 1.07[0.58] and 0.028[0.010] Gy/GBq for D/A0 and of 55[9], 71[9] and 52[18] h for T1/2eff for kidneys, spleen and red marrow respectively. CONCLUSIONS: A dosimetry procedure for organs-at-risk in 177Lu-DOTATATE therapy based on serial SPECT/CT images and blood samples can be implemented routinely in a clinical context with limited patient burden. The results obtained were in accordance with those of other centres.
Authors: Lore Santoro; L Pitalot; D Trauchessec; E Mora-Ramirez; P O Kotzki; M Bardiès; E Deshayes Journal: EJNMMI Res Date: 2021-01-04 Impact factor: 3.138
Authors: Danny Feijtel; Gabriela N Doeswijk; Nicole S Verkaik; Joost C Haeck; Daniela Chicco; Carmelina Angotti; Mark W Konijnenberg; Marion de Jong; Julie Nonnekens Journal: Theranostics Date: 2021-01-01 Impact factor: 11.556
Authors: Katarina Sjögreen Gleisner; Nicolas Chouin; Pablo Minguez Gabina; Francesco Cicone; Silvano Gnesin; Caroline Stokke; Mark Konijnenberg; Marta Cremonesi; Frederik A Verburg; Peter Bernhardt; Uta Eberlein; Jonathan Gear Journal: Eur J Nucl Med Mol Imaging Date: 2022-03-14 Impact factor: 10.057