OBJECTIVE: The aim of the present study was to perform calculation of the absorbed doses to organs at risk and to neuroendocrine tumors and to determine whether hepatic intra-arterial (IA) injection of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) would achieve higher intratumoral concentrations than standard intravenous administration of 177Lu-DOTATATE. METHODS: 29 patients with Grade I-II, inoperable, metastatic gastro-entero-pancreatic neuroendocrine tumor (GEPNET) were prospectively identified and enrolled for the study. 15 patients of GEPNETs with liver-dominant metastatic disease and less than 3 sites of extrahepatic metastatic disease were administered a single dose of 177Lu-DOTATATE therapy through the selective catheterization of the hepatic artery (IA group). The other 14 patients received a single dose of 177 Lu- DOTATATE through standard intravenous route (IV group). For dosimetry, whole-body γ (anterior and posterior planar acquisitions) and SPECT/CT scans of the abdomen at 2, 24 and 96 h post 177Lu-DOTATATE administration were acquired. Dosimetric calculations were done using the HERMES software. RESULTS: The mean dose per unit activity (DpA) in the liver and tumor lesions in the IA group differed significantly (p < 0.05) but differed insignificantly in spleen and kidneys (p > 05) with the IV group. The mean tumor/non-tumor concentration at 96 h was 76.83 ± 7.9 (range 10.2-251.3) in the IA group whereas it was 25.6 ± 5.9 (Range: 12-55) in the IV group. There was an average threefold increase in tumoral concentration over the standard intravenous group. CONCLUSION: IA administration of 177Lu-DOTATATE results in higher concentration and absorbed dose in hepatic metastases in patients of GEPNETs as compared to a single dose of PRRT administered through standard IV route, and thus seems to be a powerful tool to improve the efficacy of PRRT. ADVANCES IN KNOWLEDGE: Measurement of the dose received by the tumor lesions and the critical organs is of paramount importance for the prognostication of a radionuclide therapy. Scant data exist on the dosimetric impact of IA administration of the therapy with 177Lu-DOTATATE on the tumors and other organs, and this study would add an impact towards the better treatment outcome in patients of neuroendocrine tumor with liver-dominant metastatic disease.
OBJECTIVE: The aim of the present study was to perform calculation of the absorbed doses to organs at risk and to neuroendocrine tumors and to determine whether hepatic intra-arterial (IA) injection of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) would achieve higher intratumoral concentrations than standard intravenous administration of 177Lu-DOTATATE. METHODS: 29 patients with Grade I-II, inoperable, metastatic gastro-entero-pancreatic neuroendocrine tumor (GEPNET) were prospectively identified and enrolled for the study. 15 patients of GEPNETs with liver-dominant metastatic disease and less than 3 sites of extrahepatic metastatic disease were administered a single dose of 177Lu-DOTATATE therapy through the selective catheterization of the hepatic artery (IA group). The other 14 patients received a single dose of 177 Lu- DOTATATE through standard intravenous route (IV group). For dosimetry, whole-body γ (anterior and posterior planar acquisitions) and SPECT/CT scans of the abdomen at 2, 24 and 96 h post 177Lu-DOTATATE administration were acquired. Dosimetric calculations were done using the HERMES software. RESULTS: The mean dose per unit activity (DpA) in the liver and tumor lesions in the IA group differed significantly (p < 0.05) but differed insignificantly in spleen and kidneys (p > 05) with the IV group. The mean tumor/non-tumor concentration at 96 h was 76.83 ± 7.9 (range 10.2-251.3) in the IA group whereas it was 25.6 ± 5.9 (Range: 12-55) in the IV group. There was an average threefold increase in tumoral concentration over the standard intravenous group. CONCLUSION: IA administration of 177Lu-DOTATATE results in higher concentration and absorbed dose in hepatic metastases in patients of GEPNETs as compared to a single dose of PRRT administered through standard IV route, and thus seems to be a powerful tool to improve the efficacy of PRRT. ADVANCES IN KNOWLEDGE: Measurement of the dose received by the tumor lesions and the critical organs is of paramount importance for the prognostication of a radionuclide therapy. Scant data exist on the dosimetric impact of IA administration of the therapy with 177Lu-DOTATATE on the tumors and other organs, and this study would add an impact towards the better treatment outcome in patients of neuroendocrine tumor with liver-dominant metastatic disease.
Authors: Mattias Sandström; Ulrike Garske-Román; Dan Granberg; Silvia Johansson; Charles Widström; Barbro Eriksson; Anders Sundin; Hans Lundqvist; Mark Lubberink Journal: J Nucl Med Date: 2012-12-07 Impact factor: 10.057
Authors: Dik J Kwekkeboom; Wouter W de Herder; Boen L Kam; Casper H van Eijck; Martijn van Essen; Peter P Kooij; Richard A Feelders; Maarten O van Aken; Eric P Krenning Journal: J Clin Oncol Date: 2008-05-01 Impact factor: 44.544
Authors: Stefan E Pool; Boen L R Kam; Gerben A Koning; Mark Konijnenberg; Timo L M Ten Hagen; Woulter A P Breeman; Eric P Krenning; Marion de Jong; Casper H J van Eijck Journal: Cancer Biother Radiopharm Date: 2014-05 Impact factor: 3.099
Authors: Anna Sundlöv; Katarina Sjögreen-Gleisner; Johanna Svensson; Michael Ljungberg; Tomas Olsson; Peter Bernhardt; Jan Tennvall Journal: Eur J Nucl Med Mol Imaging Date: 2017-03-22 Impact factor: 9.236
Authors: Jonathan Strosberg; Pamela L Kunz; Andrew Hendifar; James Yao; David Bushnell; Matthew H Kulke; Richard P Baum; Martyn Caplin; Philippe Ruszniewski; Ebrahim Delpassand; Timothy Hobday; Chris Verslype; Al Benson; Rajaventhan Srirajaskanthan; Marianne Pavel; Jaume Mora; Jordan Berlin; Enrique Grande; Nicholas Reed; Ettore Seregni; Giovanni Paganelli; Stefano Severi; Michael Morse; David C Metz; Catherine Ansquer; Frédéric Courbon; Adil Al-Nahhas; Eric Baudin; Francesco Giammarile; David Taïeb; Erik Mittra; Edward Wolin; Thomas M O'Dorisio; Rachida Lebtahi; Christophe M Deroose; Chiara M Grana; Lisa Bodei; Kjell Öberg; Berna Degirmenci Polack; Beilei He; Maurizio F Mariani; Germo Gericke; Paola Santoro; Jack L Erion; Laura Ravasi; Eric Krenning Journal: Eur J Nucl Med Mol Imaging Date: 2020-03-02 Impact factor: 9.236
Authors: Robert J Lewandowski; Beau B Toskich; Daniel B Brown; Ghassan El-Haddad; Siddharth A Padia Journal: Cardiovasc Intervent Radiol Date: 2022-08-02 Impact factor: 2.797
Authors: Michelle Roytman; Sean Kim; Shannon Glynn; Charlene Thomas; Eaton Lin; Whitney Feltus; Rajiv S Magge; Benjamin Liechty; Theodore H Schwartz; Rohan Ramakrishna; Nicolas A Karakatsanis; Susan C Pannullo; Joseph R Osborne; Jonathan P S Knisely; Jana Ivanidze Journal: Front Oncol Date: 2022-01-28 Impact factor: 6.244