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  • Sandström, MattiasUppsala universitet,Avdelningen för sjukhusfysik,Enheten för nuklearmedicin och PET (author)

Individualized dosimetry of kidney and bone marrow in patients undergoing 177Lu-DOTA-octreotate treatment

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • 2012-12-07
  • Society of Nuclear Medicine,2013
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-183412
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-183412URI
  • https://doi.org/10.2967/jnumed.112.107524DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:126036096URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • The organs at risk in radionuclide therapy with 177Lu-octreotate are the bone marrow and the kidneys. The primary aim of this study was to develop an individualized dosimetry protocol for the bone marrow. The secondary aim was to identify those patients, undergoing fractionated therapy with 7.4 GBq/cycle, who first reached an accumulated dose of either 2 Gy to the bone marrow or 23 Gy to the kidneys. Methods: Two hundred patients with metastatic neuroendocrine tumors with high somatostatin receptor expression were included. After the administration of 7.4 GBq of 177Lu-octreotate, blood samples were drawn 6 times within the first 24 h. In 50 patients, additional blood samples were obtained at 96 and 168 h. Moreover, urine was collected from 30 patients during the first 24 h. Planar whole-body and SPECT/CT images over the abdomen were acquired at 24, 96, and 168 h after the infusion. Calculation of the absorbed radiation dose to the bone marrow was based on blood and urinary activity curves combined with organ-based analysis of the whole-body images. The absorbed dose to the kidney was calculated from the pharmacokinetic data obtained from SPECT/CT. Results: For a single cycle of 7.4 GBq, the absorbed dose to the bone marrow and the kidney ranged from 0.05 to 0.4 Gy and from 2 to 10 Gy, respectively. In 197 of 200 patients, the kidneys accumulated an absorbed dose of 23 Gy before the bone marrow reached 2 Gy. Between 2 and 10 cycles of 177Lu-octreotate could be administered before the upper dose limit for the individual patient was reached. Conclusion: A method based on repeated whole-body imaging in combination with blood and urinary activity data over time was developed to determine the absorbed dose to the bone marrow. The dose-limiting organ was the kidney in 197 of 200 patients. In 50% of the patients, more than 4 cycles of 7.4 GBq of 177Lu-octreotate could be administered, whereas 20% of the subjects were treated with fewer than 4 cycles. Individualized absorbed dose calculation is essential to optimize the therapy.

Subject headings and genre

  • 177Lu-DOTA-octreotate
  • Bone marrow
  • Dosimetry
  • Individualized
  • Kidney

Added entries (persons, corporate bodies, meetings, titles ...)

  • Garske-Román, UlrikeUppsala universitet,Enheten för nuklearmedicin och PET(Swepub:uu)ulgar102 (author)
  • Granberg, DanKarolinska Institutet,Uppsala universitet,Onkologisk endokrinologi(Swepub:uu)dangb (author)
  • Johansson, SilviaUppsala universitet,Enheten för onkologi(Swepub:uu)sijoh226 (author)
  • Widström, CharlesUppsala universitet,Avdelningen för sjukhusfysik (author)
  • Eriksson, BarbroUppsala universitet,Endokrin tumörbiologi(Swepub:uu)barberik (author)
  • Sundin, AndersKarolinska Institutet,Uppsala universitet,Enheten för radiologi,Enheten för nuklearmedicin och PET(Swepub:uu)anderssu (author)
  • Lundqvist, HansUppsala universitet,Enheten för biomedicinsk strålningsvetenskap(Swepub:uu)hanslund (author)
  • Lubberink, MarkUppsala universitet,Enheten för nuklearmedicin och PET(Swepub:uu)marklubb (author)
  • Uppsala universitetAvdelningen för sjukhusfysik (creator_code:org_t)

Related titles

  • In:Journal of Nuclear Medicine: Society of Nuclear Medicine54:1, s. 33-410161-55051535-56672159-662X

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