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European Journal of Nuclear Medicine and Molecular Imaging

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01.07.2011 | Original Article

Experimental facts supporting a red marrow uptake due to radiometal transchelation in ⁹⁰Y-DOTATOC therapy and relationship to the decrease of platelet counts

verfasst von: Stephan Walrand, Raffaella Barone, Stanislas Pauwels, François Jamar

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2011

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Abstract

Purpose

The aim of this study was to retrospectively evaluate whether the red marrow (RM) takes up ¹¹¹In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe¹-octreotide and ⁸⁶Y-DOTATOC and to assess the correlation between the RM absorbed doses and platelet count reduction as a biological dose estimate.

Methods

Data from 12 patients who underwent at 24 h p.i. high statistics ¹¹¹In single photon emission computed tomography (SPECT) and ⁸⁶Y positron emission tomography (PET) acquisitions of the chest were analysed. Uptake was measured on >7 cm spine length and converted to total RM uptake using standard RM distribution in man. RM absorbed doses were calculated assuming specific RM uptake and using the plasma and remainder of the body models. RM doses were correlated with the platelet count reduction at 4 weeks. In vitro experiments explored the metabolism of ¹¹¹In-DTPA-D-Phe¹-octreotide and ⁹⁰Y-DOTATOC in plasma.

Results

The correlation between the uptake of both tracers was excellent (R = 0.80), indicating that RM uptake of ⁸⁶Y-DOTATOC reflects a real physiological process and not reconstruction artefacts. The kinetics of ⁸⁶Y-DOTATOC RM activity was different than that in blood and tumours, with no activity at 4 h p.i. indicating that the uptake is not somatostatin receptor dependent. In vitro experiments showed a transchelation of both radiometals to free transferrin that could explain the RM uptake. In patients without chemotherapy and with a normal platelet count recovery, a good correlation (R = 0.96) was found between the RM doses and the platelet count reduction at the nadir.

Conclusion

These experimental facts support the existence of a true RM uptake likely related to transchelation of the radiometal to transferrin. RM uptake correlates well with the observed acute RM toxicity.

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Titel: Experimental facts supporting a red marrow uptake due to radiometal transchelation in 90Y-DOTATOC therapy and relationship to the decrease of platelet counts
verfasst von: Stephan Walrand
Raffaella Barone
Stanislas Pauwels
François Jamar
Publikationsdatum: 01.07.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2011
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1744-x

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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