Abstract
Purpose
Calculating the absorbed dose is important for the determination of risk and therapeutic benefit of internal radiation therapy. The aim of this study was to perform image-based absorbed dose calculation for critical organs during the first cycle of [177Lu]DKFZ-PSMA-617 therapy in a small cohort of patients with metastatic prostate cancer.
Procedures
Nine patients with a history of prostate cancer documented by histopathology and radiologic evidence of metastatic diseases underwent radioligand therapy with [177Lu]DKFZ-PSMA-617. Conjugated planar whole-body scintigraphies acquired at 0.5, 24, 48, 72, and 168 h post-injection were analyzed by regions of interest, and time-activity curves were generated for various organs. Cumulated activities and residence times were calculated by bi-exponential fit of the time-activity curves. Mean absorbed doses were finally estimated using OLINDA/EXM1.1™. Additionally, the uncertainty when omitting the last measurement (168 h p.i.) was studied.
Results
The following mean absorbed doses were calculated: 2.82 mGy/MBq for the lacrimal glands, 0.72 mGy/MBq for the salivary glands, 0.53 mGy/MBq for the kidneys, and 0.42 mGy/MBq for the nasal mucous membrane. Omitting the last measurement resulted in a mean deviation of 10 to 25 % for absorbed dose values as compared to the ones received by analyzing all measurements.
Conclusion
Absorbed organ doses of [177Lu]DKFZ-PSMA-617 therapy are not likely to be critical for kidneys, salivary glands, and the nasal mucous membrane. The lacrimal glands may represent the dose-limiting organs. Whole-body scintigraphy appears sufficient for dose estimation, but late measurements are mandatory, if accurate dose calculation is required.
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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Hohberg, M., Eschner, W., Schmidt, M. et al. Lacrimal Glands May Represent Organs at Risk for Radionuclide Therapy of Prostate Cancer with [177Lu]DKFZ-PSMA-617. Mol Imaging Biol 18, 437–445 (2016). https://doi.org/10.1007/s11307-016-0942-0
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DOI: https://doi.org/10.1007/s11307-016-0942-0