Skip to main content
Erschienen in: Nuclear Medicine and Molecular Imaging 5/2021

18.09.2021 | Original Article

Patient-Specific Dosimetry in Radioligand Therapy (RLT) for Metastatic Prostate Cancer Using 177Lu-DKFZ-PSMA-617

verfasst von: Elahe Mahmoudi, Elahe Pirayesh, Mohammad Reza Deevband, Mahasti Amoui, Mehrdad Ghorbani Rad, Mahdi Ghorbani

Erschienen in: Nuclear Medicine and Molecular Imaging | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

177Lu-DKFZ-PSMA-617 is a promising treatment for patients with metastatic prostate cancer. Specific dosimetry for each patient is an important factor in planning the patient’s treatment process. This study aimed to perform an image-based absorbed dose calculation for the treatment of metastatic prostate cancer with 177Lu-DKFZ-PSMA-617.

Methods

The individualized patient dosimetry calculations were based on whole-body planar scintigraphy images acquired in 10 patients with a mean age of 71.4 ± 6.07 years (range 63–85 years) at approximately 0–2 h, 4–6 h, 18–24 h, and 36–48 h after administration of the mean 6253 ± 826.4 MBq (range 5500–7400 MBq) of 177Lu-DKFZ-PSMA-617. Time-activity curves were generated for various organs. For count conversion to activities, calibration factors were calculated. Finally, the absorbed dose for an individual cycle was calculated using IDIAC-DOSE 2.1 software.

Results

On average, the calculated absorbed dose for the kidneys and salivary glands were 0.46 ± 0.09 mGy/MBq and 0.62 ± 0.07 mGy/MBq, respectively.

Conclusions

Based on the results, the177Lu-PSMA-617 therapy is a safe method for the treatment of castration-resistant prostate cancer patients. Large inter-individual variations in organ dose were found, demonstrating the need for patient-specific dosimetry and treatment planning.
Literatur
1.
Zurück zum Zitat Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.CrossRef Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.CrossRef
2.
Zurück zum Zitat Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29.CrossRef Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29.CrossRef
3.
Zurück zum Zitat Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, Bray F. International variation in prostate cancer incidence and mortality rates. Eur Urol. 2012;61:1079–92.CrossRef Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, Bray F. International variation in prostate cancer incidence and mortality rates. Eur Urol. 2012;61:1079–92.CrossRef
4.
Zurück zum Zitat Eiber M, Maurer T, Souvatzoglou M, Beer AJ, Ruffani A, Haller B, et al. Evaluation of hybrid 68Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. 2015;56:668–74.CrossRef Eiber M, Maurer T, Souvatzoglou M, Beer AJ, Ruffani A, Haller B, et al. Evaluation of hybrid 68Ga-PSMA ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy. J Nucl Med. 2015;56:668–74.CrossRef
5.
Zurück zum Zitat Zechmann CM, Afshar-Oromieh A, Armor T, Stubbs JB, Mier W, Hadaschik B, et al. Radiation dosimetry and first therapy results with a (124)I/(131)I-labeled small molecule (MIP-1095) targeting PSMA for prostate cancer therapy. Eur J Nucl Med Mol Imaging. 2014;41:1280–92.CrossRef Zechmann CM, Afshar-Oromieh A, Armor T, Stubbs JB, Mier W, Hadaschik B, et al. Radiation dosimetry and first therapy results with a (124)I/(131)I-labeled small molecule (MIP-1095) targeting PSMA for prostate cancer therapy. Eur J Nucl Med Mol Imaging. 2014;41:1280–92.CrossRef
6.
Zurück zum Zitat Eiber M, Nekolla SG, Maurer T, Weirich G, Wester HJ, Schwaiger M. (68) Ga-PSMA PET/MR with multimodality image analysis for primary prostate cancer. Abdom Imaging. 2015;40:1769–71.CrossRef Eiber M, Nekolla SG, Maurer T, Weirich G, Wester HJ, Schwaiger M. (68) Ga-PSMA PET/MR with multimodality image analysis for primary prostate cancer. Abdom Imaging. 2015;40:1769–71.CrossRef
7.
Zurück zum Zitat Wright GL Jr, Haley C, Beckett ML, Schellhammer PF. Expression of prostate specific membrane antigen in normal, benign, and malignant prostate tissues. Urol Oncol. 1995;1:18–28.CrossRef Wright GL Jr, Haley C, Beckett ML, Schellhammer PF. Expression of prostate specific membrane antigen in normal, benign, and malignant prostate tissues. Urol Oncol. 1995;1:18–28.CrossRef
8.
Zurück zum Zitat Afshar-Oromieh A, Hetzheim H, Kratochwil C, Benes ova M, Eder M, Neels OC, et al. The theranostic PSMA ligand PSMA-617 in the diagnosis of prostate cancer by PET/CT: biodistribution in humans, radiation dosimetry, and first evaluation of tumor lesions. J Nucl Med. 2015;56:1697–705.CrossRef Afshar-Oromieh A, Hetzheim H, Kratochwil C, Benes ova M, Eder M, Neels OC, et al. The theranostic PSMA ligand PSMA-617 in the diagnosis of prostate cancer by PET/CT: biodistribution in humans, radiation dosimetry, and first evaluation of tumor lesions. J Nucl Med. 2015;56:1697–705.CrossRef
9.
Zurück zum Zitat Ristau BT, O’Keefe DS, Bacich DJ. The prostate-specific membrane antigen: lessons and current clinical implications from 20 years of research. Urol Oncol. 2014;32:272–9.CrossRef Ristau BT, O’Keefe DS, Bacich DJ. The prostate-specific membrane antigen: lessons and current clinical implications from 20 years of research. Urol Oncol. 2014;32:272–9.CrossRef
10.
Zurück zum Zitat Klein Nulent TJ, Valstar MH, de Keizer B, Willems SM, Smit LA, Al-Mamgani A, et al. Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:478–86.CrossRef Klein Nulent TJ, Valstar MH, de Keizer B, Willems SM, Smit LA, Al-Mamgani A, et al. Physiologic distribution of PSMA-ligand in salivary glands and seromucous glands of the head and neck on PET/CT. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:478–86.CrossRef
11.
Zurück zum Zitat Kratochwil C, Giesel FL, Eder M, Afshar-Oromieh A, Benešová M, Mier W, Kopka K, et al. [177Lu]Lutetium-labelled PSMA ligand-induced remission in a patient with metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:987–8.CrossRef Kratochwil C, Giesel FL, Eder M, Afshar-Oromieh A, Benešová M, Mier W, Kopka K, et al. [177Lu]Lutetium-labelled PSMA ligand-induced remission in a patient with metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:987–8.CrossRef
12.
Zurück zum Zitat Delker A, Fendler WP, Kratochwil C, Brunegraf A, Gosewisch A, Gildehaus FJ, et al. Dosimetry for 177Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:42–51.CrossRef Delker A, Fendler WP, Kratochwil C, Brunegraf A, Gosewisch A, Gildehaus FJ, et al. Dosimetry for 177Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:42–51.CrossRef
13.
Zurück zum Zitat Sarnelli A, Belli ML, Di Iorio V, Mezzenga E, Celli M, Severi S, Tardelli E, Nicolini S, Oboldi D, Uccelli L, Cittanti C, Monti M, Ferrari M, Paganelli G. Dosimetry of 177Lu-PSMA-617 after mannitol infusion and glutamate tablet administration: preliminary results of EUDRACT/RSO 2016–002732-32 IRST protocol. Molecules. 2019;11(24):621.CrossRef Sarnelli A, Belli ML, Di Iorio V, Mezzenga E, Celli M, Severi S, Tardelli E, Nicolini S, Oboldi D, Uccelli L, Cittanti C, Monti M, Ferrari M, Paganelli G. Dosimetry of 177Lu-PSMA-617 after mannitol infusion and glutamate tablet administration: preliminary results of EUDRACT/RSO 2016–002732-32 IRST protocol. Molecules. 2019;11(24):621.CrossRef
14.
Zurück zum Zitat Hohberg M, Eschner W, Schmidt M, Dietlein M, Kobe C, Fischer T, Drzezga A, Wild M. Lacrimal glands may represent organs at risk for radionuclide therapy of prostate cancer with 177 Lu DKFZ-PSMA-617. Mol Imaging Biol. 2016;18:437–45.CrossRef Hohberg M, Eschner W, Schmidt M, Dietlein M, Kobe C, Fischer T, Drzezga A, Wild M. Lacrimal glands may represent organs at risk for radionuclide therapy of prostate cancer with 177 Lu DKFZ-PSMA-617. Mol Imaging Biol. 2016;18:437–45.CrossRef
15.
Zurück zum Zitat Kabasakal L, AbuQbeitah M, Aygün A, Yeyin N, Ocak M, Demirci E, Toklu T. Pre-therapeutic dosimetry of normal organs and tissues of (177)Lu-PSMA-617 prostate-specific membrane antigen (PSMA) inhibitor in patients with castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:1976–83.CrossRef Kabasakal L, AbuQbeitah M, Aygün A, Yeyin N, Ocak M, Demirci E, Toklu T. Pre-therapeutic dosimetry of normal organs and tissues of (177)Lu-PSMA-617 prostate-specific membrane antigen (PSMA) inhibitor in patients with castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:1976–83.CrossRef
16.
Zurück zum Zitat Kabasakal L, Toklu T, Yeyin N, Demirci E, Abuqbeitah M, Ocak M, Aygün A, Karayel E, Pehlivanoğlu H, Alan SN. Lu-177-PSMA-617 prostate-specific membrane antigen inhibitor therapy in patients with castration-resistant prostate cancer: stability, bio-distribution and dosimetry. Mol Imaging Radionucl Ther. 2017;26:62–8.CrossRef Kabasakal L, Toklu T, Yeyin N, Demirci E, Abuqbeitah M, Ocak M, Aygün A, Karayel E, Pehlivanoğlu H, Alan SN. Lu-177-PSMA-617 prostate-specific membrane antigen inhibitor therapy in patients with castration-resistant prostate cancer: stability, bio-distribution and dosimetry. Mol Imaging Radionucl Ther. 2017;26:62–8.CrossRef
17.
Zurück zum Zitat Divoli A, Chiavassa S, Ferrer L, Barbet J, Flux GD, Bardiès M. Effect of patient morphology on dosimetric calculations for internal irradiation as assessed by comparisons of Monte Carlo versus conventional methodologies. J Nucl Med. 2009;50:316–23.CrossRef Divoli A, Chiavassa S, Ferrer L, Barbet J, Flux GD, Bardiès M. Effect of patient morphology on dosimetric calculations for internal irradiation as assessed by comparisons of Monte Carlo versus conventional methodologies. J Nucl Med. 2009;50:316–23.CrossRef
18.
Zurück zum Zitat Howard DM, Kearfott KJ, Wilderman SJ, Dewaraja YK. Comparison of I-131 radioimmunotherapy tumor dosimetry: unit density sphere model versus patient-specific Monte Carlo calculations. Cancer Biother Radiopharm. 2011;26:615–21.CrossRef Howard DM, Kearfott KJ, Wilderman SJ, Dewaraja YK. Comparison of I-131 radioimmunotherapy tumor dosimetry: unit density sphere model versus patient-specific Monte Carlo calculations. Cancer Biother Radiopharm. 2011;26:615–21.CrossRef
19.
Zurück zum Zitat Senthamizhchelvan S, Hobbs RF, Song H, et al. Tumor dosimetry and response for 153Sm-ethylenediamine tetra methylene phosphoric acid therapy of high-risk osteosarcoma. J Nucl Med. 2012;53:215–24.CrossRef Senthamizhchelvan S, Hobbs RF, Song H, et al. Tumor dosimetry and response for 153Sm-ethylenediamine tetra methylene phosphoric acid therapy of high-risk osteosarcoma. J Nucl Med. 2012;53:215–24.CrossRef
20.
Zurück zum Zitat Andersson M, Johansson L, Eckerman K, Mattsson S. IDAC-Dose 2.1, an internal dosimetry program for diagnostic nuclear medicine based on the ICRP adult reference voxel phantoms. EJNMMI Res. 2017;7:88.CrossRef Andersson M, Johansson L, Eckerman K, Mattsson S. IDAC-Dose 2.1, an internal dosimetry program for diagnostic nuclear medicine based on the ICRP adult reference voxel phantoms. EJNMMI Res. 2017;7:88.CrossRef
21.
Zurück zum Zitat Miller C, Filipow L, Jackson S. A review of activity quantification by planar imaging methods. J Nucl Med Technol. 1995;23:3–9. Miller C, Filipow L, Jackson S. A review of activity quantification by planar imaging methods. J Nucl Med Technol. 1995;23:3–9.
22.
Zurück zum Zitat Stabin MG. Fundamentals of nuclear medicine dosimetry. 1st ed. New York: Springer Verlag; 2008. Stabin MG. Fundamentals of nuclear medicine dosimetry. 1st ed. New York: Springer Verlag; 2008.
23.
Zurück zum Zitat Konijnenberg MW, Bijster M, Krenning EP, De Jong M. A stylized computational model of the rat for organ dosimetry in support of preclinical evaluations of peptide receptor radionuclide therapy with (90) Y, (111) In, or (177) Lu. J Nucl Med. 2004;45:1260–9 ([published correction appears in J Nucl Med 2009 Dec 50(12):2092).PubMed Konijnenberg MW, Bijster M, Krenning EP, De Jong M. A stylized computational model of the rat for organ dosimetry in support of preclinical evaluations of peptide receptor radionuclide therapy with (90) Y, (111) In, or (177) Lu. J Nucl Med. 2004;45:1260–9 ([published correction appears in J Nucl Med 2009 Dec 50(12):2092).PubMed
24.
Zurück zum Zitat Stabin MG, Siegel JA. Physical models and dose factors for use in internal dose assessment. Health Phys. 2003;85:294–310.CrossRef Stabin MG, Siegel JA. Physical models and dose factors for use in internal dose assessment. Health Phys. 2003;85:294–310.CrossRef
25.
Zurück zum Zitat ICRP89. Basic anatomical and physiological data for use in radiological protection: reference values. A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP Publication 89. Ann ICRP. 2002;32:5–265.CrossRef ICRP89. Basic anatomical and physiological data for use in radiological protection: reference values. A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP Publication 89. Ann ICRP. 2002;32:5–265.CrossRef
26.
Zurück zum Zitat Snyder WS, Fisher Jr HL, Ford MR, Warner GG. MIRD pamphlet no. 5, revised: Estimates of absorbed fractions for monoenergetic photon sources uniformly distributed in various organs of a heterogeneous phantom. J Nucl Med. 1969;Suppl 3:7–52. Snyder WS, Fisher Jr HL, Ford MR, Warner GG. MIRD pamphlet no. 5, revised: Estimates of absorbed fractions for monoenergetic photon sources uniformly distributed in various organs of a heterogeneous phantom. J Nucl Med. 1969;Suppl 3:7–52.
Metadaten
Titel
Patient-Specific Dosimetry in Radioligand Therapy (RLT) for Metastatic Prostate Cancer Using 177Lu-DKFZ-PSMA-617
verfasst von
Elahe Mahmoudi
Elahe Pirayesh
Mohammad Reza Deevband
Mahasti Amoui
Mehrdad Ghorbani Rad
Mahdi Ghorbani
Publikationsdatum
18.09.2021
Verlag
Springer Singapore
Erschienen in
Nuclear Medicine and Molecular Imaging / Ausgabe 5/2021
Print ISSN: 1869-3474
Elektronische ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-021-00713-7

Weitere Artikel der Ausgabe 5/2021

Nuclear Medicine and Molecular Imaging 5/2021 Zur Ausgabe