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[68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment
Introduction Patient eligibility for [ 177 Lu]Lu-PSMA therapy remains a challenge, with only 40–60% response rate when patient selection is done based on the lesion uptake (SUV) on [ 68 Ga]Ga-PSMA-PET/CT. Prediction of absorbed dose based on this pre-treatment scan could improve patient selection an...
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| Published in: | European journal of nuclear medicine and molecular imaging 2022-03, Vol.49 (4), p.1101-1112 |
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| container_title | European journal of nuclear medicine and molecular imaging |
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| creator | Peters, Steffie M. B. Hofferber, Regina Privé, Bastiaan M. de Bakker, Maarten Gotthardt, Martin Janssen, Marcel de Lange, Frank Muselaers, Constantijn H. J. Mehra, Niven Witjes, J. Alfred Costa, Pedro F. Nagarajah, James Konijnenberg, Mark W. Jentzen, Walter |
| description | Introduction
Patient eligibility for [
177
Lu]Lu-PSMA therapy remains a challenge, with only 40–60% response rate when patient selection is done based on the lesion uptake (SUV) on [
68
Ga]Ga-PSMA-PET/CT. Prediction of absorbed dose based on this pre-treatment scan could improve patient selection and help to individualize treatment by maximizing the absorbed dose to target lesions while adhering to the threshold doses for the organs at risk (kidneys, salivary glands, and liver).
Methods
Ten patients with low-volume hormone-sensitive prostate cancer received a pre-therapeutic [
68
Ga]Ga-PSMA-11 PET/CT, followed by 3 GBq [
177
Lu]Lu-PSMA-617 therapy. Intra-therapeutically, SPECT/CT was acquired at 1, 24, 48, 72, and 168 h. Absorbed dose in organs and lesions (
n
= 22) was determined according to the MIRD scheme. Absorbed dose prediction based on [
68
Ga]Ga-PSMA-PET/CT was performed using tracer uptake at 1 h post-injection and the mean tissue effective half-life on SPECT. Predicted PET/actual SPECT absorbed dose ratios were determined for each target volume.
Results
PET/SPECT absorbed dose ratio was 1.01 ± 0.21, 1.10 ± 0.15, 1.20 ± 0.34, and 1.11 ± 0.29 for kidneys (using a 2.2 scaling factor), liver, submandibular, and parotid glands, respectively. While a large inter-patient variation in lesion kinetics was observed, PET/SPECT absorbed dose ratio was 1.3 ± 0.7 (range: 0.4–2.7, correlation coefficient
r
= 0.69,
p
|
| doi_str_mv | 10.1007/s00259-021-05538-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8921092</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2638855730</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f7e226f5429eb3f19766bcf371245a9522b986840492a2153be91577a15fc4023</originalsourceid><addsrcrecordid>eNp9kU1rFTEYhYMotlb_gAsJuHETzffHRiilXoUrFqyrUkJmJjOmziTXZEZw6y83t1OvHwsXIYH3yTnv4QDwlOCXBGP1qmBMhUGYEoSFYBrRe-CYSGKQwtrcP7wVPgKPSrnBmGiqzUNwxLikjAt2DH5cSb1x1xuHLj6-P0WEwIvzSxgmN4Q4QFegg7vsu9DOKcO-HteUlBvfwS4VX2CIMOXBxQrOMIfyBbrYwTK5cYSjLyHFW-aKKLVdrrfLaiOJgnP2bp58nB-DB70bi39yd5-AT2_OL8_eou2Hzbuz0y1queIz6pWnVPaCU-Mb1hOjpGzanilCuXBGUNoYLTXH3FBHiWCNN0Qo5YjoW44pOwGvV93d0ky-a6t1dqPd5Zo2f7fJBfv3JIbPdkjfrDaUYLMXeHEnkNPXxZfZTqG0fhxd9GkplgqNpWFY8Yo-_we9SUuONZ6lkmkthGK4UnSl2pxKyb4_LEOw3Vds14ptrdjeVmz3Wzz7M8bhy69OK8BWoNRRHHz-7f0f2Z-dCq5t</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2638855730</pqid></control><display><type>article</type><title>[68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment</title><source>Springer Nature</source><creator>Peters, Steffie M. B. ; Hofferber, Regina ; Privé, Bastiaan M. ; de Bakker, Maarten ; Gotthardt, Martin ; Janssen, Marcel ; de Lange, Frank ; Muselaers, Constantijn H. J. ; Mehra, Niven ; Witjes, J. Alfred ; Costa, Pedro F. ; Nagarajah, James ; Konijnenberg, Mark W. ; Jentzen, Walter</creator><creatorcontrib>Peters, Steffie M. B. ; Hofferber, Regina ; Privé, Bastiaan M. ; de Bakker, Maarten ; Gotthardt, Martin ; Janssen, Marcel ; de Lange, Frank ; Muselaers, Constantijn H. J. ; Mehra, Niven ; Witjes, J. Alfred ; Costa, Pedro F. ; Nagarajah, James ; Konijnenberg, Mark W. ; Jentzen, Walter</creatorcontrib><description>Introduction
Patient eligibility for [
177
Lu]Lu-PSMA therapy remains a challenge, with only 40–60% response rate when patient selection is done based on the lesion uptake (SUV) on [
68
Ga]Ga-PSMA-PET/CT. Prediction of absorbed dose based on this pre-treatment scan could improve patient selection and help to individualize treatment by maximizing the absorbed dose to target lesions while adhering to the threshold doses for the organs at risk (kidneys, salivary glands, and liver).
Methods
Ten patients with low-volume hormone-sensitive prostate cancer received a pre-therapeutic [
68
Ga]Ga-PSMA-11 PET/CT, followed by 3 GBq [
177
Lu]Lu-PSMA-617 therapy. Intra-therapeutically, SPECT/CT was acquired at 1, 24, 48, 72, and 168 h. Absorbed dose in organs and lesions (
n
= 22) was determined according to the MIRD scheme. Absorbed dose prediction based on [
68
Ga]Ga-PSMA-PET/CT was performed using tracer uptake at 1 h post-injection and the mean tissue effective half-life on SPECT. Predicted PET/actual SPECT absorbed dose ratios were determined for each target volume.
Results
PET/SPECT absorbed dose ratio was 1.01 ± 0.21, 1.10 ± 0.15, 1.20 ± 0.34, and 1.11 ± 0.29 for kidneys (using a 2.2 scaling factor), liver, submandibular, and parotid glands, respectively. While a large inter-patient variation in lesion kinetics was observed, PET/SPECT absorbed dose ratio was 1.3 ± 0.7 (range: 0.4–2.7, correlation coefficient
r
= 0.69,
p
< 0.01).
Conclusion
A single time point [
68
Ga]Ga-PSMA-PET scan can be used to predict the absorbed dose of [
177
Lu]Lu-PSMA therapy to organs, and (to a limited extent) to lesions. This strategy facilitates in treatment management and could increase the personalization of [
177
Lu]Lu-PSMA therapy.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-021-05538-2</identifier><identifier>PMID: 34623453</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Antigens ; Cancer therapies ; Cardiology ; Computed tomography ; Correlation coefficients ; Dipeptides ; Dosimetry ; Drug dosages ; Exocrine glands ; Gallium Radioisotopes ; Heterocyclic Compounds, 1-Ring ; Humans ; Imaging ; Internet resources ; Kidneys ; Lesions ; Liver ; Lutetium ; Lutetium isotopes ; Male ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Oncology ; Organs ; Organs at Risk - pathology ; Original ; Original Article ; Orthopedics ; Patients ; Positron emission ; Positron Emission Tomography Computed Tomography - methods ; Positron-Emission Tomography ; Prostate cancer ; Prostate-Specific Antigen ; Prostatic Neoplasms, Castration-Resistant - pathology ; Radiation ; Radiology ; Radiopharmaceuticals - therapeutic use ; Response rates ; Salivary gland ; Salivary glands ; Scaling factors ; Single photon emission computed tomography ; Therapy ; Tomography</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2022-03, Vol.49 (4), p.1101-1112</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f7e226f5429eb3f19766bcf371245a9522b986840492a2153be91577a15fc4023</citedby><cites>FETCH-LOGICAL-c474t-f7e226f5429eb3f19766bcf371245a9522b986840492a2153be91577a15fc4023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34623453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peters, Steffie M. B.</creatorcontrib><creatorcontrib>Hofferber, Regina</creatorcontrib><creatorcontrib>Privé, Bastiaan M.</creatorcontrib><creatorcontrib>de Bakker, Maarten</creatorcontrib><creatorcontrib>Gotthardt, Martin</creatorcontrib><creatorcontrib>Janssen, Marcel</creatorcontrib><creatorcontrib>de Lange, Frank</creatorcontrib><creatorcontrib>Muselaers, Constantijn H. J.</creatorcontrib><creatorcontrib>Mehra, Niven</creatorcontrib><creatorcontrib>Witjes, J. Alfred</creatorcontrib><creatorcontrib>Costa, Pedro F.</creatorcontrib><creatorcontrib>Nagarajah, James</creatorcontrib><creatorcontrib>Konijnenberg, Mark W.</creatorcontrib><creatorcontrib>Jentzen, Walter</creatorcontrib><title>[68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Introduction
Patient eligibility for [
177
Lu]Lu-PSMA therapy remains a challenge, with only 40–60% response rate when patient selection is done based on the lesion uptake (SUV) on [
68
Ga]Ga-PSMA-PET/CT. Prediction of absorbed dose based on this pre-treatment scan could improve patient selection and help to individualize treatment by maximizing the absorbed dose to target lesions while adhering to the threshold doses for the organs at risk (kidneys, salivary glands, and liver).
Methods
Ten patients with low-volume hormone-sensitive prostate cancer received a pre-therapeutic [
68
Ga]Ga-PSMA-11 PET/CT, followed by 3 GBq [
177
Lu]Lu-PSMA-617 therapy. Intra-therapeutically, SPECT/CT was acquired at 1, 24, 48, 72, and 168 h. Absorbed dose in organs and lesions (
n
= 22) was determined according to the MIRD scheme. Absorbed dose prediction based on [
68
Ga]Ga-PSMA-PET/CT was performed using tracer uptake at 1 h post-injection and the mean tissue effective half-life on SPECT. Predicted PET/actual SPECT absorbed dose ratios were determined for each target volume.
Results
PET/SPECT absorbed dose ratio was 1.01 ± 0.21, 1.10 ± 0.15, 1.20 ± 0.34, and 1.11 ± 0.29 for kidneys (using a 2.2 scaling factor), liver, submandibular, and parotid glands, respectively. While a large inter-patient variation in lesion kinetics was observed, PET/SPECT absorbed dose ratio was 1.3 ± 0.7 (range: 0.4–2.7, correlation coefficient
r
= 0.69,
p
< 0.01).
Conclusion
A single time point [
68
Ga]Ga-PSMA-PET scan can be used to predict the absorbed dose of [
177
Lu]Lu-PSMA therapy to organs, and (to a limited extent) to lesions. This strategy facilitates in treatment management and could increase the personalization of [
177
Lu]Lu-PSMA therapy.</description><subject>Antigens</subject><subject>Cancer therapies</subject><subject>Cardiology</subject><subject>Computed tomography</subject><subject>Correlation coefficients</subject><subject>Dipeptides</subject><subject>Dosimetry</subject><subject>Drug dosages</subject><subject>Exocrine glands</subject><subject>Gallium Radioisotopes</subject><subject>Heterocyclic Compounds, 1-Ring</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internet resources</subject><subject>Kidneys</subject><subject>Lesions</subject><subject>Liver</subject><subject>Lutetium</subject><subject>Lutetium isotopes</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Organs</subject><subject>Organs at Risk - pathology</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Positron Emission Tomography Computed Tomography - methods</subject><subject>Positron-Emission Tomography</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen</subject><subject>Prostatic Neoplasms, Castration-Resistant - pathology</subject><subject>Radiation</subject><subject>Radiology</subject><subject>Radiopharmaceuticals - therapeutic use</subject><subject>Response rates</subject><subject>Salivary gland</subject><subject>Salivary glands</subject><subject>Scaling factors</subject><subject>Single photon emission computed tomography</subject><subject>Therapy</subject><subject>Tomography</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kU1rFTEYhYMotlb_gAsJuHETzffHRiilXoUrFqyrUkJmJjOmziTXZEZw6y83t1OvHwsXIYH3yTnv4QDwlOCXBGP1qmBMhUGYEoSFYBrRe-CYSGKQwtrcP7wVPgKPSrnBmGiqzUNwxLikjAt2DH5cSb1x1xuHLj6-P0WEwIvzSxgmN4Q4QFegg7vsu9DOKcO-HteUlBvfwS4VX2CIMOXBxQrOMIfyBbrYwTK5cYSjLyHFW-aKKLVdrrfLaiOJgnP2bp58nB-DB70bi39yd5-AT2_OL8_eou2Hzbuz0y1queIz6pWnVPaCU-Mb1hOjpGzanilCuXBGUNoYLTXH3FBHiWCNN0Qo5YjoW44pOwGvV93d0ky-a6t1dqPd5Zo2f7fJBfv3JIbPdkjfrDaUYLMXeHEnkNPXxZfZTqG0fhxd9GkplgqNpWFY8Yo-_we9SUuONZ6lkmkthGK4UnSl2pxKyb4_LEOw3Vds14ptrdjeVmz3Wzz7M8bhy69OK8BWoNRRHHz-7f0f2Z-dCq5t</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Peters, Steffie M. B.</creator><creator>Hofferber, Regina</creator><creator>Privé, Bastiaan M.</creator><creator>de Bakker, Maarten</creator><creator>Gotthardt, Martin</creator><creator>Janssen, Marcel</creator><creator>de Lange, Frank</creator><creator>Muselaers, Constantijn H. J.</creator><creator>Mehra, Niven</creator><creator>Witjes, J. Alfred</creator><creator>Costa, Pedro F.</creator><creator>Nagarajah, James</creator><creator>Konijnenberg, Mark W.</creator><creator>Jentzen, Walter</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220301</creationdate><title>[68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment</title><author>Peters, Steffie M. B. ; Hofferber, Regina ; Privé, Bastiaan M. ; de Bakker, Maarten ; Gotthardt, Martin ; Janssen, Marcel ; de Lange, Frank ; Muselaers, Constantijn H. J. ; Mehra, Niven ; Witjes, J. Alfred ; Costa, Pedro F. ; Nagarajah, James ; Konijnenberg, Mark W. ; Jentzen, Walter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f7e226f5429eb3f19766bcf371245a9522b986840492a2153be91577a15fc4023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antigens</topic><topic>Cancer therapies</topic><topic>Cardiology</topic><topic>Computed tomography</topic><topic>Correlation coefficients</topic><topic>Dipeptides</topic><topic>Dosimetry</topic><topic>Drug dosages</topic><topic>Exocrine glands</topic><topic>Gallium Radioisotopes</topic><topic>Heterocyclic Compounds, 1-Ring</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internet resources</topic><topic>Kidneys</topic><topic>Lesions</topic><topic>Liver</topic><topic>Lutetium</topic><topic>Lutetium isotopes</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Organs</topic><topic>Organs at Risk - pathology</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Positron emission</topic><topic>Positron Emission Tomography Computed Tomography - methods</topic><topic>Positron-Emission Tomography</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen</topic><topic>Prostatic Neoplasms, Castration-Resistant - pathology</topic><topic>Radiation</topic><topic>Radiology</topic><topic>Radiopharmaceuticals - therapeutic use</topic><topic>Response rates</topic><topic>Salivary gland</topic><topic>Salivary glands</topic><topic>Scaling factors</topic><topic>Single photon emission computed tomography</topic><topic>Therapy</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peters, Steffie M. B.</creatorcontrib><creatorcontrib>Hofferber, Regina</creatorcontrib><creatorcontrib>Privé, Bastiaan M.</creatorcontrib><creatorcontrib>de Bakker, Maarten</creatorcontrib><creatorcontrib>Gotthardt, Martin</creatorcontrib><creatorcontrib>Janssen, Marcel</creatorcontrib><creatorcontrib>de Lange, Frank</creatorcontrib><creatorcontrib>Muselaers, Constantijn H. J.</creatorcontrib><creatorcontrib>Mehra, Niven</creatorcontrib><creatorcontrib>Witjes, J. Alfred</creatorcontrib><creatorcontrib>Costa, Pedro F.</creatorcontrib><creatorcontrib>Nagarajah, James</creatorcontrib><creatorcontrib>Konijnenberg, Mark W.</creatorcontrib><creatorcontrib>Jentzen, Walter</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peters, Steffie M. B.</au><au>Hofferber, Regina</au><au>Privé, Bastiaan M.</au><au>de Bakker, Maarten</au><au>Gotthardt, Martin</au><au>Janssen, Marcel</au><au>de Lange, Frank</au><au>Muselaers, Constantijn H. J.</au><au>Mehra, Niven</au><au>Witjes, J. Alfred</au><au>Costa, Pedro F.</au><au>Nagarajah, James</au><au>Konijnenberg, Mark W.</au><au>Jentzen, Walter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>[68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>49</volume><issue>4</issue><spage>1101</spage><epage>1112</epage><pages>1101-1112</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Introduction
Patient eligibility for [
177
Lu]Lu-PSMA therapy remains a challenge, with only 40–60% response rate when patient selection is done based on the lesion uptake (SUV) on [
68
Ga]Ga-PSMA-PET/CT. Prediction of absorbed dose based on this pre-treatment scan could improve patient selection and help to individualize treatment by maximizing the absorbed dose to target lesions while adhering to the threshold doses for the organs at risk (kidneys, salivary glands, and liver).
Methods
Ten patients with low-volume hormone-sensitive prostate cancer received a pre-therapeutic [
68
Ga]Ga-PSMA-11 PET/CT, followed by 3 GBq [
177
Lu]Lu-PSMA-617 therapy. Intra-therapeutically, SPECT/CT was acquired at 1, 24, 48, 72, and 168 h. Absorbed dose in organs and lesions (
n
= 22) was determined according to the MIRD scheme. Absorbed dose prediction based on [
68
Ga]Ga-PSMA-PET/CT was performed using tracer uptake at 1 h post-injection and the mean tissue effective half-life on SPECT. Predicted PET/actual SPECT absorbed dose ratios were determined for each target volume.
Results
PET/SPECT absorbed dose ratio was 1.01 ± 0.21, 1.10 ± 0.15, 1.20 ± 0.34, and 1.11 ± 0.29 for kidneys (using a 2.2 scaling factor), liver, submandibular, and parotid glands, respectively. While a large inter-patient variation in lesion kinetics was observed, PET/SPECT absorbed dose ratio was 1.3 ± 0.7 (range: 0.4–2.7, correlation coefficient
r
= 0.69,
p
< 0.01).
Conclusion
A single time point [
68
Ga]Ga-PSMA-PET scan can be used to predict the absorbed dose of [
177
Lu]Lu-PSMA therapy to organs, and (to a limited extent) to lesions. This strategy facilitates in treatment management and could increase the personalization of [
177
Lu]Lu-PSMA therapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34623453</pmid><doi>10.1007/s00259-021-05538-2</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1619-7070 |
| ispartof | European journal of nuclear medicine and molecular imaging, 2022-03, Vol.49 (4), p.1101-1112 |
| issn | 1619-7070 1619-7089 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8921092 |
| source | Springer Nature |
| subjects | Antigens Cancer therapies Cardiology Computed tomography Correlation coefficients Dipeptides Dosimetry Drug dosages Exocrine glands Gallium Radioisotopes Heterocyclic Compounds, 1-Ring Humans Imaging Internet resources Kidneys Lesions Liver Lutetium Lutetium isotopes Male Medicine Medicine & Public Health Nuclear Medicine Oncology Organs Organs at Risk - pathology Original Original Article Orthopedics Patients Positron emission Positron Emission Tomography Computed Tomography - methods Positron-Emission Tomography Prostate cancer Prostate-Specific Antigen Prostatic Neoplasms, Castration-Resistant - pathology Radiation Radiology Radiopharmaceuticals - therapeutic use Response rates Salivary gland Salivary glands Scaling factors Single photon emission computed tomography Therapy Tomography |
| title | [68Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [177Lu]Lu-PSMA-617 treatment |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T18%3A22%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=%5B68Ga%5DGa-PSMA-11%20PET%20imaging%20as%20a%20predictor%20for%20absorbed%20doses%20in%20organs%20at%20risk%20and%20small%20lesions%20in%20%5B177Lu%5DLu-PSMA-617%20treatment&rft.jtitle=European%20journal%20of%20nuclear%20medicine%20and%20molecular%20imaging&rft.au=Peters,%20Steffie%20M.%20B.&rft.date=2022-03-01&rft.volume=49&rft.issue=4&rft.spage=1101&rft.epage=1112&rft.pages=1101-1112&rft.issn=1619-7070&rft.eissn=1619-7089&rft_id=info:doi/10.1007/s00259-021-05538-2&rft_dat=%3Cproquest_pubme%3E2638855730%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c474t-f7e226f5429eb3f19766bcf371245a9522b986840492a2153be91577a15fc4023%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2638855730&rft_id=info:pmid/34623453&rfr_iscdi=true |