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[(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]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 a...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921092/
https://www.ncbi.nlm.nih.gov/pubmed/34623453
http://dx.doi.org/10.1007/s00259-021-05538-2
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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_facet 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 Peters, Steffie M. B.
collection PubMed
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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-021-05538-2.
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spelling pubmed-89210922022-03-17 [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment 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 Eur J Nucl Med Mol Imaging Original Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-021-05538-2. Springer Berlin Heidelberg 2021-10-08 2022 /pmc/articles/PMC8921092/ /pubmed/34623453 http://dx.doi.org/10.1007/s00259-021-05538-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
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
[(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title_full [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title_fullStr [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title_full_unstemmed [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title_short [(68)Ga]Ga-PSMA-11 PET imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)Lu]Lu-PSMA-617 treatment
title_sort [(68)ga]ga-psma-11 pet imaging as a predictor for absorbed doses in organs at risk and small lesions in [(177)lu]lu-psma-617 treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921092/
https://www.ncbi.nlm.nih.gov/pubmed/34623453
http://dx.doi.org/10.1007/s00259-021-05538-2
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