Estimation of absorbed dose to the kidneys in patients after treatment with 177Lu-octreotate: comparison between methods based on planar scintigraphy.
Estimation of absorbed dose to the kidneys in patients after treatment with 177Lu-octreotate: comparison between methods based on planar scintigraphy.
复制标题
DOI：
10.1186/2191-219x-2-49
复制
发表时间：
2012-09-24
期刊：
影响因子：
3.2
通讯作者：
Forssell-Aronsson E
中科院分区：
文献类型：
--
作者：
Larsson M;Bernhardt P;Svensson JB;Wängberg B;Ahlman H;Forssell-Aronsson E
lu- [Dota0，tyr3] -octreotate（177lu-octreotate）用于治疗具有高体皮抑制素 - 受体表达的神经内分泌肿瘤。例如，肾脏毒性是177lu-钩齿治疗的主要限制因素之一。需要这项研究的目的是估算儿童的吸收剂量，并将其与平面成像和不同剂量计的结果进行比较：（1）使用患者特异性肾脏大小（2）（2） ）PA方法，仅基于后验图像，（3）使用标准肾脏大小（CVSTANTARD大小）的时间点（CVREDUCED数据）减少（CVREDUCES数据）和（4）CV方法的CV方法。
总的来说，33例患者的3.4至8.2 GBQ最多五次，赖氨酸和精氨酸的注入可阻止肾脏的摄取，并在0、1、2和7天获得了肾脏摄取。 。连同时间点数量和标准器官尺寸的影响。
在时间活性曲线模式中发现了个体间的变化，并使用CV方法对孩子的吸收剂量：0.33至2.4 GY/GBQ（平均值= 0.80 GY/GBQ，SD = 0.30）与第一个管理的所有后续肾脏剂量的平均离职分别为1％（SD = 19％）和5％（SD = 23％），分别为左右肾脏。吸收剂量的变化。
发现肾脏剂量的个体间变异很大，表明需要特定于患者的剂量测定和治疗计划。
Lu-[DOTA0, Tyr3]-octreotate (177Lu-octreotate) is used to treat neuroendocrine tumors with high somatostatin-receptor expression. 177Lu-octreotate is mainly excreted via the kidneys, but to some extent, accumulates in the kidney cortex due to, e.g., tubular reabsorption. Renal toxicity is one of the main limiting factors in 177Lu-octreotate treatment. Further knowledge of the biodistribution and dosimetry of 177Lu-octreotate in individual patients is needed. The aim of this study was to estimate the absorbed dose to the kidneys and compare the results obtained with planar imaging and different dosimetric methods: (1) conjugate-view (CV) method using patient-specific kidney sizes, (2) PA method, based on posterior images only, (3) CV method with reduced number of time points (CVreduced data), and (4) CV method using standard kidney sizes (CVstandard size). Totally, 33 patients each received 3.4 to 8.2 GBq of 177Lu-octreotate up to five times, with infusion of lysine and arginine to block the renal uptake. Whole-body planar gamma camera images were acquired on days 0, 1, 2, and 7. The 177Lu concentration in the kidneys was determined by the CV method, and the absorbed dose was estimated with patient-specific organ sizes. Comparison to the CV method was made using posterior images only, together with the influence of the number of time points and with standard organ sizes. Large interindividual variations were found in the time-activity curve pattern and in the absorbed dose to the kidneys using the CV method: 0.33 to 2.4 Gy/GBq (mean = 0.80 Gy/GBq, SD = 0.30). In the individual patient, the mean deviation of all subsequent kidney doses compared to that of the first administration was 1% (SD = 19%) and 5% (SD = 23%) for the right and left kidneys, respectively. Excluding data for day 7 resulted in large variations in the absorbed dose. Large interindividual variations in kidney dose were found, demonstrating the need for patient-specific dosimetry and treatment planning.