1. Bone marrow dosimetry in peptide receptor radionuclide therapy with [Lu-177-DOTA(0),Tyr(3)]octreotate
- Author
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P. P. M. Kooij, Eric P. Krenning, Bert F. Bernard, Willem H. Bakker, Mark Konijnenberg, Marion de Jong, Dik J. Kwekkeboom, Flavio Forrer, Jaap J.M. Teunissen, Wouter W. de Herder, Kirsten van Lom, Radiology & Nuclear Medicine, Hematology, and Internal Medicine
- Subjects
Male ,Receptors, Peptide ,medicine.medical_treatment ,Octreotide ,[177Lu-DOTA0,Tyr3]octreotate ,Somatostatin receptor ,chemistry.chemical_compound ,Bone Marrow ,Dosimetry ,Organometallic Compounds ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Receptors, Somatostatin ,Radiometry ,Tomography, Emission-Computed, Single-Photon ,Octreotate ,Platelet Count ,business.industry ,Radiotherapy Dosage ,General Medicine ,Radiation therapy ,Neuroendocrine Tumors ,Haematopoiesis ,Radioactivity ,medicine.anatomical_structure ,chemistry ,Radiology Nuclear Medicine and imaging ,Radionuclide therapy ,Female ,Original Article ,Therapy ,Bone marrow ,Stem cell ,Somatostatin ,Nuclear medicine ,business - Abstract
Purpose Adequate dosimetry is mandatory for effective and safe peptide receptor radionuclide therapy (PRRT). Besides the kidneys, the bone marrow is a potentially dose-limiting organ. The radiation dose to the bone marrow is usually calculated according to the MIRD scheme, where the accumulated activity in the bone marrow is calculated from the accumulated radioactivity of the radiopharmaceutical in the blood. This may underestimate the absorbed dose since stem cells express somatostatin receptors. We verified the blood-based method by comparing the activity in the blood with the radioactivity in bone marrow aspirates. Also, we evaluated the absorbed cross-dose from the source organs (liver, spleen, kidneys and blood), tumours and the so-called “remainder of the body” to the bone marrow. Methods Bone marrow aspirates were drawn in 15 patients after treatment with [177Lu-DOTA0,Tyr3]octreotate. Radioactivity in the bone marrow was compared with radioactivity in the blood drawn simultaneously. The nucleated cell fraction was isolated from the bone marrow aspirate and radioactivity was measured. The absorbed dose to the bone marrow was calculated. The results were correlated to the change in platelet counts 6 weeks after treatment. Results A strong linear correlation and high agreement between the measured radioactivities in the bone marrow aspirates and in the blood was found (r=0.914, p
- Published
- 2009