Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-10-2004 | Original Article

Pre-therapeutic dosimetry and biodistribution of ⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide versus ¹¹¹In-pentetreotide in patients with advanced neuroendocrine tumours

Authors: Andreas Helisch, Gregor J. Förster, Helmut Reber, Hans-Georg Buchholz, Rudolf Arnold, Burkhard Göke, Matthias M. Weber, Bertram Wiedenmann, Stanislas Pauwels, Ulrike Haus, Hakim Bouterfa, Peter Bartenstein

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2004

Abstract

Purpose

For the internal radiotherapy of neuroendocrine tumours, the somatostatin analogue DOTATOC labelled with ⁹⁰Y is frequently used [⁹⁰Y-DOTA-Phe¹-Tyr³-octreotide (SMT487-OctreoTher)]. Radiation exposure to the kidneys is critical in this therapy as it may result in renal failure. The aim of this study was to compare cumulative organ and tumour doses based upon dosimetric data acquired with the chemically identical ⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide (considered as the gold standard) and the commercially available ¹¹¹In-pentetreotide.

Methods

The cumulative organ and tumour doses for the therapeutic administration of 13.32 GBq ⁹⁰Y-DOTA-Phe¹-Tyr³-octreotide (three cycles, each of 4.44 GBq) were estimated based on the MIRD concept (MIRDOSE 3.1 and IMEDOSE). Patients with a cumulative kidney dose exceeding 27 Gy had to be excluded from subsequent therapy with ⁹⁰Y-DOTA-Phe¹-Tyr³-octreotide, in accordance with the directives of the German radiation protection authorities.

Results

The range of doses (mGy/MBq ⁹⁰Y-DOTA-Phe¹-Tyr³-octreotide) for kidneys, spleen, liver and tumour masses was 0.6–2.8, 1.5–4.2, 0.3–1.3 and 2.1–29.5 (⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide), respectively, versus 1.3–3.0, 1.8–4.4, 0.2–0.8 and 1.4–19.7 (¹¹¹In-pentetreotide), with wide inter-subject variability. Despite renal protection with amino acid infusions, estimated cumulative kidney doses in two patients exceeded 27 Gy.

Conclusion

Compared with ⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide, dosimetry with ¹¹¹In-pentetreotide overestimated doses to kidneys and spleen, whereas the radiation dose to the tumour-free liver was underestimated. However, both dosimetric approaches detected the two patients with an exceptionally high radiation burden to the kidneys that carried a potential risk of renal failure following radionuclide therapy.

Waldherr C, Pless M, Maecke HR, Schumacher T, Crazzolara A, Nitzsche EU, Haldemann A, Mueller-Brand J. Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq ⁹⁰Y-DOTATOC. J Nucl Med 2002;43:610–616

Paganelli G, Zoboli S, Cremonesi M, Bodei L, Ferrari M, Grana C, Bartolomei M, Orsi F, De Cicco C, Macke HR, Chinol M, de Braud F. Receptor-mediated radiotherapy with ⁹⁰Y-DOTA-d-Phe¹-Tyr³-octreotide. Eur J Nucl Med 2001;28:426–434PubMed

Kwekkeboom D, Krenning EP, de Jong M. Peptide receptor imaging and therapy. J Nucl Med 2000;41:1704–1713PubMed

Cybulla M, Weiner SM, Otte A. End-stage renal disease after treatment with ⁹⁰Y-DOTATOC. Eur J Nucl Med 2001;28:1552–1554PubMed

Moll S, Nickeleit V, Mueller-Brand J, Brunner FP, Maecke HR, Mihatsch MJ. A new cause of renal thrombotic microangiopathy: yttrium 90-DOTATOC internal radiotherapy. Am J Kidney Dis 2001;37:847–851PubMed

Boerman OC, Oyen WJ, Corstens FH. Between the Scylla and Charybdis of peptide radionuclide therapy: hitting the tumor and saving the kidney. Eur J Nucl Med 2001;28:1447–1449PubMed

Jamar F, Barone R, Mathieu I, Walrand S, Labar D, Carlier P, De Camps J, Schran H, Chen T, Smith MC, Bouterfa H, Valkema R, Krenning EP, Kvols LK, Pauwels S. ⁸⁶Y-DOTA(0)-d-Phe¹-Tyr³-octreotide (SMT487)—a phase 1 clinical study: pharmacokinetics, biodistribution and renal protective effect of different regimens of amino acid co-infusion. Eur J Nucl Med Mol Imaging 2003;30:510–518PubMed

Rolleman EJ, Valkema R, De Jong M, Kooij PP, Krenning EP. Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine. Eur J Nucl Med Mol Imaging 2003;30:9–15CrossRefPubMed

Förster GJ, Engelbach M, Brockmann J, Reber H, Buchholz HG, Macke HR, Rösch F, Herzog H, Bartenstein P. Preliminary data on biodistribution and dosimetry for therapy planning of somatostatin receptor positive tumours: comparison of ⁸⁶Y-DOTATOC and ¹¹¹In-DTPA-octreotide. Eur J Nucl Med 2001;28:1743–1750PubMed

10.

Rösch F, Herzog H, Stolz B, Brockmann J, Kohle M, Muhlensiepen H, Marbach P, Müller-Gartner HW. Uptake kinetics of the somatostatin receptor ligand [⁸⁶Y]DOTA-dPhe¹-Tyr³-octreotide ([⁸⁶Y]SMT487) using positron emission tomography in non-human primates and calculation of radiation doses of the ⁹⁰Y-labelled analogue. Eur J Nucl Med 1999;26:358–366CrossRefPubMed

11.

Herzog H, Rösch F, Stocklin G, Lueders C, Qaim SM, Feinendegen LE. Measurement of pharmacokinetics of yttrium-86 radiopharmaceuticals with PET and radiation dose calculation of analogous yttrium-90 radiotherapeutics. J Nucl Med 1993;34:2222–2226PubMed

12.

Buchholz HG, Herzog H, Förster GJ, Reber H, Nickel O, Rösch F, Bartenstein P. PET imaging with yttrium-86: comparison of phantom measurements acquired with different PET scanners before and after applying background subtraction. Eur J Nucl Med Mol Imaging 2003;30:716–720PubMed

13.

Cremonesi M, Ferrari M, Zoboli S, Chinol M, Stabin MG, Orsi F, Maecke HR, Jermann E, Robertson C, Fiorenza M, Tosi G, Paganelli G. Biokinetics and dosimetry in patients administered with ¹¹¹In-DOTA-Tyr³-octreotide: implications for internal radiotherapy with ⁹⁰Y-DOTATOC. Eur J Nucl Med 1999;26:877–886PubMed

14.

Sgouros G. Bone marrow dosimetry for radioimmunotherapy: theoretical considerations. J Nucl Med 1993;34:689–694PubMed

15.

Siegel JA, Thomas SR, Stubbs JB, Stabin MG, Hays MT, Koral KF, Robertson JS, Howell RW, Wessels BW, Fisher DR, Weber DA, Brill AB. MIRD pamphlet no. 16: techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates. J Nucl Med 1999;40:37S–61SPubMed

16.

Herzog H, Zilken H, Niederbremer A, Friedrich W, Müller-Gartner HW. Calculation of residence times and radiation doses using the standard PC software Excel. Eur J Nucl Med 1997;24:1514–1521CrossRefPubMed

17.

Breeman WA, de Jong M, Kwekkeboom DJ, Valkema R, Bakker WH, Kooij PP, Visser TJ, Krenning EP. Somatostatin receptor-mediated imaging and therapy: basic science, current knowledge, limitations and future perspectives. Eur J Nucl Med 2001;28:1421–1429PubMed

18.

National Council on Radiation Protection and Measurements. Misadministration of radioactive material in medicine—scientific background. Bethesda, MD; 1991:27

19.

Konijnenberg M, Barone R, Walrand S, Jamar F, De Camps J, Pauwels S, Smith C, Kooij P, Kwekkeboom DJ, Valkema R, Krenning EP. Bone marrow dose results in peptide receptor radionuclide therapy (PRRT) with ⁹⁰Y-DOTA-Tyr³-octreotide, ¹¹¹In-DTPA-octreotide and ¹⁷⁷Lu-DOTA-octreotate: importance of dosimetry model. J Nucl Med 2002;43(Suppl):90P

Title: Pre-therapeutic dosimetry and biodistribution of 86Y-DOTA-Phe1-Tyr3-octreotide versus 111In-pentetreotide in patients with advanced neuroendocrine tumours
Authors: Andreas Helisch
Gregor J. Förster
Helmut Reber
Hans-Georg Buchholz
Rudolf Arnold
Burkhard Göke
Matthias M. Weber
Bertram Wiedenmann
Stanislas Pauwels
Ulrike Haus
Hakim Bouterfa
Peter Bartenstein
Publication date: 01-10-2004
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2004
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1561-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pre-therapeutic dosimetry and biodistribution of ⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide versus ¹¹¹In-pentetreotide in patients with advanced neuroendocrine tumours

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2004

Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting

EANM Application Form 2005

Use of 99mTc-sestamibi gated SPECT to assess the influence of anterograde flow before primary coronary angioplasty on tissue salvage and functional recovery in acute myocardial infarction

Management of thyroid nodules: a clinicopathological, evidence-based approach

In vitro and in vivo evaluation of the influence of type III NaPi co-transporter activity during apoptosis on 99mTc-(V)DMSA uptake in the human leukaemic cell line U937

Usefulness of 123I-metaiodobenzylguanidine myocardial scintigraphy for predicting the effectiveness of β-blockers in patients with dilated cardiomyopathy from the standpoint of long-term prognosis