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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2013

01-01-2013 | Original Article

Dosimetry of 223Ra-chloride: dose to normal organs and tissues

Authors: Michael Lassmann, Dietmar Nosske

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2013

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Abstract

Purpose

223Ra-Chloride (also called Alpharadin®) targets bone metastases with short range alpha particles. In recent years several clinical trials have been carried out showing, in particular, the safety and efficacy of palliation of painful bone metastases in patients with castration-resistant prostate cancer using 223Ra-chloride. The purpose of this work was to provide a comprehensive dosimetric calculation of organ doses after intravenous administration of 223Ra-chloride according to the present International Commission on Radiological Protection (ICRP) model for radium.

Methods

Absorbed doses were calculated for 25 organs or tissues.

Results

Bone endosteum and red bone marrow show the highest dose coefficients followed by liver, colon and intestines. After a treatment schedule of six intravenous injections with 0.05 MBq/kg of 223Ra-chloride each, corresponding to 21 MBq for a 70 kg patient, the absorbed alpha dose to the bone endosteal cells is about 16 Gy and the corresponding absorbed dose to the red bone marrow is approximately 1.5 Gy.

Conclusion

The comprehensive list of dose coefficients presented in this work will assist in comparing and evaluating organ doses from various therapy modalities used in nuclear medicine and will provide a base for further development of patient-specific dosimetry.
Footnotes
1
Developed at the Bundesamt für Strahlenschutz (BfS), Abteilung Strahlenschutz und Gesundheit, 85764 Oberschleißheim, Germany
 
2
As proposed by the ICRP in ICRP Publication 103 [16] as the unit for an RBE-weighted absorbed dose for deterministic biological effects
 
Literature
1.
Bruland ØS, Nilsson S, Fisher DR, Larsen RH. High-linear energy transfer irradiation targeted to skeletal metastases by the alpha-emitter 223Ra: adjuvant or alternative to conventional modalities? Clin Cancer Res 2006;12:6250s–7s.PubMedCrossRef
2.
Nilsson S, Franzén L, Parker C, Tyrrell C, Blom R, Tennvall J, et al. Bone-targeted radium-223 in symptomatic, hormone-refractory prostate cancer: a randomised, multicentre, placebo-controlled phase II study. Lancet Oncol 2007;8:587–94.PubMedCrossRef
3.
Nilsson S, Larsen RH, Fosså SD, Balteskard L, Borch KW, Westlin JE, et al. First clinical experience with alpha-emitting radium-223 in the treatment of skeletal metastases. Clin Cancer Res 2005;11:4451–9.PubMedCrossRef
4.
Nilsson S, Strang P, Aksnes AK, Franzèn L, Olivier P, Pecking A, et al. A randomized, dose–response, multicenter phase II study of radium-223 chloride for the palliation of painful bone metastases in patients with castration-resistant prostate cancer. Eur J Cancer 2012;48:678–86.PubMedCrossRef
5.
Lewington V, Lamey R, Staudacher K, Vogelzang N. Radium-223 chloride: radiation safety, tolerability, and survival gain in patients with castration-resistant prostate cancer (CRPC) and bone metastases. J Nucl Med 2012;53(Suppl 1):222.
6.
ICRP. Publication 67: Age-dependent doses to members of the public from intake of radionuclides: part 2 ingestion dose coefficients. Ann ICRP 1992;22.
7.
Lassmann M, Nosske D, Reiners C. Therapy of ankylosing spondylitis with 224Ra-radium chloride: dosimetry and risk considerations. Radiat Environ Biophys 2002;41:173–8.PubMed
8.
Salmon PL, Onischuk YN, Bondarenko OA, Lanyon LE. Alpha-particle doses to cells of the bone remodeling cycle from alpha-particle-emitting bone-seekers: indications of an antiresorptive effect of actinides. Radiat Res 1999;152:S43–7.PubMedCrossRef
9.
Leggett RW. A generic age-specific biokinetic model for calcium-like elements. Radiat Prot Dosimetry 1992;41:183–98.
10.
ICRP. Publication 71: Age-dependent doses to members of the public from intake of radionuclides: part 4 inhalation dose coefficients. Ann ICRP 1995;25.
11.
ICRP. Publication 110: Adult reference computational phantoms. Ann ICRP 2009;2.
12.
ICRP. Publication 30 (part 1): Limits for intakes of radionuclides by workers. Ann ICRP 1979;2.
13.
ICRP. Publication 100. Human alimentary tract model for radiological protection. Ann ICRP 2006;36:1–2.
14.
Howell RW, Goddu SM, Narra VR, Fisher DR, Schenter RE, Rao DV. Radiotoxicity of gadolinium-148 and radium-223 in mouse testes: relative biological effectiveness of alpha-particle emitters in vivo. Radiat Res 1997;147:342–8.PubMedCrossRef
15.
Sgouros G, Roeske JC, McDevitt MR, Palm S, Allen BJ, Fisher DR, et al. MIRD Pamphlet No. 22 (abridged): radiobiology and dosimetry of alpha-particle emitters for targeted radionuclide therapy. J Nucl Med 2010;51:311–28.PubMedCrossRef
16.
ICRP. Publication 103: The 2007 recommendations of the International Commission on Radiological Protection. Ann ICRP 2007;2007:37.
17.
Bodei L, Lam M, Chiesa C, Flux G, Brans B, Chiti A, et al. EANM procedure guideline for treatment of refractory metastatic bone pain. Eur J Nucl Med Mol Imaging 2008;35:1934–40.PubMedCrossRef
18.
Hobbs RF, Song H, Watchman CJ, Bolch WE, Aksnes AK, Ramdahl T, et al. A bone marrow toxicity model for 223Ra alpha-emitter radiopharmaceutical therapy. Phys Med Biol 2012;57:3207–22.PubMedCrossRef
19.
Hindorf C, Chittenden S, Aksnes AK, Parker C, Flux GD. Quantitative imaging of 223Ra-chloride (Alpharadin) for targeted alpha-emitting radionuclide therapy of bone metastases. Nucl Med Commun 2012;33:726–32.PubMedCrossRef
Metadata
Title
Dosimetry of 223Ra-chloride: dose to normal organs and tissues
Authors
Michael Lassmann
Dietmar Nosske
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-012-2265-y

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