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Bauwens M, Pooters I, Cobben R, Visser M, Schnerr R, Mottaghy F, Wildberger J, Wierts R. A comparison of four radionuclide dose calibrators using various radionuclides and measurement geometries clinically used in nuclear medicine. Phys Med 2019; 60:14-21. [PMID: 31000075 DOI: 10.1016/j.ejmp.2019.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/01/2019] [Accepted: 03/12/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Reliable quantification of radioactivity in nuclear medicine is becoming increasingly important in various therapeutic applications requiring a high accuracy of nuclear medicine measuring equipment, such as radionuclide calibrators. In this study the accuracy of four different radionuclide calibrators was assessed for 99mTc, 111In, 68Ga and 18F for measurement geometries clinically used. METHODS Syringes and vials were prepared with a reference activity using a stock solution of which the activity concentration was determined using gamma-ray spectroscopy. The accuracy of four different radionuclide calibrator systems, ISOMED 2000, ISOMED 2010, VIK-202 and Capintec CRC-25R, was assessed by comparing the measured activity to the reference activity. RESULTS Deviations in measured activity from reference values were found up to 12.5%, 32.0%, 29.0% and 12.6% for 99mTc, 111In, 68Ga and 18F, respectively. For 68Ga all radionuclide calibrators systematically overestimated the activity by 10-20%. For 111In, large differences in activity measurements were observed between different source geometries, in particular between syringes and vials. Deviations between radionuclide calibrator systems were found up to 11.8%, 44.4%, 14.4% and 8.7% for 99mTc, 111In, 68Ga and 18F, respectively. When comparing similar syringe types of different brands filled with identical stock solution volume, deviations up to 1.8%, 5.8%, 10.2% and 3.2% were found for 99mTc, 111In, 68Ga and 18F. CONCLUSION Substantial deviations in measured activity were found for all radionuclides and radionuclide calibrators, which may result in erroneous activity dosing and image quantification. This underlines the importance of thorough validation of radionuclide calibrators for all measurement geometries and radionuclides clinically used.
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Affiliation(s)
- Matthias Bauwens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands; Research School NUTRIM, Maastricht University, Maastricht, The Netherlands
| | - Ivo Pooters
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Rianda Cobben
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Mariëlle Visser
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Roald Schnerr
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Felix Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands; University Hospital RWTH Aachen University, Aachen, Germany
| | - Joachim Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center +, Maastricht, The Netherlands.
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Wierts R, Brans B, Havekes B, Kemerink GJ, Halders SG, Schaper NN, Backes WH, Mottaghy FM, Jentzen W. Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of 124I PET/CT. J Nucl Med 2016; 57:1027-32. [DOI: 10.2967/jnumed.115.168799] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/05/2016] [Indexed: 11/16/2022] Open
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Kletting P, Schimmel S, Hänscheid H, Luster M, Fernández M, Nosske D, Lassmann M, Glatting G. The NUKDOS software for treatment planning in molecular radiotherapy. Z Med Phys 2015; 25:264-74. [PMID: 25791740 DOI: 10.1016/j.zemedi.2015.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/22/2014] [Accepted: 01/12/2015] [Indexed: 02/04/2023]
Abstract
The aim of this work was the development of a software tool for treatment planning prior to molecular radiotherapy, which comprises all functionality to objectively determine the activity to administer and the pertaining absorbed doses (including the corresponding error) based on a series of gamma camera images and one SPECT/CT or probe data. NUKDOS was developed in MATLAB. The workflow is based on the MIRD formalism For determination of the tissue or organ pharmacokinetics, gamma camera images as well as probe, urine, serum and blood activity data can be processed. To estimate the time-integrated activity coefficients (TIAC), sums of exponentials are fitted to the time activity data and integrated analytically. To obtain the TIAC on the voxel level, the voxel activity distribution from the quantitative 3D SPECT/CT (or PET/CT) is used for scaling and weighting the TIAC derived from the 2D organ data. The voxel S-values are automatically calculated based on the voxel-size of the image and the therapeutic nuclide ((90)Y, (131)I or (177)Lu). The absorbed dose coefficients are computed by convolution of the voxel TIAC and the voxel S-values. The activity to administer and the pertaining absorbed doses are determined by entering the absorbed dose for the organ at risk. The overall error of the calculated absorbed doses is determined by Gaussian error propagation. NUKDOS was tested for the operation systems Windows(®) 7 (64 Bit) and 8 (64 Bit). The results of each working step were compared to commercially available (SAAMII, OLINDA/EXM) and in-house (UlmDOS) software. The application of the software is demonstrated using examples form peptide receptor radionuclide therapy (PRRT) and from radioiodine therapy of benign thyroid diseases. For the example from PRRT, the calculated activity to administer differed by 4% comparing NUKDOS and the final result using UlmDos, SAAMII and OLINDA/EXM sequentially. The absorbed dose for the spleen and tumour differed by 7% and 8%, respectively. The results from the example from radioiodine therapy of benign thyroid diseases and the example given in the latest corresponding SOP were identical. The implemented, objective methods facilitate accurate and reproducible results. The software is freely available.
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Affiliation(s)
- Peter Kletting
- Klinik für Nuklearmedizin, Universität Ulm, Ulm, Germany.
| | | | | | - Markus Luster
- Klinik für Nuklearmedizin, Universität Marburg, Marburg, Germany
| | - Maria Fernández
- Klinik für Nuklearmedizin, Universität Würzburg, Würzburg, Germany
| | - Dietmar Nosske
- Bundesamt für Strahlenschutz, Fachbereich Strahlenschutz und Gesundheit, Oberschleißheim, Germany
| | - Michael Lassmann
- Klinik für Nuklearmedizin, Universität Würzburg, Würzburg, Germany
| | - Gerhard Glatting
- Medical Radiation Physics/Radiation Protection, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Wild D, Fani M, Fischer R, Del Pozzo L, Kaul F, Krebs S, Fischer R, Rivier JEF, Reubi JC, Maecke HR, Weber WA. Comparison of somatostatin receptor agonist and antagonist for peptide receptor radionuclide therapy: a pilot study. J Nucl Med 2014; 55:1248-52. [PMID: 24963127 DOI: 10.2967/jnumed.114.138834] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/09/2014] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Preclinical and clinical studies have indicated that somatostatin receptor (sst)-expressing tumors demonstrate higher uptake of radiolabeled sst antagonists than of sst agonists. In 4 consecutive patients with advanced neuroendocrine tumors, we evaluated whether treatment with (177)Lu-labeled sst antagonists is feasible. METHODS After injection of approximately 1 GBq of (177)Lu-DOTA-[Cpa-c(DCys-Aph(Hor)-DAph(Cbm)-Lys-Thr-Cys)-DTyr-NH2] ((177)Lu-DOTA-JR11) and (177)Lu-DOTATATE, 3-dimensional voxel dosimetry analysis based on SPECT/CT was performed. A higher tumor-to-organ dose ratio for (177)Lu-DOTA-JR11 than for (177)Lu-DOTATATE was the prerequisite for treatment with (177)Lu-DOTA-JR11. RESULTS Reversible minor adverse effects of (177)Lu-DOTA-JR11 were observed. (177)Lu-DOTA-JR11 showed a 1.7-10.6 times higher tumor dose than (177)Lu-DOTATATE. At the same time, the tumor-to-kidney and tumor-to-bone marrow dose ratio was 1.1-7.2 times higher. All 4 patients were treated with (177)Lu-DOTA-JR11, resulting in partial remission in 2 patients, stable disease in 1 patient, and mixed response in the other patient. CONCLUSION Treatment of neuroendocrine tumors with radiolabeled sst antagonists is clinically feasible and may have a significant impact on peptide receptor radionuclide therapy.
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Affiliation(s)
- Damian Wild
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany Division of Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
| | - Melpomeni Fani
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany Division of Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
| | | | - Luigi Del Pozzo
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Felix Kaul
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany Division of Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
| | - Simone Krebs
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Richard Fischer
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Jean E F Rivier
- Clayton Foundation Laboratories for Peptide Biology, Salk Institute, La Jolla, California
| | - Jean Claude Reubi
- Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Berne, Berne, Switzerland
| | - Helmut R Maecke
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany German Cancer Consortium (DKTK), Freiburg, Germany; and
| | - Wolfgang A Weber
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany German Cancer Consortium (DKTK), Freiburg, Germany; and Department of Radiology, Sloan-Kettering Cancer Center, New York, New York
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Versari A, Sollini M, Frasoldati A, Fraternali A, Filice A, Froio A, Asti M, Fioroni F, Cremonini N, Putzer D, Erba PA. Differentiated thyroid cancer: a new perspective with radiolabeled somatostatin analogues for imaging and treatment of patients. Thyroid 2014; 24:715-26. [PMID: 24102584 DOI: 10.1089/thy.2013.0225] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The expression of somatostatin receptors (SSTR) in thyroid cells may offer the possibility to identify metastatic lesions and to select patients for peptide receptor radionuclide therapy (PRRT). We investigated (68)Ga-DOTATOC positron emission tomography/computed tomography (PET/CT) to select patients with progressive differentiated thyroid cancer (DTC) for PRRT as well as treatment response and toxicity in treated patients. METHODS We enrolled 41 patients with progressive radioiodine-negative DTC (24 women and 17 men; mean age=54.3 years, median=59 years, range=19-78 years). In all patients, [(18)F]FDG-PET/CT was performed to determine recurrent disease with enhanced glucose metabolism, and (68)Ga-DOTATOC PET/CT was used to identify SSTR expression. Dosimetric evaluation was performed with (111)In-DOTATOC scintigraphy. Eleven patients were treated with PRRT receiving a fractionated injection of 1.5-3.7 GBq (90)Y-DOTATOC/administration. Serial (68)Ga-DOTATOC PET/CT scans were performed in all treated patients to evaluate treatment response. Parameters provided by (68)Ga-DOTATOC PET/CT were analyzed as potential therapeutic predictors to differentiate responding from nonresponding. In all treated patients, adverse events and toxicity were recorded. RESULTS (68)Ga-DOTATOC PET/CT were positive in 24/41 of radioiodine-negative DTC patients. Based on the high expression of SSTR detected by (68)Ga-DOTATOC PET/CT, 13 patients were suitable for PRRT. Two out of 13 patients were not treated due to the lack of fulfillment of other study inclusion criteria. PRRT induced disease control in 7/11 patients (two partial response and five stabilization) with a duration of response of 3.5-11.5 months. Objective response was associated with symptoms relief. Functional volume (FV) over time obtained by PET/CT was the only parameter demonstrating a significant difference between lesions responding and nonresponding to PRRT (p=0.001). Main PRRT adverse events were nausea, asthenia, and transient hematologic toxicity. One patient experienced permanent renal toxicity. CONCLUSIONS In our series, SSTR imaging provided positive results in more than half of the cases with radioiodine-negative DTC, and about one third of patients were eligible for PRRT. (68)Ga-DOTATOC PET/CT seems a reliable tool both for patient selection and evaluation of treatment response. In our experience, FV determination over time seems to represent a reliable parameter to determine tumor response to PRRT, although further investigations are needed to better define its role.
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Affiliation(s)
- Annibale Versari
- 1 Nuclear Medicine, Arcispedale Santa Maria Nuova, Clinical Cancer Research Institute (IRCCS) , Reggio Emilia, Italy
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Kletting P, Schimmel S, Kestler HA, Hänscheid H, Luster M, Fernández M, Bröer JH, Nosske D, Lassmann M, Glatting G. Molecular radiotherapy: The NUKFIT software for calculating the time-integrated activity coefficient. Med Phys 2013; 40:102504. [DOI: 10.1118/1.4820367] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cutler CS, Hennkens HM, Sisay N, Huclier-Markai S, Jurisson SS. Radiometals for Combined Imaging and Therapy. Chem Rev 2012. [DOI: 10.1021/cr3003104] [Citation(s) in RCA: 281] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Cathy S. Cutler
- University of Missouri Research Reactor Center, Columbia, Missouri 65211, United
States
| | - Heather M. Hennkens
- University of Missouri Research Reactor Center, Columbia, Missouri 65211, United
States
| | - Nebiat Sisay
- University of Missouri Research Reactor Center, Columbia, Missouri 65211, United
States
- Department of Chemistry, University of Missouri, Columbia, Missouri 65211, United
States
| | - Sandrine Huclier-Markai
- Laboratoire Subatech,
UMR 6457, Ecole des Mines de Nantes/Université de Nantes/CNRS-IN2P3, 4 Rue A. Kastler, BP 20722, F-44307
Nantes Cedex 3, France
| | - Silvia S. Jurisson
- Department of Chemistry, University of Missouri, Columbia, Missouri 65211, United
States
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Gupta SK, Singla S, Bal C. Renal and Hematological Toxicity in Patients of Neuroendocrine Tumors After Peptide Receptor Radionuclide Therapy with177Lu-DOTATATE. Cancer Biother Radiopharm 2012; 27:593-9. [DOI: 10.1089/cbr.2012.1195] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Santosh K. Gupta
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suhas Singla
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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Juweid ME, Mottaghy FM. Current and future aspects of nuclear molecular therapies: a model of theranostics. Methods 2011; 55:193-5. [PMID: 22153218 DOI: 10.1016/j.ymeth.2011.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2011] [Indexed: 11/17/2022] Open
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