Abstract | PURPOSE: METHODS: In this pilot trial, 11 meningioma patients with a PET scan indicating somatostatin receptor expression received PRRT with 7.4 GBq (177)Lu-DOTATOC or (177)Lu-DOTATATE, followed by external beam radiotherapy. A second PET scan was scheduled for 3 months after therapy. During PRRT, multiple whole-body scans and a SPECT/CT scan of the head and neck region were acquired and used to determine the kinetics and dose in the voxel with the highest radionuclide uptake within the tumour. Maximum voxel dose and retention of activity 1 h after administration in PRRT were compared to the maximum standardized uptake values (SUV(max)) in the meningiomas from the PET scans before and after therapy. RESULTS: The median SUV(max) in the meningiomas was 13.7 (range 4.3 to 68.7), and the maximum fractional radionuclide uptake in voxels of size 0.11 cm³ was a median of 23.4 × 10(-6) (range 0.4 × 10(-6) to 68.3 × 10(-6)). A strong correlation was observed between SUV(max) and the PRRT radionuclide tumour retention in the voxels with the highest uptake (Spearman's rank test, P < 0.01). Excluding one patient who showed large differences in biokinetics between PET and PRRT and another patient with incomplete data, linear regression analysis indicated significant correlations between SUV(max) and the therapeutic uptake (r = 0.95) and between SUV(max) and the maximum voxel dose from PRRT (r = 0.76). Observed absolute deviations from the values expected from regression were a median of 5.6 × 10(-6) (maximum 9.3 × 10(-6)) for the voxel fractional radionuclide uptake and 0.40 Gy per GBq (maximum 0.85 Gy per GBq) (177)Lu for the voxel dose from PRRT. CONCLUSION: PET with (68)Ga-labelled somatostatin analogues allows the pretherapeutic assessment of tumour radionuclide uptake in PRRT of meningioma and an estimate of the achievable dose.
|
Authors | Heribert Hänscheid, Reinhart A Sweeney, Michael Flentje, Andreas K Buck, Mario Löhr, Samuel Samnick, Michael Kreissl, Frederik A Verburg |
Journal | European journal of nuclear medicine and molecular imaging
(Eur J Nucl Med Mol Imaging)
Vol. 39
Issue 8
Pg. 1284-8
(Aug 2012)
ISSN: 1619-7089 [Electronic] Germany |
PMID | 22526964
(Publication Type: Journal Article)
|
Chemical References |
- Gallium Radioisotopes
- Organometallic Compounds
- Receptors, Somatostatin
- Somatostatin
- lutetium Lu 177 dotatate
- Octreotide
- Edotreotide
|
Topics |
- Adult
- Aged
- Biological Transport
- Female
- Gallium Radioisotopes
(metabolism)
- Humans
- Male
- Meningioma
(diagnostic imaging, metabolism, therapy)
- Middle Aged
- Molecular Targeted Therapy
- Octreotide
(analogs & derivatives, therapeutic use)
- Organometallic Compounds
(therapeutic use)
- Positron-Emission Tomography
- Receptors, Somatostatin
(metabolism)
- Somatostatin
(analogs & derivatives, metabolism)
|