Journal Article

DZNE-2023-00144

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Biodistribution and dosimetry for combined [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T therapy using multi-isotope quantitative SPECT imaging.

Delker, A. ; Schleske, M. ; Liubchenko, G. ; Berg, I. ; Zacherl, M. J. ; Brendel, M.DZNE* ; Gildehaus, F. J. ; Rumiantcev, M. ; Resch, S. ; Hürkamp, K. ; Wenter, V. ; Unterrainer, L. M. ; Bartenstein, P. ; Ziegler, S. I. ; Beyer, L. ; Böning, G.

2023
Springer-Verl. Heidelberg [u.a.]

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Please use a persistent id in citations: doi:10.1007/s00259-022-06092-1

Abstract: Quantitative SPECT for patient-specific dosimetry is a valuable tool in the scope of radionuclide therapy, although its clinical application for 225Ac-based treatments may be limited due to low therapeutic activities. Therefore, the aim of this study was to demonstrate the feasibility of clinical quantitative low-count SPECT imaging during [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T treatment.Eight prostate cancer patients (1000 MBq/8 MBq [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T) received a single-bed quantitative 177Lu/225Ac SPECT/CT acquisition (1 h) at 24 h post treatment (high-energy collimator, 16 projections p. head à 3.5 min, 128 × 128 pixel). The gamma peak at 440 keV (width: 10%) of the progeny 213Bi was imaged along with the peak at 208 keV (width: 15%) of 177Lu. Quantification included CT-based attenuation and window-based scatter correction plus resolution modelling. Gaussian post-filtering with a full-width-half-maximum of 30 mm and 40-45 mm was employed to match the signal-to-noise ratio of 225Ac and 177Lu, respectively.Kidney (r = 0.96, p < 0.01) and lesion (r = 0.94, p < 0.01) SUV for [177Lu]Lu-PSMA-I&T and [225Ac]Ac-PSMA-I&T showed a strong and significant correlation. Kidney SUV were significantly higher (p < 0.01) for [225Ac]Ac-PSMA-I&T (2.5 ± 0.8 vs. 2.1 ± 0.9), while for [177Lu]Lu-PSMA-I&T lesion SUV were significantly higher (p = 0.03; 1.8 ± 1.1 vs. 2.1 ± 1.5). For absorbed dose estimates, significant differences regarding the kidneys remained, while no significant differences for lesion dosimetry were found.Quantitative low-count SPECT imaging of the peak at 440 keV during [225Ac]Ac-PSMA-I&T therapy is feasible. Multi-isotope imaging for [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T therapy indicates accumulation of free 213Bi in the kidneys.

Keyword(s): Humans (MeSH) ; Male (MeSH) ; Dipeptides: therapeutic use (MeSH) ; Heterocyclic Compounds, 1-Ring: therapeutic use (MeSH) ; Isotopes (MeSH) ; Prostate-Specific Antigen (MeSH) ; Prostatic Neoplasms, Castration-Resistant: diagnostic imaging (MeSH) ; Prostatic Neoplasms, Castration-Resistant: radiotherapy (MeSH) ; Prostatic Neoplasms, Castration-Resistant: drug therapy (MeSH) ; Radiopharmaceuticals: therapeutic use (MeSH) ; Tissue Distribution (MeSH) ; Tomography, Emission-Computed, Single-Photon (MeSH) ; Dipeptides ; 225Ac ; Dosimetry ; PSMA ; Prostate cancer ; SPECT ; Heterocyclic Compounds, 1-Ring ; Isotopes ; Prostate-Specific Antigen ; Radiopharmaceuticals ; Lutetium-177 ; Actinium-225

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Contributing Institute(s):

1. ALS, FTLD and Zebrafish models (AG Haass old)

Research Program(s):

1. 352 - Disease Mechanisms (POF4-352) (POF4-352)

Appears in the scientific report 2023

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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