Abstract
Purpose
As radionuclide therapy is gaining importance in palliative treatment of patients suffering from neuroendocrine tumour (NET) as well as castration resistant prostate cancer (CRPC), the radiation protection of patients, staff, family members and the general public is of increasing interest. Here, we determine patient discharge dates according to European guidelines.
Methods
In 40 patients with NET and 25 patients with CRPC organ and tumour doses based on the MIRD concept were calculated from data obtained during the first therapy cycle. Planar whole body images were recorded at 0.5, 4, 20, 68 und 92 h postinjection. Residence times were calculated from the respective time-activity-curves based on the conjugated view method. Residence times for critical organs were fitted into the commercially available OLINDA software to calculate the organ doses. The doses of tumours and salivary glands were calculated via their self-irradiation by approximation with spheres of equivalent volume. Kidney volumes were gained by organ segmentation, volumes of all other organs were estimated by means of OLINDA and hence were lean body mass corrected. Out of the whole body curves reference points for patient discharge were estimated.
Results
In patients with NET discharge dates could be properly estimated from dosimetric data, which is not only crucial for radiation protection, but also makes therapy planning easier. For 177Lu-PSMA-617 ligand therapy it is difficult to seriously estimate a generalized discharge date due to large interpatient variation resulting from different tumor loads and heavy pre-treatment.
Conclusion
Patient release is predictable for 177Lu-DOTATATE therapy but not for 177Lu-PSMA ligand therapy.
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Acknowledgements
The authors express gratitude to Martin Jeller and his nursing team as well as Angelika Hutter and her technologist team of the Department of Nuclear Medicine at the Medical University of Innsbruck. We express our gratitude to Anna Meister for helping to prepare the manuscript. The manuscript has been seen and approved by all authors.
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The authors declare that they have no financial or non-financial competing interests.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Mair, C., Warwitz, B., Fink, K. et al. Radiation exposure after 177Lu-DOTATATE and 177Lu-PSMA-617 therapy. Ann Nucl Med 32, 499–502 (2018). https://doi.org/10.1007/s12149-018-1264-x
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DOI: https://doi.org/10.1007/s12149-018-1264-x