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Pre-therapeutic dosimetry and biodistribution of 86Y-DOTA-Phe1-Tyr3-octreotide versus 111In-pentetreotide in patients with advanced neuroendocrine tumours

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

For the internal radiotherapy of neuroendocrine tumours, the somatostatin analogue DOTATOC labelled with 90Y is frequently used [90Y-DOTA-Phe1-Tyr3-octreotide (SMT487-OctreoTher)]. Radiation exposure to the kidneys is critical in this therapy as it may result in renal failure. The aim of this study was to compare cumulative organ and tumour doses based upon dosimetric data acquired with the chemically identical 86Y-DOTA-Phe1-Tyr3-octreotide (considered as the gold standard) and the commercially available 111In-pentetreotide.

Methods

The cumulative organ and tumour doses for the therapeutic administration of 13.32 GBq 90Y-DOTA-Phe1-Tyr3-octreotide (three cycles, each of 4.44 GBq) were estimated based on the MIRD concept (MIRDOSE 3.1 and IMEDOSE). Patients with a cumulative kidney dose exceeding 27 Gy had to be excluded from subsequent therapy with 90Y-DOTA-Phe1-Tyr3-octreotide, in accordance with the directives of the German radiation protection authorities.

Results

The range of doses (mGy/MBq 90Y-DOTA-Phe1-Tyr3-octreotide) for kidneys, spleen, liver and tumour masses was 0.6–2.8, 1.5–4.2, 0.3–1.3 and 2.1–29.5 (86Y-DOTA-Phe1-Tyr3-octreotide), respectively, versus 1.3–3.0, 1.8–4.4, 0.2–0.8 and 1.4–19.7 (111In-pentetreotide), with wide inter-subject variability. Despite renal protection with amino acid infusions, estimated cumulative kidney doses in two patients exceeded 27 Gy.

Conclusion

Compared with 86Y-DOTA-Phe1-Tyr3-octreotide, dosimetry with 111In-pentetreotide overestimated doses to kidneys and spleen, whereas the radiation dose to the tumour-free liver was underestimated. However, both dosimetric approaches detected the two patients with an exceptionally high radiation burden to the kidneys that carried a potential risk of renal failure following radionuclide therapy.

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Acknowledgements

The authors thank G. Fischer for her excellent technical assistance. This study was supported financially by Novartis Pharmaceuticals, including radionuclide costs, patients’ accommodation and logistical assistance. Additionally, this work was supported in part by a grant from the German research foundation DFG EN 450/1-1 (to MMW).

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Mainz, Langenbeckstr. 1, 55101, Mainz, Germany

    Andreas Helisch, Gregor J. Förster, Helmut Reber, Hans-Georg Buchholz & Peter Bartenstein

  2. Division of Gastroenterology and Endocrinology, Department of Internal Medicine, Philips University, Marburg, Germany

    Rudolf Arnold

  3. Department of Internal Medicine II, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany

    Burkhard Göke

  4. Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Mainz, Mainz, Germany

    Matthias M. Weber

  5. Department of Hepatology and Gastroenterology, Charité Medical School, Campus Virchow Clinic, Berlin, Germany

    Bertram Wiedenmann

  6. Center of Nuclear Medicine, Catholic University of Louvain, Brussels, Belgium

    Stanislas Pauwels

  7. Novartis Pharmaceuticals, Nuremberg, Germany

    Ulrike Haus

  8. Novartis Pharmaceuticals, Basel, Switzerland

    Hakim Bouterfa

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  1. Andreas Helisch
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Correspondence to Andreas Helisch.

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Helisch, A., Förster, G.J., Reber, H. et al. Pre-therapeutic dosimetry and biodistribution of 86Y-DOTA-Phe1-Tyr3-octreotide versus 111In-pentetreotide in patients with advanced neuroendocrine tumours. Eur J Nucl Med Mol Imaging 31, 1386–1392 (2004). https://doi.org/10.1007/s00259-004-1561-6

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  • DOI: https://doi.org/10.1007/s00259-004-1561-6

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