Pre-therapeutic dosimetry of normal organs and tissues of 177Lu-PSMA-617 prostate-specific membrane antigen (PSMA) inhibitor in patients with castration-resistant prostate cancer.
Abstract
Purpose (177)Lu-617-prostate-specific membrane antigen (PSMA) ligand seems to be a promising tracer for radionuclide therapy of progressive prostate cancer. However, there are no published data regarding the radiation dose given to the normal tissues. The aim of the present study was to estimate the pretreatment radiation doses in patients who will undergo radiometabolic therapy using a tracer amount of (177)Lu-labeled PSMA ligand.Methods The study included seven patients with progressive prostate cancer with a mean age of 63.9 ± 3.9 years. All patients had prior PSMA positron emission tomography (PET) imaging and had intense tracer uptake at the lesions. The injected (177)Lu-PSMA-617 activity ranged from 185 to 210 MBq with a mean of 192.6 ± 11.0 MBq. To evaluate bone marrow absorbed dose 2-cc blood samples were withdrawn in short variable times (3, 15, 30, 60, and 180 min and 24, 48, and 120 h) after injection. Whole-body images were obtained at 4, 24, 48, and 120 h post-injection (p.i.). The geometric mean of anterior and posterior counts was determined through region of interest (ROI) analysis. Attenuation correction was applied using PSMA PET/CT images. The OLINDA/EXM dosimetry program was used for curve fitting, residence time calculation, and absorbed dose calculations.Results The calculated radiation-absorbed doses for each organ showed substantial variation. The highest radiation estimated doses were calculated for parotid glands and kidneys. Calculated radiation-absorbed doses per megabecquerel were 1.17 ± 0.31 mGy for parotid glands and 0.88 ± 0.40 mGy for kidneys. The radiation dose given to the bone marrow was significantly lower than those of kidney and parotid glands (p < 0.05). The calculated radiation dose to bone marrow was 0.03 ± 0.01 mGy/MBq.Conclusion Our first results suggested that (177)Lu-PSMA-617 therapy seems to be a safe method. The dose-limiting organ seems to be the parotid glands rather than kidneys and bone marrow. The lesion radiation doses are within acceptable ranges; however, there is a substantial individual variance so patient dosimetry seems to be mandatory.
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Current clinical TAT research relies greatly on indirect approximation by extrapolating pre-existing 177Lu-labeled pharmaceuticals.
“Thus, current clinical TAT research relies greatly on indirect approximation by extrapolating pre-existing 177Lu-labeled pharmaceuticals (84, 112, 113).”
From Alpha-peptide receptor radionuclide therapy using actinium-225 labeled somatostatin receptor agonists and antagonists (2022) · cites this paper as [113]
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Self-citation
- Authors
- Kabasakal, L., AbuQbeitah, M., Aygün, A., Yeyin, N., Ocak, M., Demirci, E., & Toklu, T.
- Affiliations
- Istanbul University-Cerrahpaşa (TR)
- Istanbul University (TR)
- Şişli Etfal Eğitim ve Araştırma Hastanesi (TR)
- Corresponding author
- Kabasakal, Levent
- Venue
- European Journal of Nuclear Medicine and Molecular Imaging
- Published
- 2015-07-31
- Volume
- 42
- Issue
- 13
- Pages
- 1976-1983
- ISSN
- 1619-7070 (ISSN-L)
- 1619-7089
- OpenAlex
- W1497206380
- Cited by
- 208
- References
- 34
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 14 · 2023: 20 · 2022: 17 · 2021: 23 · 2020: 18 · 2019: 23 · 2018: 23 · 2017: 18 · 2016: 27 · 2015: 1
- FWCI
- 18.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Nuclear Medicine and Molecular Imaging (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- 177Lu-PSMA-617, prostate-specific membrane antigen, castration-resistant prostate cancer, parotid gland, kidney, PSMA PET/CT, OLINDA/EXM, treatment safety, radionuclide therapy, residence time
- MeSH terms
- Aged, Antigens, Surface, Bone Marrow, Dipeptides, Heterocyclic Compounds, 1-Ring, Humans, Kidney, Lutetium, Male, Middle Aged, Parotid Gland, Radiotherapy Dosage, Prostate-Specific Antigen, Radiopharmaceuticals, Glutamate Carboxypeptidase II, Organs at Risk, Prostatic Neoplasms, Castration-Resistant
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