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Dosimetry for 177Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer

Delker, Andreas, Fendler, Wolfgang Peter, Kratochwil, Clemens, Brunegraf, Anika, Gosewisch, Astrid, Gildehaus, Franz Josef, Tritschler, Stefan, Stief, Christian Georg, Kopka, Klaus, Haberkorn, Uwe, Bartenstein, Peter, Böning, Guido·2016·European Journal of Nuclear Medicine and Molecular Imaging

DOI 10.1007/s00259-015-3174-7

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Abstract

Purpose Dosimetry is critical to achieve the optimal therapeutic effect of radioligand therapy (RLT) with limited side effects. Our aim was to perform image-based absorbed dose calculation for the new PSMA ligand (177)Lu-DKFZ-PSMA-617 in support of its use for the treatment of metastatic prostate cancer.Methods Whole-body planar images and SPECT/CT images of the abdomen were acquired in five patients (mean age 68 years) for during two treatment cycles at approximately 1, 24, 48 and 72 h after administration of 3.6 GBq (range 3.4 to 3.9 GBq) (177)Lu-DKFZ-PSMA-617. Quantitative 3D SPECT OSEM reconstruction was performed with corrections for photon scatter, photon attenuation and detector blurring. A camera-specific calibration factor derived from phantom measurements was used for quantitation. Absorbed doses were calculated for various organs from the images using a combination of linear approximation, exponential fit, and target-specific S values, in accordance with the MIRD scheme. Absorbed doses to bone marrow were estimated from planar and SPECT images and with consideration of the blood sampling method according to the EANM guidelines.Results The average (± SD) absorbed doses per cycle were 2.2 ± 0.6 Gy for the kidneys (0.6 Gy/GBq), 5.1 ± 1.8 Gy for the salivary glands (1.4 Gy/GBq), 0.4 ± 0.2 Gy for the liver (0.1 Gy/GBq), 0.4 ± 0.1 Gy for the spleen (0.1 Gy/GBq), and 44 ± 19 mGy for the bone marrow (0.012 Gy/GBq). The organ absorbed doses did not differ significantly between cycles. The critical absorbed dose reported for the kidneys (23 Gy) was not reached in any patient. At 24 h there was increased uptake in the colon with 50 - 70 % overlap to the kidneys on planar images. Absorbed doses for tumour lesions ranged between 1.2 and 47.5 Gy (13.1 Gy/GBq) per cycle.Conclusion The salivary glands and kidneys showed high, but not critical, absorbed doses after RLT with (177)Lu-DKFZ-PSMA-617. We suggest that (177)Lu-DKFZ-PSMA-617 is suitable for radiotherapy, offering tumour-to-kidney ratios comparable to those with RLT agents currently available for the treatment of neuroendocrine tumours. Our dosimetry results suggest that (177)Lu-DKFZ-PSMA-617 treatment with higher activities and more cycles is possible without the risk of damaging the kidneys.

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Authors: Delker, A., Fendler, W. P., Kratochwil, C., Brunegraf, A., Gosewisch, A., Gildehaus, F. J., Tritschler, S., Stief, C. G., Kopka, K., Haberkorn, U., Bartenstein, P., & Böning, G.
Affiliations: Ludwig-Maximilians-Universität München (DE)
University Hospital Heidelberg (DE)
German Cancer Research Center (DE)
Corresponding author: Böning, Guido
ORCID: Fendler, Wolfgang Peter
Kratochwil, Clemens
Gildehaus, Franz Josef
Tritschler, Stefan
Stief, Christian Georg
Kopka, Klaus
Haberkorn, Uwe
Bartenstein, Peter
Böning, Guido
Venue: European Journal of Nuclear Medicine and Molecular Imaging
Publisher: Springer Science and Business Media LLC
Published: 2015-08-29
Volume: 43
Issue: 1
Pages: 42-51
ISSN: 1619-7070 (ISSN-L)
1619-7089
DOI: 10.1007/s00259-015-3174-7
OpenAlex: W1140456871
Cited by: 322
References: 42
Citations by year: 2026: 16 · 2025: 20 · 2024: 23 · 2023: 21 · 2022: 31 · 2021: 51 · 2020: 41 · 2019: 33 · 2018: 32 · 2017: 27 · 2016: 26 · 2015: 1
FWCI: 23.21
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)
Funders: Deutschen Konsortium für Translationale Krebsforschung
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: radioligand therapy, dosimetry, absorbed dose, metastatic prostate cancer, PSMA ligands, SPECT/CT, kidney dose, salivary gland dose, bone marrow dose, critical organ dose, tumor dose, EANM guidelines
MeSH terms: Aged, Aged, 80 and over, Antigens, Surface, Humans, Male, Middle Aged, Neoplasm Metastasis, Organometallic Compounds, Peptides, Radiometry, Radiopharmaceuticals, Glutamate Carboxypeptidase II, Prostatic Neoplasms, Castration-Resistant

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Dosimetry for 177Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer

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