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Assessment of Organ Dosimetry for Planning Repeat Treatments of High-Dose 131I-MIBG Therapy: 123I-MIBG Versus Posttherapy 131I-MIBG Imaging
Open accessAbstract
PURPOSE: To evaluate detailed organ-based radiation-absorbed dose for planning double high-dose treatment with I-MIBG. METHODS: In a prospective study, 33 patients with high-risk refractory or recurrent neuroblastoma were treated with high-dose I-MIBG. Organ dosimetry was estimated from the first I-MIBG posttherapy imaging and from subsequent I-MIBG imaging prior to the planned second administration. Three serial whole-body scans were performed per patient 2 to 6 days after I-MIBG therapy (666 MBq/kg or 18 mCi/kg) and approximately 0.5, 24, and 48 hours after the diagnostic I-MIBG dose (370 MBq/kg or 10 mCi/1.73 m). Organ radiation doses were calculated using OLINDA. I-MIBG scan dosimetry estimations were used to predict doses for the second I-MIBG therapy and compared with I-MIBG posttherapy estimates. RESULTS: Mean ± SD whole-body doses from I-MIBG and I-MIBG scans were 0.162 ± 112 and 0.141 ± 0.068 mGy/MBq, respectively. I-MIBG and I-MIBG organ doses were variable-generally higher for I-MIBG-projected doses than those projected using posttherapy I-MIBG scans. Mean ± SD doses to liver, heart wall, and lungs were 0.487 ± 0.28, 0.225 ± 0.20, and 0.40 ± 0.26, respectively, for I-MIBG and 0.885 ± 0.56, 0.618 ± 0.37, and 0.458 ± 0.56, respectively, for I-MIBG. Mean ratio of I-MIBG to I-MIBG estimated radiation dose was 1.81 ± 1.95 for the liver, 2.75 ± 1.84 for the heart, and 1.13 ± 0.93 for the lungs. No unexpected toxicities were noted based on I-MIBG-projected doses and cumulative dose limits of 30, 20, and 15 Gy to liver, kidneys, and lungs, respectively. CONCLUSIONS: For repeat I-MIBG treatment planning, both I-MIBG and I-MIBG imaging yielded variable organ doses. However, I-MIBG-based dosimetry yielded a more conservative estimate of maximum allowable activity and would be suitable for planning and limiting organ toxicity with repeat high-dose therapies.
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Whole-body absorbed dose has been used effectively as a surrogate for marrow dosimetry in pediatric patients receiving 131I-MIBG, often 3-4 Gy over 2 treatments.
“whole-body absorbed dose has been used effectively as a surrogate for marrow dosimetry in pediatric patients receiving 131 I-MIBG (often 3 -4 Gy over 2 treatments) ( 91 )”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [91]
The Background and Discussion describe whole-body dosimetry in planning ¹³¹I-MIBG therapy for pediatric neuroblastoma and report a maximum whole-body absorbed dose of 4 Gy across two administrations. They do not establish that whole-body dose is an effective surrogate for marrow dosimetry; the Discussion instead says earlier studies used whole-body and red-marrow estimates and notes large variation in whole-body methods. The copy also does not give a 3–4 Gy range. (LLM, conf=0.87)
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Metadata
- Authors
- Pandit-Taskar, N., Zanzonico, P., Hilden, P., Ostrovnaya, I., Carrasquillo, J. A., & Modak, S.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Pandit-Taskar, Neeta
- Carrasquillo, Jorge A.
- ORCID
- Venue
- Clinical Nuclear Medicine
- Published
- 2017-10
- Volume
- 42
- Issue
- 10
- Pages
- 741-748
- ISSN
- 0363-9762 (ISSN-L)
- PMC
- PMC5753751
- OpenAlex
- W2740168840
- Cited by
- 22
- References
- 24
- Citations by year
- 2026: 4 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 1
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Clinical Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P30CA008748)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- organ dosimetry, neuroblastoma, Olinda, radiation dose assessment, liver dose, heart dose, lung dose, radiation toxicity, whole-body scan, refractory neuroblastoma, relapsed neuroblastoma
- MeSH terms
- Adult, Female, Humans, Male, Neuroblastoma, Prospective Studies, Radiation Dosage, Radiometry, Radionuclide Imaging, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, 3-Iodobenzylguanidine
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