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Dosimetry of 177 Lu-PSMA-617 in Metastatic Castration-Resistant Prostate Cancer: Correlations Between Pretherapeutic Imaging and Whole-Body Tumor Dosimetry with Treatment Outcomes
Open accessAbstract
177Lu-prostate-specific membrane antigen (PSMA)–617 enables targeted delivery of β-particle radiation to prostate cancer. We determined its radiation dosimetry and relationships to pretherapeutic imaging and outcomes. Methods: Thirty patients with prostate cancer receiving 177Lu-PSMA-617 within a prospective clinical trial (ACTRN12615000912583) were studied. Screening 68Ga-PSMA-11 PET/CT demonstrated high PSMA expression in all patients. After therapy, patients underwent quantitative SPECT/CT at 4, 24, and 96 h. Pharmacokinetic uptake and clearance at a voxel level were calculated and translated into absorbed dose using voxel S values. Volumes of interest were drawn on normal tissues and tumor to assess radiation dose, and a whole-body tumor dose was defined. Correlations between PSMA PET/CT parameters, dosimetry, and biochemical and therapeutic response were analyzed to identify relationships between absorbed dose, tumor burden, and patient physiology. Results: Mean absorbed dose to kidneys, submandibular and parotid glands, liver, spleen, and bone marrow was 0.39, 0.44, 0.58, 0.1, 0.06, and 0.11 Gy/MBq, respectively. Median whole-body tumor-absorbed dose was 11.55 Gy and correlated with prostate-specific antigen (PSA) response at 12 wk. A median dose of 14.1 Gy was observed in patients achieving a PSA decline of at least 50%, versus 9.6 Gy for those achieving a PSA decline of less than 50% (P < 0.01). Of 11 patients receiving a tumor dose of less than 10 Gy, only one achieved a PSA response of at least 50%. On screening PSMA PET, whole-body tumor SUVmean correlated with mean absorbed dose (r = 0.62), and SUVmax of the parotids correlated with absorbed dose (r = 0.67). There was an inverse correlation between tumor volume and mean dose to the parotids (r = −0.41) and kidneys (r = −0.43). The mean parotid dose was also reduced with increasing body mass (r = −0.41) and body surface area (r = −0.37). Conclusion:177Lu-PSMA-617 delivers high absorbed doses to tumor, with a significant correlation between whole-body tumor dose and PSA response. Patients receiving less than 10 Gy were unlikely to achieve a fall in PSA of at least 50%. Significant correlations between aspects of screening 68Ga-PET/CT and tumor and normal tissue dose were observed, providing a rationale for patient-specific dosing. Reduced salivary and kidney doses were observed in patients with a higher tumor burden. The parotid dose also reduced with increasing body mass and body surface area.
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“This scenario is common for many RPTs agents, and perhaps most prominently for prostate cancer ( 39 , 40 ), where metastatic dissemination is coincident with the marrow.”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [39]
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“In a phase 2 study of 28 patients who underwent 51 Cr-EDTA GFR measurement before and 3 mo after completion of 4 cycles of 177 Lu-PSMA, a very modest decline of approximately 12 mL/min in GFR was noted ( 39 , 68 , 69 ).”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [69]
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“The dosimetry studies of small molecules targeting PSMA such as 124 I/ 131 I-MIP-1095, or 177 Lu-PSMA-617 or 177 Lu-PSMA I&T have shown salivary glands commonly receive the highest radiation-absorbed dose among normal organs ( 69 , 74 ).”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [69]
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In the citing paper
“In a phase 2 study of 28 patients who underwent 51 Cr-EDTA GFR measurement before and 3 mo after completion of 4 cycles of 177 Lu-PSMA, a very modest decline of approximately 12 mL/min in GFR was noted ( 39 , 68 , 69 ).”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [39]
Experimental — accuracy not yet measuredIn the citing paper
“High SUVmean values indicate high average PSMA expression levels, which may promote tumor binding and uptake of 177Lu-PSMA-617, leading to greater delivery of radiation and greater antitumor activity (18,19).”
From Quantitative 68 Ga-PSMA-11 PET and Clinical Outcomes in Metastatic Castration-resistant Prostate Cancer Following 177 Lu-PSMA-617 (VISION Trial) (2024) · cites this paper as [19]
In the citing paper
“High SUVmean values indicate high average PSMA expression levels, which may promote tumor binding and uptake of 177Lu-PSMA-617, leading to greater delivery of radiation and greater antitumor activity (18,19).”
From Quantitative 68 Ga-PSMA-11 PET and Clinical Outcomes in Metastatic Castration-resistant Prostate Cancer Following 177 Lu-PSMA-617 (VISION Trial) (2024) · cites this paper as [19]
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Cites
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- Fendler, 2016, 177Lu-PSMA-617 therapy, dosimetry and follow-up in patients with metastatic castration-resistant prostate cancer [in German], Nucl Med (Stuttg)., 55, 123
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Items 101–200 of 504
Unlocking ferroptosis in prostate cancer — the road to novel therapies and imaging markers
Cao, P. H. A., Dominic, A., Lujan, F. E., Senthilkumar, S., Bhattacharya, P. K., Frigo, D. E., & Subramani, E. (2024) · Nature Reviews Urology · doi:10.1038/s41585-024-00869-9 · Cited by 43
“In 2022, the FDA approved 177 Lu-PSMA-617 as the first PSMA-targeted radioligand therapy for the treatment of patients with PSMA-positive metastatic CRPC resistant to anti-androgen drugs and chemotherapy 207–209 .”
Pharmacological Optimization of PSMA-Based Radioligand Therapy
van der Gaag, S., Bartelink, I. H., Vis, A. N., Burchell, G. L., Oprea‐Lager, D. E., & Hendrikse, H. (2022) · Biomedicines · doi:10.3390/biomedicines10123020 · Cited by 37
Kiess, A. P., O’Donoghue, J. A., Uribe, C., Bodei, L., Hobbs, R. F., Hesterman, J. Y., Kesner, A., Sgouros, G., Bäck, T. A., Bardiès, M., et al. (2024) · Journal of Clinical Oncology · doi:10.1200/jco.23.01241 · Cited by 39
Derlin, T., Werner, R. A., Lafos, M., Henkenberens, C., von Klot, C. A. J., Sohns, J. M. S., Roß, T. L., & Bengel, F. M. (2020) · Journal of Nuclear Medicine · doi:10.2967/jnumed.120.241588 · Cited by 34
“From PSMA PET, for example, prior work showed that uptake in the parotid glands correlated with absorbed dose, and whole-body tumor dose was associated with PSA response at 12 wk (12).”
MethodFeuerecker, B., Chantadisai, M., Allmann, A., Tauber, R., Allmann, J., Steinhelfer, L., Rauscher, I., Wurzer, A. J., Wester, H., Weber, W., et al. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.262671 · Cited by 34
“For 177 Lu-PSMA-617, Violet et al. reported mean absorbed doses of 5.28 Gy/GBq for bone metastases and 3.91 Gy/GBq for lymph node metastases ( 32 ).”
BackgroundResultInfluentialTrägårdh, E., Enqvist, O., Ulén, J., Hvittfeldt, E., Garpered, S., Belal, S. L., Bjartell, A. S., & Edenbrandt, L. (2022) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-022-05806-9 · Cited by 34
“Furthermore, it has been shown that tumour burden and the corresponding therapeutic radioligand dose received by the tumour correlate with the treatment response of PSMA-directed radioligand therapy [21].”
BackgroundHohberg, M., Reifegerst, M., Drzezga, A. E., Wild, M., & Schmidt, M. C. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.122.264953 · Cited by 34
Yusufaly, T., Roncali, E., Brosch-Lenz, J., Uribe, C., Jha, A. K., Currie, G. M., Dutta, J., Fakhri, G. E., McMeekin, H., Pandit-Taskar, N. D., et al. (2025) · Journal of Nuclear Medicine · doi:10.2967/jnumed.124.267927 · Cited by 34
Targeted radionuclide therapy: an emerging field in solid tumours
Artigas, C., Mileva, M., Flamen, P., & Karfis, I. (2021) · Current Opinion in Oncology · doi:10.1097/cco.0000000000000762 · Cited by 33
Abbott, E. M., Falzone, N., Lenzo, N. P., & Vallis, K. A. (2021) · Clinical Oncology · doi:10.1016/j.clon.2021.09.004 · Cited by 33
A review of 177Lu dosimetry workflows: how to reduce the imaging workloads?
Vergnaud, L., Dewaraja, Y. K., Giraudet, A., Badel, J., & Sarrut, D. (2024) · EJNMMI Physics · doi:10.1186/s40658-024-00658-8 · Cited by 34
“Other authors, such as Violet et al. [21], defined a WB tumor absorbed dose correlated with the PSA response, while Peters et al. [78] correlated it with the absorbed dose by individual lesions.”
BackgroundMethodInfluentialKhreish, F., Wiessner, M., Rosar, F., Ghazal, Z., Sabet, A., Maus, S., Linxweiler, J., Bartholomä, M. D., & Ezziddin, S. (2021) · Biomolecules · doi:10.3390/biom11081099 · Cited by 32
“found a significant correlation between tumoral uptake on pretherapeutic 68Ga-PSMA PET and absorbed dose by the tumor, estimated on a 177LuPSMA-617 whole-body scan using an automated voxelized dosimetry tool [18].”
MethodPrivé, B. M., Janssen, M. J. R., van Oort, I. M., Muselaers, S., Jonker, M. A., van Gemert, W. A., de Groot, M., Westdorp, H., Mehra, N., Verzijlbergen, J. F., et al. (2021) · Trials · doi:10.1186/s13063-021-05733-4 · Cited by 32
Uijen, M. J. M., Privé, B. M., van Herpen, C. M. L., Westdorp, H., van Gemert, W. A., de Bakker, M., Gotthardt, M., Konijnenberg, M., Peters, S. M. B., & Nagarajah, J. (2023) · Nuclear Medicine Communications · doi:10.1097/mnm.0000000000001658 · Cited by 33
Maffey-Steffan, J., Scarpa, L., Svirydenka, A., Nilica, B., Mair, C., Buxbaum, S., Bektić, J., von Guggenberg, E., Uprimny, C., Horninger, W., et al. (2019) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-019-04660-6 · Cited by 32
Tandem Isotope Therapy with 225 Ac- and 177 Lu-PSMA-617 in a Murine Model of Prostate Cancer
Meyer, C. A. L., Stuparu, A. D., Lückerath, K., Calais, J., Czernin, J. G., Slavik, R., & Dahlbom, M. L. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.123.265433 · Cited by 31
“Although treatment with 177 Lu-PSMA-617 is largely well tolerated, with a favorable dosimetry pro fi le ( 11 – 13 ), in the setting of diffuse bone marrow in fi ltration, treatment with b -emitters may be limited by hematologic toxicity due to the irradiation of the surrounding healthy bone marrow…”
BackgroundMorgan, K. A., Wichmann, C. W., Osellame, L. D., Cao, Z., Guo, N. Y., Scott, A. M., & Donnelly, P. S. (2024) · Chemical Science · doi:10.1039/d3sc06365h · Cited by 31
Prostate-Specific Membrane Antigen (PSMA)-Targeted Radionuclide Therapies for Prostate Cancer
Sun, M., Niaz, M. J., Niaz, M. O., & Tagawa, S. T. (2021) · Current Oncology Reports · doi:10.1007/s11912-021-01042-w · Cited by 35
A Review of 177Lutetium-PSMA and 225Actinium-PSMA as Emerging Theranostic Agents in Prostate Cancer
Alam, R., Singh, S. B., Thapaliya, S., Shrestha, S., Deo, S., & Khanal, K. (2022) · Cureus · doi:10.7759/cureus.29369 · Cited by 34
“Because most prostate cancer patients had repeated relapses before receiving PSMA-RLT therapy, the results are pretty encouraging [11,14,15].”
Wang, G., Zang, J., Jiang, Y., Liu, Q., Sui, H., Wang, R., Fan, X., Zhang, J., Zhu, Z., & Chen, X. S. (2022) · Journal of Nuclear Medicine · doi:10.2967/jnumed.122.264857 · Cited by 33
“In addition, a previous dosimetry study demonstrated that whole-body PSMA SUVmean was associated with the average absorbed radiation dose and therapeutic response (27).”
BackgroundTheranostics: The Role of Quantitative Nuclear Medicine Imaging
Könik, A., O’Donoghue, J. A., Wahl, R. L., Graham, M. M., & den Abbeele, A. D. V. (2020) · Seminars in Radiation Oncology · doi:10.1016/j.semradonc.2020.07.003 · Cited by 33
Yusufi, N., Wurzer, A. J., Herz, M., D’Alessandria, C., Feuerecker, B., Weber, W., Wester, H., Nekolla, S. G., & Eiber, M. (2020) · Journal of Nuclear Medicine · doi:10.2967/jnumed.120.254516 · Cited by 29
177Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer
Şanlı, Y., Şimşek, D. H., Şanlı, Ö., Subramaniam, R. M., & Kendi, A. T. (2021) · Biomedicines · doi:10.3390/biomedicines9040430 · Cited by 30
“5 GBq if weight < 70 kg or GFR < 60 mL/min [20].”
BackgroundMethodResultInfluentialSgouros, G., Frey, E. C., Du, Y., Hobbs, R. F., & Bolch, W. E. (2021) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-021-05583-x · Cited by 30
Theoretical aspects on the use of single-time-point dosimetry for radionuclide therapy
Gustafsson, J., & Taprogge, J. (2021) · Physics in Medicine and Biology · doi:10.1088/1361-6560/ac46e0 · Cited by 30
Grkovski, M., O’Donoghue, J. A., Imber, B. S., Andl, G., Tu, C., Lafontaine, D., Schwartz, J., Thor, M., Zeléfsky, M. J., Humm, J. L., et al. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.123.265763 · Cited by 29
“Correlations between aspects of screening PSMA PET and tumor and normal-tissue dose provide a rationale for patient-speci fi c dosing ( 37 ).”
BackgroundBauckneht, M., Ciccarese, C., Laudicella, R., Mosillo, C., D’Amico, F., Anghelone, A., Strusi, A., Beccia, V., Sergio Bracarda, A., Fornarini, G., et al. (2024) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2024.102698 · Cited by 32
Systemic Radiotherapy of Bone Metastases With Radionuclides
Murray, I., & Du, Y. (2021) · Clinical Oncology · doi:10.1016/j.clon.2020.11.028 · Cited by 33
Prostate-specific Membrane Antigen–based Imaging of Castration-resistant Prostate Cancer
Weber, M., Hadaschik, B. A., Ferdinandus, J., Rahbar, K., Bögemann, M., Herrmann, K., Fendler, W. P., & Kesch, C. V. (2021) · European Urology Focus · doi:10.1016/j.euf.2021.01.002 · Cited by 28
Self-citationVölter, F., Mittlmeier, L. M., Gosewisch, A., Brosch-Lenz, J., Gildehaus, F. J., Zacherl, M. J., Beyer, L., Stief, C. G., Holzgreve, A., Rübenthaler, J., et al. (2021) · Diagnostics · doi:10.3390/diagnostics11030428 · Cited by 29
“presented encouraging data on the value of SPECT dosimetry in 30 patients receiving up to four cycles of 177Lu-PSMA-617 within a prospective trial [13].”
BackgroundMethodSatapathy, S., Sahoo, R. K., & Bal, C. S. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.123.265414 · Cited by 29
“It is known that higher cumulative activities of [(177)Lu]LuPSMA-RLT are necessary for an adequate tumor-absorbed dose and for causing a tumor response (28,29).”
BackgroundVlachostergios, P. J., Niaz, M. J., Skafida, M., Mosallaie, S. A., Thomas, C., Christos, P. J., Osborne, J. R., Molina, A. M., Nanus, D. M., Bander, N. H., et al. (2021) · The Prostate · doi:10.1002/pros.24104 · Cited by 28
“Planar imaging has an overall lower sensitivity for lesion detection compared to (68)Ga/(18)F‐PSMA PET/CT and may fail to detect small volume disease.(11) Hence, it is likely that a proportion of our patients with IS of 0‐1 (54/171, 31%) who were all assessed by SPECT imaging only, might have been re‐classified as hav…”
Mahajan, S., Grewal, R. K., Friedman, K. P., Schöder, H. M., & Pandit-Taskar, N. D. (2022) · Translational Oncology · doi:10.1016/j.tranon.2022.101445 · Cited by 31
Ma, T. M., Czernin, J. G., Felix, C., Alano, R. M., Wilhalme, H. M., Valle, L., Steinberg, M. L., Dahlbom, M. L., Reiter, R. E., Rettig, M. B., et al. (2023) · British Journal of Urology · doi:10.1111/bju.15988 · Cited by 27
Yadav, S., Lowery, B., Tuchayi, A. M., Jiang, F., Saelee, R., Aggarwal, R. R., Juarez, R., Flavell, R. R., & Hope, T. A. (2024) · Journal of Nuclear Medicine · doi:10.2967/jnumed.124.267955 · Cited by 28
“Prior research has primarily focused on leveraging posttreatment SPECT/CT for evaluating dose – response relationships ( 10,12,18,19 ).”
Brosch-Lenz, J., Uribe, C., Gosewisch, A., Kaiser, L., Todica, A. S., Ilhan, H., Gildehaus, F. J., Bartenstein, P., Rahmim, A., Celler, A. M., et al. (2021) · EJNMMI Physics · doi:10.1186/s40658-021-00369-4 · Cited by 27
Mix, M. D., Renaud, T., Kind, F., Nemer, U., Yousefzadeh‐Nowshahr, E., Moalosi, T. C. G., Ormrane, A. M., Meyer, P. T., & Ruf, J. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.262245 · Cited by 26
“These observations were confirmed by the updated analysis of the prospective phase II (177)Lu-PSMA trial indicating that approximately 4 cycles of RLT are well tolerated and that renal impairment is to be expected only after a higher number of cycles (3).”
ResultKurth, J., Heuschkel, M., Tonn, A., Schildt, A., Hakenberg, O. W., Krause, B. J., & Schwarzenböck, S. M. (2021) · Cancers · doi:10.3390/cancers13153884 · Cited by 30
Resch, S., Fouladgar, S. T., Zacherl, M. J., Sheikh, G. T., Liubchenko, G., Rumiantcev, M., Unterrainer, L. M., Wenter, V., Bartenstein, P., Ziegler, S. I., et al. (2023) · EJNMMI Physics · doi:10.1186/s40658-023-00529-8 · Cited by 28
“Specifically, the biologically effective dose (BED) can be correlated with treatment outcomes such as tumor volume reduction or changes in the PSA levels, offering the potential for an improved therapy [9, 10].”
BackgroundProstate Cancer Theranostics With 177Lu-PSMA
Ahmadzadehfar, H., Seifert, R., Afshar‐Oromieh, A., Kratochwil, C., & Rahbar, K. (2024) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2024.02.007 · Cited by 29
Szymaszek, P., Tyszka‐Czochara, M., & Ortyl, J. (2024) · Molecules · doi:10.3390/molecules29133164 · Cited by 27
“Phase II trial [167] 177 Lu-PSMA-617 and 68 Ga-PSMA-11 Accumulation and prolonged retention of 177 Lu-PSMA-617 in tumour tissues compared to normal cells in treated metastatic prostate cancer patients resulted in decreased prostate-specific antigen (PSA) levels, which are overexpressed in prostate…”
BackgroundRethinking Dosimetry: A European Perspective
Tran‐Gia, J., Cicone, F., Koole, M. J. B., Giammarile, F., Gear, J. I., Deshayes, E., Gabiña, P. M., Cremonesi, M., Wadsley, J., Bernhardt, P., et al. (2025) · Journal of Nuclear Medicine · doi:10.2967/jnumed.124.269378 · Cited by 26
Georgiev, T., Migliorini, F., Ciamarone, A., Mueller, M., Biancofiore, I., Faviana, P., Bartoli, F., Kim, Y. S. P., Principi, L., Gilardoni, E., et al. (2025) · Nature Biomedical Engineering · doi:10.1038/s41551-025-01432-6 · Cited by 28
“The clinical efficacy and safety profiles of those products correlate with their distribution in tumour and healthy organs 53 .”
Meeting report from the Prostate Cancer Foundation PSMA theranostics state of the science meeting
Miyahira, A. K., Pienta, K. J., Babich, J. W., Bander, N. H., Calais, J., Choyke, P. L., Hofman, M. S., Larson, S. M., Lin, F. I., Morris, M. J., et al. (2020) · The Prostate · doi:10.1002/pros.24056 · Cited by 28
“Importantly, dosimetry evaluation of the Australian phase 2 (177)Lu‐PSMA‐617 study demonstrated that the dose to tumor is strongly predictive of response to (177)Lu‐PSMA‐617.(125) Although there were some patients who received high doses to tumor and did not”
Self-citationCalais, J., & Czernin, J. G. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.263159 · Cited by 27
Role of PSMA PET/CT Imaging in the Diagnosis, Staging and Restaging of Prostate Cancer
Bagguley, D., Ong, S., Buteau, J. P., Koschel, S. G., Dhiantravan, N., Hofman, M. S., Emmett, L., Murphy, D. G., & Lawrentschuk, N. (2021) · Future Oncology · doi:10.2217/fon-2020-1293 · Cited by 26
Self-citationHicks, R. J., Iravani, A., & Sandhu, S. K. (2019) · PET Clinics · doi:10.1016/j.cpet.2019.08.007 · Cited by 25
Self-citationKamaldeep, Wanage, G., Sahu, S., Maletha, P., Adnan, A., Suman, S., Basu, S. K., Das, T., & Banerjee, S. (2020) · Cancer Biotherapy and Radiopharmaceuticals · doi:10.1089/cbr.2020.3640 · Cited by 26
“14,16,17,24,25 In this study, they adopted pixel-based approach, wherein small ROIs were drawn over the organ/tumor to avoid the contribution from overlying or underlying organs, and later, the counts under ROI were escalated to actual pixel size of the organ, assuming uniform activity distribution…”
InfluentialBarna, S., Haug, A. R., Hartenbach, M., Rasul, S., Grubmüller, B., Kramer, G., & Blaickner, M. (2020) · Clinical Nuclear Medicine · doi:10.1097/rlu.0000000000003157 · Cited by 25
Seifert, K. E., Seifert, R., Kessel, K., Roll, W., Schlack, K., Boegemann, M., & Rahbar, K. (2021) · Cancers · doi:10.3390/cancers13153715 · Cited by 25
Peterson, A. B., Wang, C.-S., Wong, K.-K., Frey, K., Muzik, O., Schipper, M., & Dewaraja, Y. (2023) · Clinical Nuclear Medicine · doi:10.1097/rlu.0000000000004599 · Cited by 14
Kostos, L. K., Buteau, J. P., Hofman, M. S., & Azad, A. (2023) · Therapeutic Advances in Medical Oncology · doi:10.1177/17588359231179309 · Cited by 27
Self-citationPrognostic Value of PSMA PET/CT in Prostate Cancer
Lawal, I. O., Ndlovu, H., Kgatle, M., Mokoala, K. M. G., & Sathekge, M. M. (2023) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2023.07.003 · Cited by 26
Performance study of a 360° CZT camera for monitoring 177Lu-PSMA treatment
Vergnaud, L., Badel, J., Giraudet, A., Kryza, D., Mognetti, T., Baudier, T., Rida, H., Dieudonné, A., & Sarrut, D. (2023) · EJNMMI Physics · doi:10.1186/s40658-023-00576-1 · Cited by 28
“Quantification can be performed with 2D planar scintigraphy [8–10] or from 3D reconstructed images [11, 12], the latter showing better accuracy [13].”
BackgroundHong, S., Leonio, M. I., Ferri, V., Duan, H., Aparici, C. M., Davidzon, G., Franc, B. L., Moradi, F., Shah, J. C., Bergstrom, C. P., et al. (2024) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-024-06718-6 · Cited by 26
“Nevertheless, a fast whole-body digital SPECT/CT will likely enhance patient compliance to dosimetry studies to improve our understanding of dose based efficacy and toxicity in radioligand therapy [29, 30].”
Yazdani, E., Sadeghi, M., Ziarati, N. K., Jabari, P., Amini, P., Vosoughi, H., Akbari, M. S., Asadi, M., Kheradpisheh, S. R., & Geramifar, P. (2025) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2025.05.014 · Cited by 23
Prostate‐specific membrane antigen theranostics in advanced prostate cancer: an evolving option
Mayor, N., Sathianathen, N. J., Buteau, J. P., Koschel, S. G., Antón-Juanilla, M., Kapoor, J., Azad, A., Hofman, M. S., & Murphy, D. G. (2020) · British Journal of Urology · doi:10.1111/bju.15143 · Cited by 24
Self-citationArmstrong, A. J., Sartor, O. A., Bono, J. S. D., Chi, K., Fizazi, K. S., Krause, B. J., Herrmann, K., Rahbar, K., Tagawa, S. T., Fred Saad, C., et al. (2024) · European Urology · doi:10.1016/j.eururo.2024.08.021 · Cited by 28
Jackson, P. A., McIntosh, L., Hofman, M. S., Kong, G., & Hicks, R. J. (2020) · Medical Physics · doi:10.1002/mp.14243 · Cited by 23
Self-citationGeneral Concepts in Theranostics.
Nunes, R. F., Zuppani, R. M. F., Coutinho, A., Barbosa, F. G., Sapienza, M., Marin, J. F., & Buchpiguel, C. (2021) · PET Clinics · doi:10.1016/j.cpet.2021.03.010 · Cited by 14
Chatachot, K., Shiratori, S., Chaiwatanarat, T., & Khamwan, K. (2021) · Annals of Nuclear Medicine · doi:10.1007/s12149-021-01659-8 · Cited by 23
“4 GBq for 177Lu-PSMA I&T, which was comparable to previous published bone marrow dosimetry data (Table 4) [24, 28, 30, 32, 33].”
ResultKristiansson, A., Örbom, A., Timmermand, O. V., Ahlstedt, J., Strand, S., & Åkerström, B. (2021) · Antioxidants · doi:10.3390/antiox10081271 · Cited by 23
Reimbursement Approaches for Radiopharmaceutical Dosimetry: Current Status and Future Opportunities
Graves, S. A., Bageac, A., Crowley, J., & Merlino, D. A. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.262752 · Cited by 23
Kristiansson, A., Örbom, A., Ahlstedt, J., Karlsson, H., Zedan, W., Gram, M., Åkerström, B., Strand, S., Altai, M., Strand, J., et al. (2021) · Biomolecules · doi:10.3390/biom11020263 · Cited by 23
de Kouchkovsky, I., Aggarwal, R. R., & Hope, T. A. (2021) · Translational Andrology and Urology · doi:10.21037/tau-20-1047 · Cited by 21
“Several studies have investigated the relationship between pre-treatment (68)Ga-PSMA-11 PET uptake and treatment outcomes in patients receiving (177)Lu RLT: in one analysis of 30 patients with mCRPC, whole body tumor SUVmean on pre-treatment (68)Ga-PSMA-11 PET imaging predicted absorbed radiation dose on post-treatmen…”
Läppchen, T., Bilinska, A., Pilatis, E., Menéndez, E., Imlimthan, S., Moon, E. S., Afshar‐Oromieh, A., Rösch, F., Rominger, A., & Gourni, E. (2024) · Molecules · doi:10.3390/molecules29133093 · Cited by 22
Pouget, J., Gabiña, P. M., Herrmann, K., Deandreis, D., Konijnenberg, M., Taïeb, D., van Leeuwen, F. W. B., Kurth, J., Eberlein, U., Laßmann, M., et al. (2024) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-024-06963-9 · Cited by 24
Fizazi, K. S., Morris, M. J., Shore, N. D., Chi, K. N., Crosby, M. J., Bono, J. S. D., Herrmann, K., Roubaud, G., Nagarajah, J., Fleming, M. T., et al. (2025) · The Lancet Oncology · doi:10.1016/s1470-2045(25)00189-5 · Cited by 29
Tuncel, M., Telli, T., Tuncalı, M. Ç., & Karabulut, E. (2021) · Annals of Nuclear Medicine · doi:10.1007/s12149-021-01593-9 · Cited by 22
Burgard, C., Rosar, F., Marlowe, R. J., Bartholomä, M. D., Dewes, S., Schaefer-Schuler, A., Linxweiler, J., Khreish, F., & Ezziddin, S. (2023) · Cancers · doi:10.3390/cancers15092592 · Cited by 23
“These observations closely align with findings in one or both of the salivary glands and splenic tissue in all of the five clinical studies [2,14–16, 19 Less closely aligned with observations of most [2,14,19], but not all [16], of the four previously published studies and of the single case report…”
BackgroundResultQuantitative SPECT/CT—Technique and Clinical Applications
Ritt, P., & Kuwert, T. (2020) · Recent results in cancer research/Recent Results in Cancer Research · doi:10.1007/978-3-030-42618-7_17 · Cited by 21
Bone marrow dosimetry in low volume mHSPC patients receiving Lu-177-PSMA therapy using SPECT/CT
Grob, D., Privé, B. M., Muselaers, S., Mehra, N., Nagarajah, J., Konijnenberg, M., & Peters, S. M. B. (2024) · EJNMMI Physics · doi:10.1186/s40658-024-00636-0 · Cited by 21
PSMA-RLT in Patients with Metastatic Hormone-Sensitive Prostate Cancer: A Retrospective Study
Banda, A., Privé, B. M., Allach, Y., Uijen, M. J. M., Peters, S. M. B., Loeff, C. C., Gotthardt, M., Muselaers, S., Witjes, J. A., van Oort, I. M., et al. (2022) · Cancers · doi:10.3390/cancers15010297 · Cited by 20
Hoshi, S., Yaginuma, K., Meguro, S., Onagi, A., Matsuoka, K., Hata, J., Sato, Y., Akaihata, H., Kataoka, M., Ogawa, S., et al. (2023) · Current Oncology · doi:10.3390/curroncol30080529 · Cited by 20
From biology to the clinic — exploring liver metastasis in prostate cancer
Ni, X., Yu, W., Li, X., Pan, J., Fang, B., Zhang, T., Lu, Y., Ye, D., & Zhu, Y. (2024) · Nature Reviews Urology · doi:10.1038/s41585-024-00875-x · Cited by 21
Karimzadeh, A., Heck, M., Tauber, R., Solaris, E., Nekolla, S., Knorr, K., Haller, B., D’Alessandria, C., Weber, W. A., Eiber, M., et al. (2023) · Journal of Nuclear Medicine · doi:10.2967/jnumed.122.265346 · Cited by 19
Huang, B., Yang, Q., Xiao, L., Wu, Y., Liu, Z., Pan, Z., Zhong, S., Song, S., & Zuo, C. (2023) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-023-06551-3 · Cited by 21
“Moreover, clinical research has indicated the association between the burden of prostate cancer tumors and the success of PSMA-directed radiation therapy [15].”
Denis, C., Cousin, F., Laere, B. D., Hustinx, R., Sautois, B. R., & Withofs, N. (2022) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.263611 · Cited by 19
“Various thresholding techniques, such as using fi xed thresholds (mostly, SUV max of greater than 3) or relative thresholds (e.g., 40% – 45% of the SUV max of the selected lesion), also exist for PET image segmentation ( 16 – 18, 23 ).”
MethodUse of imaging-based dosimetry for personalising radiopharmaceutical therapy of cancer
Beauregard, J. (2022) · Cancer Imaging · doi:10.1186/s40644-022-00505-y · Cited by 22
Vorster, M., Hadebe, B., & Sathekge, M. M. (2023) · Frontiers in Nuclear Medicine · doi:10.3389/fnume.2023.1236565 · Cited by 19
Quantitative imaging for 177Lu-PSMA treatment response monitoring and dosimetry
Meyer, C. A. L., Szidonya, L. K., Winters, C., Mench, A. M., Mallak, N., & Mittra, E. (2023) · Frontiers in Nuclear Medicine · doi:10.3389/fnume.2023.1291253 · Cited by 20
Quantitative calibration of Tb-161 SPECT/CT in view of personalised dosimetry assessment studies
McIntosh, L., Jackson, P. A., Emmerson, B., Buteau, J. P., Alipour, R., Kong, G., & Hofman, M. S. (2024) · EJNMMI Physics · doi:10.1186/s40658-024-00611-9 · Cited by 19
Self-citationNautiyal, A., Jha, A. K., Mithun, S., & Rangarajan, V. (2022) · Nuclear Medicine Communications · doi:10.1097/mnm.0000000000001535 · Cited by 19
Alsadi, R., Djekidel, M., Bouhali, O., & O’Doherty, J. (2022) · Frontiers in Physics · doi:10.3389/fphy.2022.940677 · Cited by 21
Hematological Toxicity in Mice after High Activity Injections of 177Lu-PSMA-617
Kristiansson, A., Timmermand, O. V., Altai, M., Strand, J., Strand, S., Åkerström, B., & Örbom, A. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14040731 · Cited by 18
“Therefore, even though the activity is considerably higher, measured in GBq/kg, than the activity given to patients (~5–8 GBq/cycle [20,31,32]), the absorbed dose in the bone marrow is still much lower than the generally accepted bone marrow absorbed dose in patients of 2 Gy [33,34].”
BackgroundPrecision strikes: PSMA-targeted radionuclide therapy in prostate cancer – a narrative review
Szponar, P., Petrasz, P., Brzeźniakiewicz‐Janus, K., Drewa, T. A., Zorga, P., & Adamowicz, J. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1239118 · Cited by 18
PSMA Radiotheranostics in Prostate Cancer: Principles, Practice, and Future Prospects
Szidonya, L. K., Barwick, T. D., Challapalli, A., Naik, M., Eccles, A., Barbon, D. A., & Mallak, N. (2024) · Radiographics · doi:10.1148/rg.240080 · Cited by 18
Characterisation of a hand-held CZT-based gamma camera for 177Lu imaging
Roth, D. R., Larsson, E., Sundlöv, A., & Gleisner, K. S. (2020) · EJNMMI Physics · doi:10.1186/s40658-020-00313-y · Cited by 18
Tsai, W. K., Zettlitz, K. A., Dahlbom, M. L., Reiter, R. E., & Wu, A. M. (2020) · Molecular Imaging and Biology · doi:10.1007/s11307-020-01518-4 · Cited by 18
Topal, E., Kovan, B., Çelik, A. İ., Kuyumcu, S., Başaran, M., Demirtaş, A. M., Şanlı, Ö., & Şanlı, Y. (2025) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-025-07125-1 · Cited by 19
Grkovski, M., Krebs, S. S., O’Donoghue, J. A., Kuten, J., Mauguen, A., Shobeiri, P., Lafontaine, D., Thor, M., Augensen, F., Fox, J. J., et al. (2025) · Journal of Nuclear Medicine · doi:10.2967/jnumed.125.270170 · Cited by 19
Parent, E. E., Savir-Baruch, B., Gayed, I. W., Almaguel, F. A., Chin, B. B., Pantel, A. R., Armstrong, E., Morley, A., Ippisch, R. C., & Flavell, R. R. (2022) · Journal of Nuclear Medicine Technology · doi:10.2967/jnmt.122.263814 · Cited by 19
“(34), which demonstrated that patients receiving less than 10 Gy to tumors were unlikely to achieve a PSA response, defined as more than a 50% decline in pretreatment PSA level after therapy.”
BackgroundPSMA‐Hornet: Fully‐automated, multi‐target segmentation of healthy organs in PSMA PET/CT images
Klyuzhin, I. S., Chaussé, G., Bloise, I., Harsini, S., Ferres, J. L., Uribe, C., & Rahmim, A. (2023) · Medical Physics · doi:10.1002/mp.16658 · Cited by 18
Mechanistic Insights for Optimizing PSMA Radioligand Therapy
Kumar, A. S. R., & Hofman, M. S. (2020) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-20-0209 · Cited by 17
“Other future approaches to optimize PSMARLTmay include better patient selection with liquid biopsies or sophisticated image analysis using radiomics and machine learning to elucidate disease heterogeneity, molecular or genetic markers for radiation sensitivity, prospective dosimetry to avoid futile therapy, increase r…”
BackgroundSelf-citationRosar, F., Pauly, P., Ries, M., Schaefer-Schuler, A., Maus, S., Schreckenberger, M., Khreish, F., & Ezziddin, S. (2020) · PubMed Central · Cited by 18
Recommendations for Multicentre Clinical Trials Involving Dosimetry for Molecular Radiotherapy
Taprogge, J., Wadsley, J., Miles, E. A., & Flux, G. (2020) · Clinical Oncology · doi:10.1016/j.clon.2020.12.002 · Cited by 17
“[12] observed a significant correlation between whole-body tumour dose and prostate-specific antigen response in metastatic castrationresistant prostate cancer patients treated with (177)Lu-PSMA617.”
BackgroundMolecular Imaging of Recurrent and Metastatic Prostate Cancer
Ware, R. E., Williams, S., & Hicks, R. J. (2019) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2019.02.005 · Cited by 17
Self-citationComparison of PSMA-TO-1 and PSMA-617 labeled with gallium-68, lutetium-177 and actinium-225
Meyer, C. A. L., Prasad, V., Stuparu, A. D., Kletting, P., Glatting, G., Miksch, J., Solbach, C., Lückerath, K., Nyiranshuti, L., Zhu, S., et al. (2022) · EJNMMI Research · doi:10.1186/s13550-022-00935-6 · Cited by 16
“The current literature reports salivary gland dose coefficients from 177LuPSMA-617 treatment ranging from 0.44 and 0.58 Gy/ GBq [4] (for submandibular and parotid glands, respectively) to 1.4 Gy/GBq [27].”
BackgroundInfluentialMuralidhar, A., Potluri, H. K., Jaiswal, T., & McNeel, D. G. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15010252 · Cited by 17
Strosberg, J., Hofman, M. S., Al‐Toubah, T., & Hope, T. A. (2024) · Journal of Nuclear Medicine · doi:10.2967/jnumed.123.267167 · Cited by 16
Self-citation
Metadata
- Authors
- Violet, J., Jackson, P., Ferdinandus, J., Sandhu, S., Akhurst, T., Iravani, A., Kong, G., Kumar, A. R., Thang, S. P., Eu, P., Scalzo, M., Murphy, D., Williams, S., Hicks, R. J., & Hofman, M. S.
- Affiliations
- Peter MacCallum Cancer Centre (AU)
- The University of Melbourne (AU)
- ORCID
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2018-10-05
- Volume
- 60
- Issue
- 4
- Pages
- 517-523
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2895593497
- Cited by
- 504
- References
- 52
- Citations by year
- 2026: 69 · 2025: 71 · 2024: 85 · 2023: 75 · 2022: 61 · 2021: 81 · 2020: 38 · 2019: 22 · 2018: 2
- FWCI
- 24.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Australian Nuclear Science and Technology Organisation
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Urology › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- 177Lu-PSMA-617, prostate-specific membrane antigen, castration-resistant prostate cancer, metastatic prostate cancer, radiation dosimetry, absorbed dose, PSMA PET/CT, 68Ga-PSMA-11, quantitative SPECT/CT, parotid gland dose, kidney dose, PSA response, treatment outcome prediction, body mass
- MeSH terms
- Single Photon Emission Computed Tomography Computed Tomography, Dipeptides, Heterocyclic Compounds, 1-Ring, Humans, Lutetium, Male, Neoplasm Metastasis, Radioisotopes, Radiometry, Treatment Outcome, Prostate-Specific Antigen, Prostatic Neoplasms, Castration-Resistant
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