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Basic Science Investigations |
1 Department of Nuclear Medicine, University Hospital Dresden, Dresden, Germany
2 Nuclear Medicine Group, Oak Ridge National Laboratory, Oak Ridge, Tennessee
188Re-Hydroxyethylidene diphosphonate (188Re-HEDP) was used in previous studies for the palliative treatment of metastatic bone pain. However, the kinetic and radiation-absorbed doses have not been well documented. Therefore, the aim of this study was to gather dosimetric data for 188Re-HEDP. Methods: Thirteen prostate cancer patients with skeletal involvement were treated with 2,700–3,459 MBq (mean dose, 3,120 MBq) 188Re-HEDP. Patients underwent whole-body scans 3, 20, and 28 h after therapy. The effective half-life, residence time, and radiation-absorbed dose values were calculated for the whole body, bone marrow, kidneys, and bladder as well as for 29 bone metastases. The urinary excretion rate was determined in 6 urine samples of each patient collected over 48 h at 8-h intervals beginning immediately after the administration of 188Re-HEDP. After injection of 188Re-HEDP, blood samples were taken weekly for 6 wk, and platelet and leukocyte counts were performed. Results: The mean effective half-life was 15.9 ± 3.5 h in bone metastases, 10.9 ± 2.1 h in the bone marrow, 11.6 ± 2.1 h in the whole body, 12.7 ± 2.2 h in the kidneys, and 7.7 ± 3.4 h in the bladder. The following radiation-absorbed doses were calculated: 3.83 ± 2.01 mGy/MBq for bone metastases, 0.61 ± 0.21 mGy/MBq for the bone marrow, 0.07 ± 0.02 mGy/MBq for the whole body, 0.71 ± 0.22 mGy/MBq for the kidneys, and 0.99 ± 0.18 mGy/MBq for the bladder. 188Re-HEDP showed a rapid urinary excretion within the first 8 h after therapy, with 41% of the 188Re-HEDP administered being excreted. Forty-eight hours after therapy, the excretion rate was 60% ± 12%. Only 1 patient showed a decrease of platelet count below 100 x 109 counts/L. None of the patients presented with a decrease of leukocyte count below 3.0 x 109 counts/L. Conclusion: 188Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain. The radiation-absorbed dose is acceptable for bone pain palliation with low doses for the normal bone marrow and the whole body.
Key Words: radiation-absorbed dose • kinetics • 188Re-hydroxyethylidene diphosphonate • bone metastases
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