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Patient-Specific Dosimetry Calculations Using Mathematic Models of Different Anatomic Sizes During Therapy with ¹¹¹In-DTPA-D-Phe¹-Octreotide Infusions After Catheterization of the Hepatic Artery

Nuclear Medicine Division, Radiology Department, Aretaieion University Hospital, Athens, Greece

Correspondence: For correspondence or reprints contact: Georgios S. Limouris, MD, PhD, Nuclear Medicine Division, Radiology Department, Aretaieion University Hospital, 76 Vas. Sophias Ave., Athens, Greece 11528. E-mail: nucleard{at}aretaieio.uoa.gr

The aim of the study was to provide dosimetric data on intrahepatic ¹¹¹In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe¹-octreotide therapy for neuroendocrine tumors with overexpression of somatostatin receptors. Methods: A dosimetric protocol was designed to estimate the absorbed dose to the tumor and healthy tissue in a course of 48 treatments for 12 patients, who received a mean activity of 5.4 ± 1.7 GBq per session. The patient-specific dosimetry calculations, based on quantitative biplanar whole-body scintigrams, were performed using a Monte Carlo simulation program for 3 male and 3 female mathematic models of different anatomic sizes. Thirty minutes and 2, 6, 24, and 48 h after the radionuclide infusion, blood-sample data were collected for estimation of the red marrow radiation burden. Results: The mean absorbed doses per administered activity (mGy/MBq) by the critical organs liver, spleen, kidneys, bladder wall, and bone marrow were 0.14 ± 0.04, 1.4 ± 0.6, 0.41 ± 0.08, 0.094 ± 0.013, and (3.5 ± 0.8) x 10^–3, respectively; the tumor absorbed dose ranged from 2.2 to 19.6 mGy/MBq, strongly depending on the lesion size and tissue type. Conclusion: The results of the present study quantitatively confirm the therapeutic efficacy of transhepatic administration; the tumor–to–healthy-tissue uptake ratio was enhanced, compared with the results after antecubital infusions. Planning of treatment was also optimized by use of the patient-specific dosimetric protocol.

Key Words: neuroendocrine tumors • dosimetry • ¹¹¹In-DTPA-D-Phe¹-octreotide • peptide therapy • hepatic artery catheterization

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