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Patient-Specific Dosimetry in Predicting Renal Toxicity with 90Y-DOTATOC: Relevance of Kidney Volume and Dose Rate in Finding a Dose–Effect Relationship

Raffaella Barone, MD1, Françoise Borson-Chazot, MD, PhD1, Roelf Valkema, MD, PhD2, Stéphan Walrand, PhD1, Franck Chauvin, MD, PhD3, Lida Gogou, MD1, Larry K. Kvols, MD4, Eric P. Krenning, MD, PhD2, François Jamar, MD, PhD1 and Stanislas Pauwels, MD, PhD1

1 Centre of Nuclear Medicine and Laboratory of Positron Emission Tomography; Université Catholique de Louvain, Brussels and Louvain-la-Neuve, Belgium
2 Department of Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
3 Department of Biostatistics, Centre Léon Bérard, Lyon, France
4 H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, Florida



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  		FIGURE 1. Individual kidney volumes measured by CT, in males (n = 9) and females (n = 9). Dotted lines represent standard ORNL phantom values (288 mL in males, 264 mL in females), and continuous lines represent median kidney volumes obtained from CT (365 mL in males, 302 mL in females). Filled circles represent patients with CLR loss per year >20%.

 


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  		FIGURE 2. Individual kidney absorbed dose of 90Y-DOTATOC, using 86Y-DOTATOC quantitative imaging. MIRDOSE3.1 was used for dosimetric calculations. Data are reported for males (n = 9) and females (n = 9). The continuous line represents median kidney dose in each group. Filled circles represent patients with CLR loss per year >20%.

 


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  		FIGURE 3. Correlation between KAD or BED, and the loss in CLR. (A) KADStdVol computed by MIRDOSE3.1 KADStdVol. (B) KADCTVol computed by MIRD Pamphlet 19. (C) Correlation between BED and current CLR loss per year. (D) Correlation between BED and percentage of CLR loss after 18-mo follow-up. Size of symbols reflects number of treatment cycles received by each patient (from 1 for smallest to 5 for largest). Points were fitted to power exponential function (see Eq. 4 in text). In C, note clear difference in BED values observed between patients with rapid CLR decline (CLR loss per year >20%) compared with those with a slower decline.

 




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