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Research ArticleClinical Investigations

Dose Response of Pancreatic Neuroendocrine Tumors Treated with Peptide Receptor Radionuclide Therapy Using 177Lu-DOTATATE

Ezgi Ilan, Mattias Sandström, Cecilia Wassberg, Anders Sundin, Ulrike Garske–Román, Barbro Eriksson, Dan Granberg and Mark Lubberink
Journal of Nuclear Medicine February 2015, 56 (2) 177-182; DOI: https://doi.org/10.2967/jnumed.114.148437
Ezgi Ilan
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
2Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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Mattias Sandström
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
2Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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Cecilia Wassberg
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
3Molecular Imaging, Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden; and
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Anders Sundin
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
3Molecular Imaging, Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden; and
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Ulrike Garske–Román
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
3Molecular Imaging, Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden; and
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Barbro Eriksson
4Section of Endocrine Oncology, Department of Medical Science, Uppsala University Hospital, Uppsala, Sweden
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Dan Granberg
4Section of Endocrine Oncology, Department of Medical Science, Uppsala University Hospital, Uppsala, Sweden
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Mark Lubberink
1Nuclear Medicine and PET, Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
2Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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  • FIGURE 1.
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    FIGURE 1.

    RC vs. sphere diameter (3.7, 2.8, 2.2, and 1.7). For each sphere in National Electrical Manufacturers Association image quality phantom, 6 RCs were determined, and the mean and SD of these 6 values are shown. Solid line represents 2-parameter sigmoid fit.

  • FIGURE 2.
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    FIGURE 2.

    Measured sphere diameter using a 42% isocontour VOI vs. true sphere diameter in National Electrical Manufacturers Association image quality phantom. Dashed line represents line of identity.

  • FIGURE 3.
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    FIGURE 3.

    Frequency distribution of absorbed doses in 24 tumors. (A) Absorbed dose distribution during first treatment cycle. (B) Distribution of tumor-absorbed dose until best response. Numbers on x axes are centers of absorbed dose intervals used for each bar (20 Gy = 20 ± 10 Gy [A], 40 Gy = 40 ± 20 Gy [B]).

  • FIGURE 4.
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    FIGURE 4.

    Example of dose response in patient with inoperable metastasized PNET in liver (patient 19). (A) Transversal contrast-enhanced CT images in late arterial phase. (B) Fused SPECT/CT images. Shown left to right are examinations at baseline and after 2 and 3 cycles of PRRT.

  • FIGURE 5.
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    FIGURE 5.

    Tumor dose–response relationship for patients with PNETs treated with PRRT using 177Lu-DOTATATE, including tumors larger than 2.2 cm (A) and only tumors larger than 4 cm (B). Solid lines represent 2-parameter sigmoid fits (y = 100/(1+ (α/x)β)), where α and β are fitting parameters. Parameters α and β were 445 and 0.79, with SEs of 104 and 0.14, respectively, for tumors larger than 2.2 cm and 504 and 0.84, with SEs of 83 and 0.1, respectively, for tumors larger than 4 cm. Pearson correlation coefficients (R2) were 0.64 (A) and 0.91 (B).

Tables

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    TABLE 1

    Details of Patient Cohort Treated with177Lu-DOTATATE

    Patient no.SexNo. of tumorsA1 (GBq)A2 (GBq)A3 (GBq)A4 (GBq)A5 (GBq)A6 (GBq)
    1Female27.4*7.47.47.4*7.47.4
    2Female17.4*7.47.47.4——
    3Female17.4*7.47.47.4*7.4—
    4Male37.4*7.46.0———
    5Male17.4*7.47.4———
    6Male17.4*7.47.47.4*
    7Female17.4*7.47.47.4*7.4—
    8Female17.4*7.47.47.4*7.47.4
    9Male27.4*7.47.4*7.47.4—
    10Male17.4*7.47.47.4*——
    11Male37.4*7.4————
    12Male17.4*7.46.0*7.47.4*—
    13Male27.4*7.4*7.47.4——
    14Female27.4*7.46.0*7.4——
    15Female17.4*5.07.4*4.0——
    16Male17.4*7.47.47.4*——
    17Male47.4*7.47.4*7.4——
    18Male17.4*7.47.4*7.4——
    19Female17.4*7.47.4*———
    20Female37.4*7.47.4*7.47.4—
    21Male17.4*7.47.4*———
    22Female47.4*7.47.47.4*——
    23Female17.4*7.45.0*———
    24Male37.4*5.05.0*———
    • ↵* Complete dosimetric evaluation.

    • A1–6 is amount of administered activity at each treatment up to 6 cycles.

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Journal of Nuclear Medicine: 56 (2)
Journal of Nuclear Medicine
Vol. 56, Issue 2
February 1, 2015
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Dose Response of Pancreatic Neuroendocrine Tumors Treated with Peptide Receptor Radionuclide Therapy Using 177Lu-DOTATATE
Ezgi Ilan, Mattias Sandström, Cecilia Wassberg, Anders Sundin, Ulrike Garske–Román, Barbro Eriksson, Dan Granberg, Mark Lubberink
Journal of Nuclear Medicine Feb 2015, 56 (2) 177-182; DOI: 10.2967/jnumed.114.148437

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Dose Response of Pancreatic Neuroendocrine Tumors Treated with Peptide Receptor Radionuclide Therapy Using 177Lu-DOTATATE
Ezgi Ilan, Mattias Sandström, Cecilia Wassberg, Anders Sundin, Ulrike Garske–Román, Barbro Eriksson, Dan Granberg, Mark Lubberink
Journal of Nuclear Medicine Feb 2015, 56 (2) 177-182; DOI: 10.2967/jnumed.114.148437
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Keywords

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