Article Figures & Data
Figures
- FIGURE 1.
SPECT/CT images from patient 14 show delineated VOIs (green contours). (A) Sagittal view of delineated T9–L5 vertebrae and sternum. (B) Orientation and position of each image slice in coronal plane. (C) Transverse slice of descending aorta and sternum. (D) Hypogastric and iliac regions and delineations of L5 vertebrae, left and right hip bones, and subcutaneous adipose tissue.
- FIGURE 2.
Biodistributions of 70-y-old woman (patient 1) with liver metastases. Activity concentrations from delineated red marrow regions in SPECT images are shown before (A) and after (B) averaging. B also presents biodistributions for aorta and adipose tissue regions. C and D show results from compartment model, which is based on data shown in B, separating specific and nonspecific uptake for mean of T9–L5 vertebrae (C) and mean of left and right hip bones (D).
- FIGURE 3.
Mean values for biodistributions at 4 time points in T9–L5 vertebrae, hip bones, aorta, and adipose compartments from SPECT images of 10 patients without bone metastases (A) and 6 patients with confirmed bone metastases (patient 5 was removed) (B).
- FIGURE 4.
Mean compartment model biodistributions for aorta, T9–L5 vertebrae, and hip bones in all patients without (A) and with (B) bone metastases.
- FIGURE 5.
Mean relative biodistributions of vertebrae, hip bones, and tumors for 10 patients without bone metastases (A) and difference between effective half-life of 177Lu in red marrow sites and tumor vs. effective half-life of 177Lu in tumors (B).
- FIGURE 6.
Total absorbed dose to red marrow (Gy/GBq) estimated for vertebrae compared with hip bones and blood-based methodology for 10 patients without bone metastases (A) and 7 patients with bone metastases (B).
Tables
- TABLE 1.
Studies Showing Mean Absorbed Dose (Gy/GBq) to Red Marrow Using Image-Based Dosimetry Methods
Study Patients (n) Red marrow SD Santoro (36) 9 0.043 0.019 Marin (37) 47 0.028 0.010 Del Prete (8) 34 0.038 0.024 Hagmarker (7) 24* 0.051 0.015 Huizing (34) 10 0.087 0.030 Kim (38) 20 0.065 0.061 Vergnaud (39) 13 0.040 0.030 Kamaldeep (40) 60 0.040 0.020 ↵* Without bone metastases.
- TABLE 2.
177Lu S Values and Volumes and Volume Fractions of Red Marrow from University of Florida Male/Female Hybrid Phantom at Skeletal Sites Used for Absorbed Dose Calculations in This Study
Skeletal site S (RM ← RM) (mGy/MBq/s) Red marrow volume (cm3) Red marrow volume fraction ICRP 70 cellularity (%) Male Female Male Female Male Female T vertebrae 1.05E−04 1.35E−04 147.2 112.5 0.63 0.62 70 L vertebrae 1.05E−04 1.08E−04 146.9 141.0 0.63 0.61 70 T/L vertebrae 5.25E−05 6.00E−05 294.0 253.5 0.63 0.62 70 Hip bones 3.85E−05 5.26E−05 299.7 225.5 0.43 0.46 48 Skeletal average 1.07E−05 1.40E−05 1170 904 0.52 0.47 — ICRP = International Commission on Radiological Protection.
- TABLE 3.
Absorbed Dose to Red Marrow Estimated Using Image-Based Activity Concentrations in T9–L5 Vertebrae, Hip Bones, and Thoracic Aorta
Patient no. Bone metastases Vertebrae Hip bones Blood-based (skeletal average) Specific Nonspecific Total Specific Nonspecific Total 1 No 0.068 0.026 0.093 0.066 0.019 0.085 0.015 2 No 0.025 0.019 0.044 0.016 0.014 0.030 0.011 3 Yes 0.016 0.018 0.033 0.028 0.013 0.042 0.012 4 No 0.022 0.014 0.036 0.014 0.011 0.025 0.010 5* Yes 0.496 0.028 0.524 0.251 0.022 0.273 0.019 6 No 0.018 0.016 0.034 0.022 0.012 0.034 0.011 7 No 0.020 0.023 0.042 0.012 0.017 0.028 0.017 8 No 0.029 0.021 0.050 0.039 0.015 0.054 0.012 9 No 0.038 0.024 0.062 0.028 0.017 0.045 0.013 10 No 0.047 0.023 0.070 0.024 0.017 0.040 0.013 11 Yes 0.065 0.041 0.106 0.049 0.030 0.079 0.023 12 Yes 0.052 0.025 0.077 0.040 0.018 0.058 0.014 13 No 0.052 0.041 0.093 0.030 0.030 0.059 0.023 14 Yes 0.056 0.037 0.093 0.069 0.027 0.096 0.021 15 Yes 0.114 0.042 0.157 0.084 0.032 0.116 0.029 16 Yes 0.026 0.013 0.039 0.020 0.010 0.030 0.009 17 No 0.043 0.043 0.086 0.052 0.033 0.085 0.029 ↵* Removed from all averages because of large number of bone metastases.
Data are Gy/GBq. For vertebrae and hip bones, absorbed dose contributions were divided into specific (somatostatin receptor type 2–based) and nonspecific (blood-based, Eq. 4). Equation 5 was used for solely blood-based dosimetry in right column.
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