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Research ArticleBasic Science Investigation
Open Access

Establishing In Vitro Dosimetric Models and Dose–Effect Relationships for 177Lu-DOTATATE in Neuroendocrine Tumors

Giulia Tamborino, Pleun Engbers, Tijmen H. de Wolf, Thom G.A. Reuvers, Rob Verhagen, Mark Konijnenberg and Julie Nonnekens
Journal of Nuclear Medicine May 2025, jnumed.125.269470; DOI: https://doi.org/10.2967/jnumed.125.269470
Giulia Tamborino
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Pleun Engbers
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Tijmen H. de Wolf
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Thom G.A. Reuvers
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Rob Verhagen
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Mark Konijnenberg
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
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Julie Nonnekens
1Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands; and
2Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • FIGURE 1.
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    FIGURE 1.

    S value simulation setups for GOT1 and NCI-H69 cells using Geant4. (A) Floating GOT1 clusters during 4-h uptake phase modeled with random close packing, with zoomed-in views on right. (B) Microscopic image of GOT1 cells plated for 7-d follow-up phase (top left) modeled with cluster size probabilities (top right) and hexagonal packing (bottom right) or microscopic image-derived placements (bottom left). (C) Simulated cluster geometry for NCI-H69 cells in suspension at day 0 (compact, N° = 12) and day 7, illustrating exponential growth and random placement after proliferation. Sim. = simulated.

  • FIGURE 2.
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    FIGURE 2.

    Time-dependent activity per cell for GOT1 (A) and NCI-H69 (B) cells at various activity concentrations. Asterisks indicate extrapolated data points. Error bars indicate SD.

  • FIGURE 3.
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    FIGURE 3.

    Cross-dose variability and absorbed dose rate heterogeneity in GOT1 cells. (A) Cross-dose contribution relative to total for 2 target cells within same setup. (B) Absorbed dose rate maps (excluding medium contribution) for 10 target cells at start of incubation at 0.1 and 1 MBq/mL. Abs. = absorbed.

  • FIGURE 4.
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    FIGURE 4.

    Radiobiologic correlations for GOT1 cells. (A) Time-dependent dose rate (left, y-axis) and fraction of alive cells (right, y-axis) at 1 and 0.25 MBq/mL. (B) Correlation between absorbed dose and fraction of alive cells for same added activities. (C) Fraction of alive cells over time for EBRT exposure. Error bars indicate SD. Dashed lines indicate dose rate heterogeneity. K = death rate constant; K0​ = regrowth rate constant.

  • FIGURE 5.
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    FIGURE 5.

    Radiobiologic correlations for NCI-H69 cells. (A) Time-dependent dose rate (left, y-axis) and fraction of alive cells (right, y-axis) at 1 and 0.25 MBq/mL. (B) Correlation between absorbed dose and fraction of alive cells for same added activities. (C) Fraction of alive cells over time for EBRT exposure. Error bars indicate SD. Dashed lines indicate dose rate heterogeneity. K = death rate constant.

  • FIGURE 6.
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    FIGURE 6.

    Dose–response curves showing absorbed dose vs. viability at 7 d for GOT1 and NCI-H69 cells exposed to EBRT or PRRT. Error bars indicate SD.

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    TABLE 1.

    Summary of Best Fitting Parameters Used for Dose Responses Shown in Figure 6 After Exposure of GOT1 and NCI-H69 Cells to EBRT and PRRT

    NCI-H69GOT1
    LQL
    ExposureR2AICα (Gy−1)β (Gy−2)Linearized α (Gy−1)R2AICα (Gy−1)
    EBRT0.99−32.810.24 ± 0.050.06 ± 0.020.38 ± 0.030.97−31.300.27 ± 0.02
    177Lu-DOTATATE0.85−34.250.03 ± 0.100.09 ± 0.070.16 ± 0.020.94−43.200.06 ± 0.02
    • LQ = linear quadratic; AIC = Akaike information criterion; L = linear.

    • R2 and AIC are reported to evaluate best fit.

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Journal of Nuclear Medicine: 66 (6)
Journal of Nuclear Medicine
Vol. 66, Issue 6
June 1, 2025
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Establishing In Vitro Dosimetric Models and Dose–Effect Relationships for 177Lu-DOTATATE in Neuroendocrine Tumors
Giulia Tamborino, Pleun Engbers, Tijmen H. de Wolf, Thom G.A. Reuvers, Rob Verhagen, Mark Konijnenberg, Julie Nonnekens
Journal of Nuclear Medicine May 2025, jnumed.125.269470; DOI: 10.2967/jnumed.125.269470

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Establishing In Vitro Dosimetric Models and Dose–Effect Relationships for 177Lu-DOTATATE in Neuroendocrine Tumors
Giulia Tamborino, Pleun Engbers, Tijmen H. de Wolf, Thom G.A. Reuvers, Rob Verhagen, Mark Konijnenberg, Julie Nonnekens
Journal of Nuclear Medicine May 2025, jnumed.125.269470; DOI: 10.2967/jnumed.125.269470
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Keywords

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