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Hepatic absorbed radiation dosimetry during I-131 Metaiodobenzylguanadine (MIBG) therapy for refractory neuroblastoma

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Abstract

Purpose

To compare the prediction of therapeutic hepatic radiation-absorbed dose rates from tracer imaging plus a linearity assumption to estimation based on intra-therapy imaging in 131I metaiodobenzylguanidine (MIBG) therapy of refractory neuroblastoma.

Materials and methods

Conjugate-view images of the liver were obtained before therapy for seven patients at seven times after a tracer infusion of 131I MIBG and at three times after the therapy infusion. Measured liver activities were converted to dose-rate estimates. Three statistical models of the rates assuming double exponential dependences on time were examined. One of the three models allowed for a multiplicative correction to the therapeutic late-phase dose-rate amplitude. Results from that model: (1) the tracer prediction of the late-phase absorbed-dose-rate amplitude was a factor of 1.75 times the intra-therapy-estimated value, and (2) the difference between tracer prediction of the radiation-absorbed dose and intra-therapy estimation of it was statistically significant, and (3) the liver radiation-absorbed dose did not reach 30 Gy.

Conclusions

A statistical modeling analysis finds that the radiation-absorbed dose after therapy appears to be lower than that which is predicted from the linear scaling with administered activity of the tracer radiation-absorbed dose. Hepatocyte toxicity is the most likely reason but it is not high enough to produce clinically observable results.

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Acknowledgements

The research was supported in part by the National Institute of Health grant PO1 CA81403, R21 CA097758, 2MO1 RR0127, as well by donations from the Katie Dougherty Family Foundation, Alex’s Lemonade Stand Foundation, Children’s Neuroblastoma Cancer Foundation, Neuroblastoma Children’s Cancer Society, Pediatric Cancer Research Foundation, and the Evan T. J. Dunbar Neuroblastoma Foundation. No conflict of interest exists for any of the authors.

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Authors and Affiliations

  1. Department of Radiology, Nuclear Medicine Division, University of Michigan, Ann Arbor, MI, USA

    Kenneth F. Koral & Denise Regan

  2. Department of Nuclear Medicine, University of California San Francisco, San Francisco, CA, USA

    John P. Huberty

  3. Biostatistics Unit, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA

    Bill Frame

  4. Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA

    Katherine K. Matthay

  5. Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    John M. Maris

  6. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA

    Daniel Normolle

  7. Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA

    Gregory A. Yanik

Authors
  1. Kenneth F. Koral
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  2. John P. Huberty
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  3. Bill Frame
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  4. Katherine K. Matthay
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  5. John M. Maris
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  6. Denise Regan
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  7. Daniel Normolle
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  8. Gregory A. Yanik
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Corresponding author

Correspondence to Kenneth F. Koral.

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Koral, K.F., Huberty, J.P., Frame, B. et al. Hepatic absorbed radiation dosimetry during I-131 Metaiodobenzylguanadine (MIBG) therapy for refractory neuroblastoma. Eur J Nucl Med Mol Imaging 35, 2105–2112 (2008). https://doi.org/10.1007/s00259-008-0873-3

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  • DOI: https://doi.org/10.1007/s00259-008-0873-3

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