The addition of DTPA to [177Lu-DOTA0,Tyr3]octreotate prior to administration reduces rat skeleton uptake of radioactivity

Eur J Nucl Med Mol Imaging. 2003 Feb;30(2):312-5. doi: 10.1007/s00259-002-1054-4. Epub 2002 Nov 29.

Abstract

Peptide receptor-targeted radionuclide therapy is nowadays also being performed with DOTA-conjugated peptides, such as [DOTA(0),Tyr(3)]octreotate, labelled with radionuclides like (177)Lu. The incorporation of (177)Lu is typically >/=99.5%; however, since a total patient dose can be as high as 800 mCi, the amount of free (177)Lu(3+) (= non-DOTA-incorporated) can be substantial. Free (177)Lu(3+) accumulates in bone with unwanted irradiation of bone marrow as a consequence. (177)Lu-DTPA is reported to be stable in serum in vitro, and in vivo it has rapid renal excretion. Transforming free Lu(3+) to Lu-DTPA might reroute this fraction from accumulation in bone to renal clearance. We therefore investigated: (a) the biodistribution in rats of (177)LuCl(3), [(177)Lu-DOTA(0),Tyr(3)]octreotate and (177)Lu-DTPA; (b) the possibilities of complexing the free (177)Lu(3+) in [(177)Lu-DOTA(0),Tyr(3)]octreotate to (177)Lu-DTPA prior to intravenous injection; and (c) the effects of free (177)Lu(3+) in [(177)Lu-DOTA(0),Tyr(3)]octreotate, in the presence and absence of DTPA, on the biodistribution in rats. (177)LuCl(3) had high skeletal uptake (i.e. 5% ID per gram femur, with localization mainly in the epiphyseal plates) and a 24-h total body retention of 80% injected dose (ID). [(177)Lu-DOTA(0),Tyr(3)]octreotate had high and specific uptake in somatostatin receptor-positive tissues, and 24-h total body retention of 19% ID. (177)Lu-DTPA had rapid renal clearance, and 24-h total body retention of 4% ID. Free (177)Lu(3+) in [(177)Lu-DOTA(0),Tyr(3)]octreotate could be complexed to (177)Lu-DTPA. Accumulation of (177)Lu in femur, blood, liver and spleen showed a dose relation to the amount of free (177)Lu(3+), while these accumulations could be normalized by the addition of DTPA. After labelling [DOTA(0),Tyr(3)]octreotate with (177)Lu the addition of DTPA prior to intravenous administration of [(177)Lu-DOTA(0),Tyr(3)]octreotate is strongly recommended.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Animals
  • Bone Marrow / diagnostic imaging
  • Bone Marrow / drug effects
  • Bone Marrow / metabolism
  • Femur / diagnostic imaging
  • Femur / drug effects*
  • Femur / metabolism*
  • Heterocyclic Compounds, 1-Ring / administration & dosage
  • Heterocyclic Compounds, 1-Ring / pharmacokinetics
  • Injections, Intravenous
  • Kidney / diagnostic imaging
  • Kidney / drug effects
  • Kidney / metabolism
  • Lutetium / administration & dosage
  • Lutetium / pharmacokinetics
  • Male
  • Octreotide / analogs & derivatives
  • Organ Specificity
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / pharmacokinetics*
  • Pentetic Acid / administration & dosage*
  • Radiation-Protective Agents / administration & dosage*
  • Radioisotopes / administration & dosage
  • Radioisotopes / pharmacokinetics
  • Radiometry / methods
  • Radionuclide Imaging
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / pharmacokinetics
  • Rats
  • Rats, Wistar
  • Tissue Distribution

Substances

  • Heterocyclic Compounds, 1-Ring
  • Organometallic Compounds
  • Radiation-Protective Agents
  • Radioisotopes
  • Radiopharmaceuticals
  • 1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid
  • Lutetium
  • Pentetic Acid
  • lutetium Lu 177 dotatate
  • Octreotide