Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
    • Continuing Education
    • JNM Podcasts
  • Subscriptions
    • Subscribers
    • Institutional and Non-member
    • Rates
    • Journal Claims
    • Corporate & Special Sales
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Reviewers
    • Permissions
    • Advertisers
  • About
    • About Us
    • Editorial Board
    • Contact Information
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI

User menu

  • Subscribe
  • My alerts
  • Log in
  • Log out
  • My Cart

Search

  • Advanced search
Journal of Nuclear Medicine
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI
  • Subscribe
  • My alerts
  • Log in
  • Log out
  • My Cart
Journal of Nuclear Medicine

Advanced Search

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
    • Continuing Education
    • JNM Podcasts
  • Subscriptions
    • Subscribers
    • Institutional and Non-member
    • Rates
    • Journal Claims
    • Corporate & Special Sales
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Reviewers
    • Permissions
    • Advertisers
  • About
    • About Us
    • Editorial Board
    • Contact Information
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • View or Listen to JNM Podcast
  • Visit JNM on Facebook
  • Join JNM on LinkedIn
  • Follow JNM on Twitter
  • Subscribe to our RSS feeds
Meeting ReportOral - PhysicianPharm

Prediction of absorbed dose by tumors and critical organs after Lu-177-DOTATATE therapy using pretherapeutic Ga-68-DOTATOC PET/CT

Yong-il Kim, Jungsu Oh, Changhoon Yoo, Baek-Yeol Ryoo and Jin-Sook Ryu
Journal of Nuclear Medicine May 2021, 62 (supplement 1) 76;
Yong-il Kim
1Asan Medical Center Seoul Korea, Republic of
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jungsu Oh
1Asan Medical Center Seoul Korea, Republic of
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Changhoon Yoo
1Asan Medical Center Seoul Korea, Republic of
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Baek-Yeol Ryoo
1Asan Medical Center Seoul Korea, Republic of
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jin-Sook Ryu
1Asan Medical Center Seoul Korea, Republic of
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Abstract

76

Purpose: Lu-177-DOTATATE (Lutathera®), a type of peptide receptor radionuclide therapy (PRRT) targeting the somatostatin receptor (SSTR), has been shown effective in patients with metastatic neuroendocrine tumors (NETs) [1, 2]. Pretherapeutic personalized determination of PRRT dosimetry is essential to maximize its therapeutic effects, and identify the critical organs and maximum tolerated accumulated activity for individual patients [3, 4]. Ga-68-DOTATOC is routinely used to evaluate the feasibility of PRRT and select appropriate candidates by targeting SSTRs [5, 6]. The absorbed dose of Lu-177-DOTATE therapy can be estimated by single time-point SPECT/CT after Lu-177-DOTATATE treatment, making it an alternative to Lu-177-DOTATATE scintigraphy performed at least 4-5 times [7, 8]. The present study investigated whether the standardized uptake value (SUV) of pretherapeutic Ga-68-DOTATOC PET/CT could predict absorbed dose of tumors and critical organs after Lu-177-DOTATATE treatment.

Methods: Patients who underwent pretherapeutic Ga-68-DOTATOC PET/CT within 3 months prior to Lu-177-DOTATATE therapy between December 2019 and November 2020 were retrospectively evaluated. Mean SUVs (SUVmean) of tumors (hepatic metastases and other tumors) larger than 2 cm in diameter were measured on Ga-68-DOTATOC PET/CT by determining volumes-of-interest (VOIs) with 50% of SUVmax cut-off [9]. For critical organs (kidneys, liver, and bone marrow), the SUVmean of spherical VOIs 4 cm3 were drawn for normal kidney parenchyme, liver parenchyme, and L5-S1 bone marrow [3, 10]. Four days after treatment with 200 mCi of Lu-177 DOTATATE, the absorbed dose by tumors and critical organs was estimated on SPECT/CT images by drawing the VOIs in the same manner with Ga-68-DOTATOC PET/CT [7]. SUVs of each lesion were measured twice using Syngo.Via (Siemens Healthcare, Knoxville, TN, USA), and the results were averaged. The SUVmean on Ga-68-DOTATOC PET/CT and estimated absorbed doses after Lu-177-DOTATATE treatment were compared by correlation and linear regression analyses. A P-value less than 0.05 was considered statistically significant.

Results: This study enrolled 13 consecutive patients with metastatic NETs, including seven men and six women, of mean age; 51.1 ± 12.5 years. The primary sites of NETs were pancreas in nine patients, duodenum, rectum, kidney, and unknown site in each patient, respectively. The mean Ki-67 index was 17.9 ± 17.0%. Mean treatment dose of Lu-177-DOTATATE was 196.9 ± 5.2 mCi, with Lu-177-DOTATATE SPECT/CT performed 98.7 ± 0.9 hours after the start of treatment. The mean absorbed dose by tumors was 19.2 ± 16.1 Gy (24.3 ± 15.8 Gy by the hepatic metastases and 10.3 ± 12.4Gy by the other tumors). The mean absorbed dose by critical organs was 2.7 ± 2.5 Gy (4.7 ± 1.7 Gy by the kidneys, 1.2 ± 1.2 Gy by the liver, and 0.2 ± 0.2 Gy by bone marrow). The SUVmean on Ga-68-DOTATOC PET/CT and estimated absorbed doses after Lu-177-DOTATATE correlated significantly in tumors (R = 0.77, P < 0.001) and critical organs (R = 0.62, P < 0.001). Linear regression analysis showed that estimated absorbed dose after Lu-177-DOTATATE therapy could be predicted as follows; (1) Tumor absorbed dose (Gy) = 0.98 × (SUVmean of Ga-68-DOTATOC PET/CT) - 0.32, (2) Critical organ absorbed dose (Gy) = 0.53 × (SUVmean of Ga-68-DOTATOC PET/CT) + 0.41.

Conclusions: Quantitative measurement on pretherapeutic Ga-68-DOTATOC PET/CT was predictive of the absorbed dose by tumors after Lu-177-DOTATATE therapy in individual patients. In addition, prediction of absorbed doses by critical organs might help to estimate possible toxicities. Pretherapeutic prediction of absorbed dose of Lu-177-DOTATATE therapy could serve as the platform of personalized therapy guide.

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint
View this table:
  • View inline
  • View popup

Absorbed dose after Lu-177-DOTATATE therapy and correlation analysis with Ga-68-DOTATOC PET/CT

Previous
Back to top

In this issue

Journal of Nuclear Medicine
Vol. 62, Issue supplement 1
May 1, 2021
  • Table of Contents
  • Index by author
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Journal of Nuclear Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Prediction of absorbed dose by tumors and critical organs after Lu-177-DOTATATE therapy using pretherapeutic Ga-68-DOTATOC PET/CT
(Your Name) has sent you a message from Journal of Nuclear Medicine
(Your Name) thought you would like to see the Journal of Nuclear Medicine web site.
Citation Tools
Prediction of absorbed dose by tumors and critical organs after Lu-177-DOTATATE therapy using pretherapeutic Ga-68-DOTATOC PET/CT
Yong-il Kim, Jungsu Oh, Changhoon Yoo, Baek-Yeol Ryoo, Jin-Sook Ryu
Journal of Nuclear Medicine May 2021, 62 (supplement 1) 76;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Prediction of absorbed dose by tumors and critical organs after Lu-177-DOTATATE therapy using pretherapeutic Ga-68-DOTATOC PET/CT
Yong-il Kim, Jungsu Oh, Changhoon Yoo, Baek-Yeol Ryoo, Jin-Sook Ryu
Journal of Nuclear Medicine May 2021, 62 (supplement 1) 76;
Twitter logo Facebook logo LinkedIn logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Bookmark this article

Jump to section

  • Article
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • Specific Uptake in the Bone Marrow Causes High Absorbed Red Marrow Doses During [177Lu]Lu-DOTATATE Treatment
  • Specific Uptake in the Bone Marrow Causes High Absorbed Red Marrow Doses During [177Lu]Lu-DOTATATE Treatment
  • Google Scholar

More in this TOC Section

Oral - PhysicianPharm

  • Safety and efficacy of radioligand therapy with 177lutetium-PSMA-617 within 3 months after 223Radium-dichloride
  • Usefulness of99mTc SESTAMIBI Scintigraphy in Persistent Hyperparathyroidism after Kidney Transplant
  • Toll-like receptor 5 in triple-negative breast cancer: a novel reporter for tumor progression
Show more Oral - PhysicianPharm

Cancer Radiopharmaceutical Therapy

  • Study evaluating the prognostic value of PET parameters after 177Lu-DOTATATE Peptide Receptor Therapy in NET patients
  • Relationship of Marrow Radiation Dose and Timing of Engraftment for Targeted Radioimmunotherapy with Anti-CD45 Iodine (131I) Apamistamab [Iomab-B] in Patients with Active Relapsed or Refractory Acute Myeloid Leukemia
Show more Cancer Radiopharmaceutical Therapy

Similar Articles

SNMMI

© 2025 SNMMI

Powered by HighWire