Relationships between uptake of [68Ga]Ga-DOTA-TATE and absorbed dose in [177Lu]Lu-DOTA-TATE therapy
Stenvall, Anna LU ; Gustafsson, Johan LU ; Larsson, Erik LU ; Roth, Daniel LU
; Sundlöv, Anna
LU
; Jönsson, Lena
LU
; Hindorf, Cecilia
LU
; Ohlsson, Tomas
and Sjögreen Gleisner, Katarina
LU
(2022)
In EJNMMI Research
12(1).
- Abstract
Background: Somatostatin receptor 68Ga PET imaging is standard for evaluation of a patient’s suitability for 177Lu peptide receptor radionuclide therapy of neuroendocrine tumours (NETs). The 68Ga PET serves to ensure sufficient somatostatin receptor expression, commonly evaluated qualitatively. The aim of this study is to investigate the quantitative relationships between uptake in 68Ga PET and absorbed doses in 177Lu therapy. Method: Eighteen patients underwent [68Ga]Ga-DOTA-TATE PET imaging within 20 weeks prior to their first cycle of [177Lu]Lu-DOTA-TATE. Absorbed doses for therapy were estimated for tumours, kidney, spleen, and normal liver parenchyma using... (More)
Background: Somatostatin receptor 68Ga PET imaging is standard for evaluation of a patient’s suitability for 177Lu peptide receptor radionuclide therapy of neuroendocrine tumours (NETs). The 68Ga PET serves to ensure sufficient somatostatin receptor expression, commonly evaluated qualitatively. The aim of this study is to investigate the quantitative relationships between uptake in 68Ga PET and absorbed doses in 177Lu therapy. Method: Eighteen patients underwent [68Ga]Ga-DOTA-TATE PET imaging within 20 weeks prior to their first cycle of [177Lu]Lu-DOTA-TATE. Absorbed doses for therapy were estimated for tumours, kidney, spleen, and normal liver parenchyma using a hybrid SPECT/CT–planar method. Gallium-68 activity concentrations were retrieved from PET images and also used to calculate SUVs and normalized SUVs, using blood and tissue for normalization. The 68Ga activity concentrations per injected activity, SUVs, and normalized SUVs were compared with 177Lu activity concentrations 1 d post-injection and 177Lu absorbed doses. For tumours, for which there was a variable number per patient, both inter- and intra-patient correlations were analysed. Furthermore, the prediction of 177Lu tumour absorbed doses based on a combination of tumour-specific 68Ga activity concentrations and group-based estimates of the effective half-lives for grade 1 and 2 NETs was explored. Results: For normal organs, only spleen showed a significant correlation between the 68Ga activity concentration and 177Lu absorbed dose (r = 0.6). For tumours, significant, but moderate, correlations were obtained, with respect to both inter-patient (r = 0.7) and intra-patient (r = 0.45) analyses. The correlations to absorbed doses did not improve when using 68Ga SUVs or normalized SUVs. The relationship between activity uptakes for 68Ga PET and 177Lu SPECT was stronger, with correlation coefficients r = 0.8 for both inter- and intra-patient analyses. The 177Lu absorbed dose to tumour could be predicted from the 68Ga activity concentrations with a 95% coverage interval of − 65% to 248%. Conclusions: On a group level, a high uptake of [68Ga]Ga-DOTA-TATE is associated with high absorbed doses at 177Lu-DOTA-TATE therapy, but the relationship has a limited potential with respect to individual absorbed dose planning. Using SUV or SUV normalized to reference tissues do not improve correlations compared with using activity concentration per injected activity.
(Less)
- author
- Stenvall, Anna
LU
; Gustafsson, Johan
LU
; Larsson, Erik
LU
; Roth, Daniel
LU
; Sundlöv, Anna
LU
; Jönsson, Lena
LU
; Hindorf, Cecilia
LU
; Ohlsson, Tomas
and Sjögreen Gleisner, Katarina
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Lu SPECT, Ga PET, Dosimetry, DOTA-TATE, Neuroendocrine tumours, Peptide receptor radionuclide therapy, Radionuclide therapy, Somatostatin receptor imaging
- in
- EJNMMI Research
- volume
- 12
- issue
- 1
- article number
- 75
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85144308024
- pmid:36534192
- ISSN
- 2191-219X
- DOI
- 10.1186/s13550-022-00947-2
- language
- English
- LU publication?
- yes
- id
- b7f5297c-9f97-49bf-b807-92df3f82be33
- date added to LUP
- 2023-01-12 10:52:17
- date last changed
- 2024-04-18 18:36:08
@article{b7f5297c-9f97-49bf-b807-92df3f82be33,
abstract = {{<p>Background: Somatostatin receptor <sup>68</sup>Ga PET imaging is standard for evaluation of a patient’s suitability for <sup>177</sup>Lu peptide receptor radionuclide therapy of neuroendocrine tumours (NETs). The <sup>68</sup>Ga PET serves to ensure sufficient somatostatin receptor expression, commonly evaluated qualitatively. The aim of this study is to investigate the quantitative relationships between uptake in <sup>68</sup>Ga PET and absorbed doses in <sup>177</sup>Lu therapy. Method: Eighteen patients underwent [<sup>68</sup>Ga]Ga-DOTA-TATE PET imaging within 20 weeks prior to their first cycle of [<sup>177</sup>Lu]Lu-DOTA-TATE. Absorbed doses for therapy were estimated for tumours, kidney, spleen, and normal liver parenchyma using a hybrid SPECT/CT–planar method. Gallium-68 activity concentrations were retrieved from PET images and also used to calculate SUVs and normalized SUVs, using blood and tissue for normalization. The <sup>68</sup>Ga activity concentrations per injected activity, SUVs, and normalized SUVs were compared with <sup>177</sup>Lu activity concentrations 1 d post-injection and <sup>177</sup>Lu absorbed doses. For tumours, for which there was a variable number per patient, both inter- and intra-patient correlations were analysed. Furthermore, the prediction of <sup>177</sup>Lu tumour absorbed doses based on a combination of tumour-specific <sup>68</sup>Ga activity concentrations and group-based estimates of the effective half-lives for grade 1 and 2 NETs was explored. Results: For normal organs, only spleen showed a significant correlation between the <sup>68</sup>Ga activity concentration and <sup>177</sup>Lu absorbed dose (r = 0.6). For tumours, significant, but moderate, correlations were obtained, with respect to both inter-patient (r = 0.7) and intra-patient (r = 0.45) analyses. The correlations to absorbed doses did not improve when using <sup>68</sup>Ga SUVs or normalized SUVs. The relationship between activity uptakes for <sup>68</sup>Ga PET and <sup>177</sup>Lu SPECT was stronger, with correlation coefficients r = 0.8 for both inter- and intra-patient analyses. The <sup>177</sup>Lu absorbed dose to tumour could be predicted from the <sup>68</sup>Ga activity concentrations with a 95% coverage interval of − 65% to 248%. Conclusions: On a group level, a high uptake of [<sup>68</sup>Ga]Ga-DOTA-TATE is associated with high absorbed doses at <sup>177</sup>Lu-DOTA-TATE therapy, but the relationship has a limited potential with respect to individual absorbed dose planning. Using SUV or SUV normalized to reference tissues do not improve correlations compared with using activity concentration per injected activity.</p>}},
author = {{Stenvall, Anna and Gustafsson, Johan and Larsson, Erik and Roth, Daniel and Sundlöv, Anna and Jönsson, Lena and Hindorf, Cecilia and Ohlsson, Tomas and Sjögreen Gleisner, Katarina}},
issn = {{2191-219X}},
keywords = {{Lu SPECT; Ga PET; Dosimetry; DOTA-TATE; Neuroendocrine tumours; Peptide receptor radionuclide therapy; Radionuclide therapy; Somatostatin receptor imaging}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{EJNMMI Research}},
title = {{Relationships between uptake of [<sup>68</sup>Ga]Ga-DOTA-TATE and absorbed dose in [<sup>177</sup>Lu]Lu-DOTA-TATE therapy}},
url = {{http://dx.doi.org/10.1186/s13550-022-00947-2}},
doi = {{10.1186/s13550-022-00947-2}},
volume = {{12}},
year = {{2022}},
}