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Dosimetric quantities of neuroendocrine tumors over treatment cycles with 177Lu-DOTA-TATE

Roth, Daniel LU orcid ; Gustafsson, Johan LU ; Warfvinge, Carl Fredrik LU ; Sundlöv, Anna LU orcid ; Åkesson, Anna ; Tennvall, Jan LU and Sjögreen Gleisner, Katarina LU (2022) In Journal of Nuclear Medicine 63(3). p.399-405
Abstract

Tumor dosimetry was performed for 177Lu-DOTA-TATE with the aims of better understanding i) the range and variation of the tumor absorbed doses (ADs), ii) how different dosimetric quantities evolve over the treatment cycles, and iii) whether this evolution differs depending on the tumor grade. Such information is important for radiobiological interpretation and may inform the design of alternative administration schemes. Methods: Data come from 41 patients with neuroendocrine tumors (NETs) of grade 1 (n = 23) or 2 (n = 18), that had received between 2 and 9 treatment cycles. Dosimetry was performed for 182 individual lesions, giving in total 880 individual AD assessments across all cycles. Hybrid planar-SPECT/CT imaging was used,... (More)

Tumor dosimetry was performed for 177Lu-DOTA-TATE with the aims of better understanding i) the range and variation of the tumor absorbed doses (ADs), ii) how different dosimetric quantities evolve over the treatment cycles, and iii) whether this evolution differs depending on the tumor grade. Such information is important for radiobiological interpretation and may inform the design of alternative administration schemes. Methods: Data come from 41 patients with neuroendocrine tumors (NETs) of grade 1 (n = 23) or 2 (n = 18), that had received between 2 and 9 treatment cycles. Dosimetry was performed for 182 individual lesions, giving in total 880 individual AD assessments across all cycles. Hybrid planar-SPECT/CT imaging was used, including quantitative SPECT reconstruction, voxel-based absorbed-dose-rate calculation, semi-automatic image segmentation, and partial-volume correction. Linear mixed-effect models were used to analyze changes over cycles in tumor ADs, absorbed-dose rates and activity concentrations at day-1, effective half-times, and tumor volumes. Tumors smaller than 8 ml were excluded from analyses. Results: Tumor ADs ranged between 2 and 77 Gy per cycle. On average the AD decreased over the cycles, with significantly different rates (P < 0.05) for grade 1 and 2 NETs of 6% and 14% per cycle, respectively. The absorbed-dose rates and activity concentrations at day-1 decreased by similar amounts. The effective half-times were less variable but shorter for grade 2 than grade 1 (P < 0.001). For grade 2 NETS the tumor volumes decreased, with a similar tendency in grade 1. Conclusion: The tumor AD, absorbed-dose rate and activity uptake decrease, in parallel with tumor volumes, between 177Lu-DOTA-TATE treatment cycles, particularly for grade 2 NETs. The effective half-times vary less but are lower for grade 2 than grade 1 NETs. These results may indicate the development of radiation-induced fibrosis and could have implications for the design of future treatment and dosimetry protocols.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Nuclear Medicine
volume
63
issue
3
pages
7 pages
publisher
Society of Nuclear Medicine
external identifiers
  • scopus:85123766696
  • pmid:34272319
ISSN
0161-5505
DOI
10.2967/jnumed.121.262069
language
English
LU publication?
yes
additional info
Copyright © 2021 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
id
d2715eb4-7994-41c6-b248-a02e153043ee
date added to LUP
2021-10-29 18:44:58
date last changed
2024-11-09 01:35:09
@article{d2715eb4-7994-41c6-b248-a02e153043ee,
  abstract     = {{<p>Tumor dosimetry was performed for 177Lu-DOTA-TATE with the aims of better understanding i) the range and variation of the tumor absorbed doses (ADs), ii) how different dosimetric quantities evolve over the treatment cycles, and iii) whether this evolution differs depending on the tumor grade. Such information is important for radiobiological interpretation and may inform the design of alternative administration schemes. Methods: Data come from 41 patients with neuroendocrine tumors (NETs) of grade 1 (n = 23) or 2 (n = 18), that had received between 2 and 9 treatment cycles. Dosimetry was performed for 182 individual lesions, giving in total 880 individual AD assessments across all cycles. Hybrid planar-SPECT/CT imaging was used, including quantitative SPECT reconstruction, voxel-based absorbed-dose-rate calculation, semi-automatic image segmentation, and partial-volume correction. Linear mixed-effect models were used to analyze changes over cycles in tumor ADs, absorbed-dose rates and activity concentrations at day-1, effective half-times, and tumor volumes. Tumors smaller than 8 ml were excluded from analyses. Results: Tumor ADs ranged between 2 and 77 Gy per cycle. On average the AD decreased over the cycles, with significantly different rates (P &lt; 0.05) for grade 1 and 2 NETs of 6% and 14% per cycle, respectively. The absorbed-dose rates and activity concentrations at day-1 decreased by similar amounts. The effective half-times were less variable but shorter for grade 2 than grade 1 (P &lt; 0.001). For grade 2 NETS the tumor volumes decreased, with a similar tendency in grade 1. Conclusion: The tumor AD, absorbed-dose rate and activity uptake decrease, in parallel with tumor volumes, between 177Lu-DOTA-TATE treatment cycles, particularly for grade 2 NETs. The effective half-times vary less but are lower for grade 2 than grade 1 NETs. These results may indicate the development of radiation-induced fibrosis and could have implications for the design of future treatment and dosimetry protocols.</p>}},
  author       = {{Roth, Daniel and Gustafsson, Johan and Warfvinge, Carl Fredrik and Sundlöv, Anna and Åkesson, Anna and Tennvall, Jan and Sjögreen Gleisner, Katarina}},
  issn         = {{0161-5505}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{399--405}},
  publisher    = {{Society of Nuclear Medicine}},
  series       = {{Journal of Nuclear Medicine}},
  title        = {{Dosimetric quantities of neuroendocrine tumors over treatment cycles with 177Lu-DOTA-TATE}},
  url          = {{http://dx.doi.org/10.2967/jnumed.121.262069}},
  doi          = {{10.2967/jnumed.121.262069}},
  volume       = {{63}},
  year         = {{2022}},
}