Selective irradiation of lymph nodes by radiolutecium (Lu177)

Kyker, Granvil C.; Christopherson, William M.; Berg, Harold F.; Brucer, Marshall

doi:10.1002/1097-0142(195605/06)9:3<489::aid-cncr2820090310>3.0.co;2-5

Cited by 13 publications

(4 citation statements)

References 21 publications

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“…In early animal experiments, it was shown that after injection the 177 Lu salts transform to hydroxide and form colloids, which are cleared by phagocytosis to regional lymph nodes (1). Animal biodistribution studies have demonstrated that approximately 60% of soluble 177 Lu salts circulating in the bloodstream will concentrate in the skeleton, resulting in high absorbed doses (57).…”

Section: Clinical Applications Of 177 Lumentioning

confidence: 99%

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MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

et al. 2015

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The accuracy of absorbed dose calculations in personalized internal radionuclide therapy is directly related to the accuracy of the activity (or activity concentration) estimates obtained at each of the imaging time points. MIRD Pamphlet no. 23 presented a general overview of methods that are required for quantitative SPECT imaging. The present document is next in a series of isotope-specific guidelines and recommendations that follow the general information that was provided in MIRD 23. This paper focuses on 177 Lu (lutetium) and its application in radiopharmaceutical therapy. Theradi onuclide 177 Lu (lutetium) has been proven useful in several targeted radionuclide therapies because of its favorable decay characteristics and the possibility of reliable labeling of biomolecules used for tumor targeting. Initially, 177 Lu was used in a colloidal form for interstitial injections for sterilization of peritumoral lymph nodes (1). A second important clinical application of 177 Lu has been for peptide receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE and other structurally related peptides. The PRRT use in treatment of neuroendocrine tumors (NETs) is motivated by the fact that the carrier peptide, octreotate, shows highaffinity binding to somatostatin receptors, which are overexpressed on the cell surface of many NETs (2-6). Furthermore, 177 Lu has been used in radioimmunotherapy clinical trials to label different kinds of monoclonal antibodies (7-15).There is a growing body of evidence that radionuclide therapy should follow patient-specific planning protocols, similar to those that are being routinely used in external-beam radiation therapy. Recent literature reviews show correlations between absorbed dose and tumor response as well as normal-tissue toxicity (16). Such correlations indicate that treatments should be based on personalized dosimetry, aiming to deliver therapeutically effective absorbed doses to tumors, while keeping doses to organs at risk below the threshold levels for deterministic adverse effects. In clinical PRRT studies, the primary adverse effects have been mainly renal and hematologic toxicities (2,6).Although several studies have reported estimates of absorbed doses (4,7-9,12) for 177 Lu-DOTATATE PRRT and 177 Lu radioimmunotherapy, most of these estimates have been based on planar imaging and conjugate-view activity quantification. Planar imaging, however, is known to have inherent limitations regarding the accuracy of activity quantification (17). As a result, an increasing number of clinical dosimetry protocols currently include 177 Lu SPECT/CT imaging studies (15,(17)(18)(19) because of their superior accuracy. Comparisons of renal dose estimates in 177 Lu-DOTATATE PRRT based on planar imaging and SPECT/CT, for example, have been reported (17,20) and are summarized in Cremonesi et al. (21).This document presents a set of guidelines outlining data acquisition protocols and image reconstruction techniques that are recommended for quantitative 177 Lu SPECT imaging. The guidelines are...

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Section: Clinical Applications Of 177 Lumentioning

confidence: 99%

“…Initially, 177 Lu was used in a colloidal form for interstitial injections for sterilization of peritumoral lymph nodes (1). A second important clinical application of 177 Lu has been for peptide receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE and other structurally related peptides.…”

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confidence: 99%

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

et al. 2015

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“…Two rare earth isotopes (177Lu and 153Sin) which have found some application also in nuclear medicine [9,11] were chosen for animal experiments.…”

Section: A) Radionuclidesmentioning

confidence: 99%

Studies on incorporated short-lived?-emitters with regard to the induction of late effects

Müller

Schäffer

Linzner

1980

Radiat Environ Biophys

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The rare earth radionuclides 177 Lu and 153Sm were administered as single i.p. injections in NMRI mice. Lu was deposited principally (up to 60%) in the skeleton if the quantity of stable carrier was low. Increase of stable carrier enhanced deposition in the reticulo-endothelial system. Sm was preferentially deposited in the liver; the liver deposits were further increased by the addition of stable Sm. Liver doses of between 75 and 150 Gy, resulting from a single injection of 153Sm together with 2 mg/kg stable carrier, led to severe lesions in the liver five months after treatment. Administration of 177Lu resulting in skeletal doses of between 28 and 224 Gy was found to be osteosarcomogenic. Up to 40% osteosarcoma incidence was obtained in animals with 56 and 112 Gy doses in the skeleton. Skeletal doses of this order of magnitude are also known to be osteosarcomogenic when given as 90Sr injections. The analogous situation with alpha-emitters is discussed.

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“…The possible use of radiolutetium as a radiotherapeutic agent, particularly for lymph nodes, has been rather thoroughly investigated by Kyker et at. (204,205).…”

Section: Consideration Of Specific Radioelementsmentioning

confidence: 99%

Vertebrate Radiobiology: Metabolism of Internal Emitters

Thompson¹

1960

Annu. Rev. Nucl. Sci.

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Selective irradiation of lymph nodes by radiolutecium (Lu177)

Cited by 13 publications

References 21 publications

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

Studies on incorporated short-lived?-emitters with regard to the induction of late effects

Vertebrate Radiobiology: Metabolism of Internal Emitters

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Selective irradiation of lymph nodes by radiolutecium (Lu177)

Cited by 13 publications

References 21 publications

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative 177Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative 177Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

Studies on incorporated short-lived?-emitters with regard to the induction of late effects

Vertebrate Radiobiology: Metabolism of Internal Emitters

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MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy

MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative ¹⁷⁷Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy