Whither peptide receptor radionuclide therapy for neuroendocrine tumors: an Einsteinian view of the facts and myths

Prasad, Vikas; Bodei, Lisa; Kidd, Mark; Modlin, Irvin M.

doi:10.1007/s00259-014-2780-0

Cited by 7 publications

(7 citation statements)

References 42 publications

(52 reference statements)

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“…The clinical value of PRRT in patients with disseminated neuroendocrine tumors has been reported in several publications [1,2,4,9]. However, many issues remain to be solved in order to improve and personalize the therapy [25]. There is a general agreement in the literature on the importance of individualized therapy using dosimetry as a tool to achieve an individual risk-assessment for sensitive organs [26].…”

Section: Discussionmentioning

confidence: 99%

Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

et al. 2017

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“…A range of publications during recent years has reported on the clinical value of radionuclide therapy directed towards somatostatin receptors for therapy of patients with neuroendocrine tumours [ 3 , 4 , 6 , 13 ]. Still, many issues remain to be solved in order to improve and personalize the therapy [ 26 ]. In the literature, a general agreement on the importance of individualized therapy is noted, where dosimetry is one tool to achieve an individual risk-assessment for sensitive organs [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Method dependence, observer variability and kidney volumes in radiation dosimetry of 177Lu-DOTATATE therapy in patients with neuroendocrine tumours

et al. 2015

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BackgroundRadionuclide therapy can be individualized by performing dosimetry. To determine absorbed organ doses in 177Lu-DOTATATE therapy, three methods based on activity concentrations are currently in use: the small volume of interest (sVOI) method, and two methods based on large VOIs either on anatomical CT (aVOI) or on thresholds on functional images (tVOI). The main aim of the present work was to validate the sVOI in comparison to the other two methods regarding agreement and time efficiency. Secondary aims were to investigate inter-observer variability for the sVOI and the change of functional organ volumes following therapy.MethodsThirty patients diagnosed with neuroendocrine tumours undergoing therapy with 177Lu-DOTATATE were included. Each patient underwent three SPECT/CT scans at 1, 4 and 7 days after the treatment. Three independent observers calculated absorbed doses to the right and left kidney and the spleen using sVOI and one observer used aVOI. For tVOI, the absorbed doses were calculated based on automatically drawn isocontours around the organs at different thresholds (42, 50, 60 and 70 %). The inter-observer difference between the calculated absorbed doses for sVOI was calculated, and the differences between the three methods were computed. Ratios of organ volumes acquired at days 1, 4 and 7 versus the volume at day 1 were calculated for the tVOI method.ResultsThe differences in results of the absorbed dose calculations using all the sVOI and tVOI were small (<5 %). Absorbed dose calculations using aVOI differed slightly more from these results but were still below 10 %. The differences between the three dose calculation methods varied between <5 and 10 %. The organ volumes derived from the tVOI were independent of time for the spleen while they decreased with time for the kidneys. The fastest analysis was performed with the sVOI method.ConclusionsAll three dose calculation methods rendered comparable results with small inter-observer differences for sVOI. Unlike the spleen, the functional volume of the kidneys decreased over time during therapy, which suggests that the absorbed dose calculation for the kidneys on activity concentrations should be performed for each time point. The sVOI is the preferred method for calculating absorbed doses in solid organs.

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“…Although there was no difference in overall survival (OS) between patient groups undergoing PRRT with 90 Y and 177 Lu [6], the advantage of using 90 Y for larger tumours and 177 Lu for smaller tumours was suggested, based on animal models [7]. PRRT is generally well tolerated with a major concern for nephrotoxicity and haematotoxicity [8]. However, the risk of nephrotoxicity or haematotoxicity is less with 177 Lu-labelled PRRT [9].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of 177Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis

Kim

Pak

Koo

et al. 2015

Eur J Nucl Med Mol Imaging

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Whither peptide receptor radionuclide therapy for neuroendocrine tumors: an Einsteinian view of the facts and myths

Cited by 7 publications

References 42 publications

Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

Method dependence, observer variability and kidney volumes in radiation dosimetry of 177Lu-DOTATATE therapy in patients with neuroendocrine tumours

The efficacy of 177Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis

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Whither peptide receptor radionuclide therapy for neuroendocrine tumors: an Einsteinian view of the facts and myths

Cited by 7 publications

References 42 publications

Kidney dosimetry during 177Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

Kidney dosimetry during 177Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

Method dependence, observer variability and kidney volumes in radiation dosimetry of 177Lu-DOTATATE therapy in patients with neuroendocrine tumours

The efficacy of 177Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis

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Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance

Kidney dosimetry during ¹⁷⁷Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance