Bone marrow dosimetry in peptide receptor radionuclide therapy with [177Lu-DOTA0,Tyr3]octreotate

• DOI: 10.1007/s00259-009-1072-6
• Publication Date: 2009-02-26T11:03:25Z
• Authors: Flavio Forrer; Eric P. Krenning; Peter P. Kooij; Bert F. Bernard; Mark Konijnenberg; Willem H. Bakker; Jaap J. M. Teunissen; Marion de Jong; Kirsten van Lom; Wouter W. de Herder; Dik J. Kwekkeboom
• Keywords: Radionuclide therapy

Adequate dosimetry is mandatory for effective and safe peptide receptor radionuclide therapy (PRRT). Besides the kidneys, bone marrow a potentially dose-limiting organ. The radiation dose to usually calculated according MIRD scheme, where accumulated activity in from radioactivity of radiopharmaceutical blood. This may underestimate absorbed since stem cells express somatostatin receptors. We verified blood-based method by comparing blood with aspirates. Also, we evaluated cross-dose source organs (liver, spleen, kidneys blood), tumours so-called "remainder body" marrow. Bone aspirates were drawn 15 patients after treatment [177Lu-DOTA0,Tyr3]octreotate. Radioactivity was compared simultaneously. nucleated cell fraction isolated aspirate measured. calculated. results correlated change platelet counts 6 weeks treatment. A strong linear correlation high agreement between measured radioactivities found (r=0.914, p<0.001). No platelets found. There considerable contribution other remainder body dose. (1) After PRRT [177Lu-DOTA0,Tyr3]octreotate, concentration identical that blood; (2) no significant binding precursor cells; (3) cross significant; (4) variation patients. These findings imply individual optimization, calculation necessary.