Quantitative SPECT/CT for Dosimetry of Peptide Receptor Radionuclide Therapy.

John Kennedy, Alexandre Chicheportiche, Zohar Keidar

Journal: Seminars in nuclear medicine 2022;52(2):229-242

PMID: 34911637

Full Text on Elsevier Science View on PubMed

Abstract

Neuroendocrine tumors (NETs) are uncommon malignancies of increasing incidence and prevalence. As these slow growing tumors usually overexpress somatostatin receptors (SSTRs), the use of Ga-DOTA-peptides (gallium-68 chelated with dodecane tetra-acetic acid to somatostatin), which bind to the SSTRs, allows for PET based imaging and selection of patients for peptide receptor radionuclide therapy (PRRT). PRRT with radiolabeled somatostatin analogues such as Lu-DOTATATE (lutetium-177-[DOTA,Tyr]-octreotate), is mainly used for the treatment of metastatic or inoperable NETs. However, PRRT is generally administered at a fixed injected activity in order not to exceed dose limits in critical organs, which is suboptimal given the variability in radiopharmaceutical uptake among patients. Advances in SPECT (single photon emission computed tomography) imaging enable the absolute quantitative measure of the true radiopharmaceutical distribution providing for PRRT dosimetry in each patient. Personalized PRRT based on patient-specific dosimetry could improve therapeutic efficacy by optimizing effective tumor absorbed dose while limiting treatment related radiotoxicity.

Address: Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel; B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: [email protected].; Department of Nuclear Medicine and Biophysics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.; Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel; B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

DOI: 10.1053/j.semnuclmed.2021.11.004

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MeSH Terms: Humans, Neuroendocrine Tumors, Positron-Emission Tomography, Radioisotopes, Radionuclide Imaging, Radiopharmaceuticals, Receptors, Somatostatin, Single Photon Emission Computed Tomography Computed Tomography, Somatostatin