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Delker, A.* ; Schleske, M.* ; Liubchenko, G.* ; Berg, I.* ; Zacherl, M.J.* ; Brendel, M.* ; Gildehaus, F.J.* ; Rumiantcev, M.* ; Resch, S.* ; Hürkamp, K. ; Wenter, V.* ; Unterrainer, L.M.* ; Bartenstein, P.* ; Ziegler, S.I.* ; Beyer, L.* ; Böning, G.*

Biodistribution and dosimetry for combined [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T therapy using multi-isotope quantitative SPECT imaging.

Eur. J. Nucl. Med. Mol. Imaging 50, 1280-1290 (2023)
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PURPOSE: Quantitative SPECT for patient-specific dosimetry is a valuable tool in the scope of radionuclide therapy, although its clinical application for 225Ac-based treatments may be limited due to low therapeutic activities. Therefore, the aim of this study was to demonstrate the feasibility of clinical quantitative low-count SPECT imaging during [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T treatment. METHODS: Eight prostate cancer patients (1000 MBq/8 MBq [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T) received a single-bed quantitative 177Lu/225Ac SPECT/CT acquisition (1 h) at 24 h post treatment (high-energy collimator, 16 projections p. head à 3.5 min, 128 × 128 pixel). The gamma peak at 440 keV (width: 10%) of the progeny 213Bi was imaged along with the peak at 208 keV (width: 15%) of 177Lu. Quantification included CT-based attenuation and window-based scatter correction plus resolution modelling. Gaussian post-filtering with a full-width-half-maximum of 30 mm and 40-45 mm was employed to match the signal-to-noise ratio of 225Ac and 177Lu, respectively. RESULTS: Kidney (r = 0.96, p < 0.01) and lesion (r = 0.94, p < 0.01) SUV for [177Lu]Lu-PSMA-I&T and [225Ac]Ac-PSMA-I&T showed a strong and significant correlation. Kidney SUV were significantly higher (p < 0.01) for [225Ac]Ac-PSMA-I&T (2.5 ± 0.8 vs. 2.1 ± 0.9), while for [177Lu]Lu-PSMA-I&T lesion SUV were significantly higher (p = 0.03; 1.8 ± 1.1 vs. 2.1 ± 1.5). For absorbed dose estimates, significant differences regarding the kidneys remained, while no significant differences for lesion dosimetry were found. CONCLUSION: Quantitative low-count SPECT imaging of the peak at 440 keV during [225Ac]Ac-PSMA-I&T therapy is feasible. Multi-isotope imaging for [177Lu]Lu-PSMA-I&T/[225Ac]Ac-PSMA-I&T therapy indicates accumulation of free 213Bi in the kidneys.
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Publication type Article: Journal article
Document type Scientific Article
Keywords 225ac ; Dosimetry ; Psma ; Prostate Cancer ; Spect; Resistant Prostate-cancer; Targeted Alpha-therapy; Radioligand Therapy; Radiation; Ac-225; Endoradiotherapy
Language english
Publication Year 2023
HGF-reported in Year 2023
ISSN (print) / ISBN 1619-7070
e-ISSN 1432-105X
Journal European Journal of Nuclear Medicine and Molecular Imaging
Quellenangaben Volume: 50, Issue: 5, Pages: 1280-1290 Article Number: , Supplement: ,
Publisher Springer
Publishing Place One New York Plaza, Suite 4600, New York, Ny, United States
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)
POF-Topic(s) 30203 - Molecular Targets and Therapies
Research field(s) Radiation Sciences
PSP Element(s) G-501391-001
Grants German Research Foundation (DFG) under Germany's Excellence Strategy
German Research Foundation (DFG)
Federal Ministry of Education and Research (BMBF)
Projekt DEAL
DOI 10.1007/s00259-022-06092-1
WOS ID WOS:000912260400001
WOS ID 000912260400001
Scopus ID 85145996760
PubMed ID 36629878
Erfassungsdatum 2023-01-17
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