Effect of previous ¹⁷⁷Lu-DOTATATE treatment on ⁹⁰Y-microsphere treatment response in neuroendocrine tumor patients with liver metastasis.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2025-08-25 DOI:10.1007/s12149-025-02101-z

Fuad Aghazada, Lebriz Uslu-Besli, Ali Kibar, Onur Erdem Sahin, Nami Yeyin, Eren Ertek, Ahmet Bas, Haluk Burcak Sayman

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引用次数: 0

Abstract

Objective: This study evaluates the impact of prior PRRT with Lu-177 DOTATATE on the response to TARE in NET patients with liver metastases.

Methods: Twenty-one patients who underwent TARE after PRRT between 2015 and 2022 were retrospectively analyzed. Tumor-specific cumulative Lu-177 DOTATATE counts were calculated from SPECT/CT images. Treatment planning was conducted with a standard target dose of 150 Gy to the tumoral tissue. Treatment response was assessed using changes in SUVmax, SUVmean, and somatostatin receptor-expressing tumor volume (SRE-TV) values derived from Ga-68 DOTATATE PET/CT before and 2-4 months after TARE. Lesion size was evaluated using RECIST v1.1 criteria. Dosimetry calculations were performed on Tc-99 m MAA SPECT/CT and Y-90 microsphere PET/MRI using Simplicit90Y™. Statistical analyses included Spearman correlation and Kruskal-Wallis tests.

Results: The median age of patients was 56 years (range 36-78 years). PRRT involved a mean cumulative Lu-177 DOTATATE dose of 43.5 ± 13.4 GBq (1175 ± 362 mCi). Post-TARE reductions in SUVmax (38.49 ± 20.46 to 19.94 ± 10.43 g/mL), SUVmean (9.51 ± 5.60 to 5.39 ± 3.64 g/mL), and SRE-TV (217.43 ± 155.87 to 175.62 ± 147.77 cm³) were observed. No significant correlation was found between cumulative Lu-177 DOTATATE counts and changes in SUV parameters, SRE-TV values, or lesion size after TARE. Similarly, no correlation was detected between tumor-to-normal liver activity ratios, calculated using either the partition model or voxel-based dosimetry and cumulative Lu-177 DOTATATE counts.

Conclusion: Prior PRRT does not significantly affect TARE response in NET patients with liver metastases. Radioembolization planning should prioritize factors like tumor, target, or healthy liver doses over previous PRRT.

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177Lu-DOTATATE治疗对肝转移性神经内分泌肿瘤患者90y -微球治疗反应的影响

目的：本研究评估既往PRRT加Lu-177 DOTATATE对NET肝转移患者TARE疗效的影响。方法：回顾性分析2015 - 2022年间21例PRRT术后TARE患者。通过SPECT/CT图像计算肿瘤特异性累积lu177 DOTATATE计数。治疗计划以150戈瑞的标准靶剂量照射肿瘤组织。通过TARE前和TARE后2-4个月Ga-68 DOTATATE PET/CT的SUVmax、SUVmean和生长抑素受体表达肿瘤体积（SRE-TV）值的变化来评估治疗效果。病变大小采用RECIST v1.1标准评估。使用Simplicit90Y™对Tc-99 m MAA SPECT/CT和Y-90微球PET/MRI进行剂量学计算。统计分析包括Spearman相关检验和Kruskal-Wallis检验。结果：患者中位年龄56岁（范围36-78岁）。PRRT涉及平均累积lu177 DOTATATE剂量为43.5±13.4 GBq（1175±362 mCi）。经皮后SUVmax（38.49±20.46 ~ 19.94±10.43 g/mL）、SUVmean（9.51±5.60 ~ 5.39±3.64 g/mL）、SRE-TV（217.43±155.87 ~ 175.62±147.77 cm3）降低。累积lu177 DOTATATE计数与TARE后SUV参数、SRE-TV值或病变大小的变化无显著相关性。同样，使用分区模型或基于体素的剂量学和累积Lu-177 DOTATATE计数计算的肿瘤与正常肝脏活性比之间没有发现相关性。结论：先前的PRRT对NET肝转移患者的TARE反应没有显著影响。放射栓塞计划应优先考虑肿瘤、靶标或健康肝脏剂量等因素，而不是先前的PRRT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.