基于血液样本和图像的不同模型对 177Lu 标记的体生长抑素受体疗法后骨髓剂量测定的影响。

IF 3 2区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Physics Pub Date : 2024-04-02 DOI:10.1186/s40658-024-00615-5

Delphine Vallot, Séverine Brillouet, Séléna Pondard, Lavinia Vija, Jean-Sébastien Texier, Lawrence Dierickx, Frédéric Courbon

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引用次数: 0

摘要

背景：用177Lu-DOTATATE进行肽受体放射性核素治疗是治疗神经内分泌肿瘤的公认选择，除肾脏和骨髓外，毒性很小。骨髓剂量一般是通过基于SPECT/CT图像的4个时间点或基于血液的多达9个时间点的方法得出的，但目前还没有参考方法。这项单中心回顾性研究针对同一批患者，使用单、双或三指数模型比较了两种方法计算出的骨髓给药剂量。对于基于图像的方法，剂量是通过 Planetdose© 软件估算的。计算了皮尔逊相关系数。我们还研究了两种方法的后期时间点的影响：结果：使用基于血液的方法计算了 131 次治疗的骨髓剂量，使用基于图像的方法计算了 17 次治疗的骨髓剂量。前者在单指数、双指数和三指数模型下的吸收剂量中值分别为 15.3、20.5 和 28.3 mGy/GBq。在基于图像的方法中，单、双和三指数模型的吸收剂量中值分别为 63.9、41.9 和 60.8。在双指数模型中，注射后 24 小时的血液样本显示骨髓吸收剂量没有任何变化。相反，在基于图像的模型中，注射后 6 天的时间点信息量更大：本研究证实，采用基于血液的方法估计的骨髓剂量明显低于基于图像的方法。采用双指数模型的血液估算法特别有用，无需在注射后 24 小时后采集血液样本。不过，这种基于血液的方法是基于一种假设，需要进一步验证。这两种方法之间的巨大差异无法确定哪种方法是估算真实吸收剂量的最佳方法，因此有必要进行进一步的研究，以便与生物效应进行比较。

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Impact of different models based on blood samples and images for bone marrow dosimetry after ¹⁷⁷Lu-labeled somatostatin-receptor therapy.

Background: Peptide receptor radionuclide therapy with ¹⁷⁷Lu-DOTATATE is a recognized option for treating neuroendocrine tumors and has few toxicities, except for the kidneys and bone marrow. The bone marrow dose is generally derived from a SPECT/CT image-based method with four timepoints or from a blood-based method with up to 9 timepoints, but there is still no reference method. This retrospective single-center study on the same cohort of patients compared the calculated bone marrow dose administered with both methods using mono, bi- or tri-exponential models. For the image-based method, the dose was estimated using Planetdose© software. Pearson correlation coefficients were calculated. We also studied the impact of late timepoints for both methods.

Results: The bone marrow dose was calculated for 131 treatments with the blood-based method and for 17 with the image-based method. In the former, the median absorbed dose was 15.3, 20.5 and 28.3 mGy/GBq with the mono-, bi- and tri-exponential model, respectively. With the image-based method, the median absorbed dose was 63.9, 41.9 and 60.8 with the mono-, bi- and tri-exponential model, respectively. Blood samples after 24h post-injection did not evidence any change in the absorbed bone marrow dose with the bi-exponential model. On the contrary, the 6-day post-injection timepoint was more informative with the image-based model.

Conclusion: This study confirms that the estimated bone marrow dose is significantly lower with the blood-based method than with the image-based method. The blood-based method with a bi-exponential model proved particularly useful, without the need for blood samples after 24h post-injection. Nevertheless, this blood-based method is based on an assumption that needs to be more validated. The important difference between the two methods does not allow to determine the optimal one to estimate the true absorbed dose and further studies are necessary to compare with biological effects.

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来源期刊

EJNMMI Physics Physics and Astronomy-Radiation

CiteScore

6.70

自引率

10.00%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Physics is an international platform for scientists, users and adopters of nuclear medicine with a particular interest in physics matters. As a companion journal to the European Journal of Nuclear Medicine and Molecular Imaging, this journal has a multi-disciplinary approach and welcomes original materials and studies with a focus on applied physics and mathematics as well as imaging systems engineering and prototyping in nuclear medicine. This includes physics-driven approaches or algorithms supported by physics that foster early clinical adoption of nuclear medicine imaging and therapy.