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Katarina Sjögreen Gleisner

Professor

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Relationship Between Absorbed Dose and Response in Neuroendocrine Tumors Treated with [177Lu]Lu-DOTATATE

Författare

  • Carl Fredrik Warfvinge
  • Johan Gustafsson
  • Daniel Roth
  • Jan Tennvall
  • Johanna Svensson
  • Peter Bernhardt
  • Anna Åkesson
  • Elinore Wieslander
  • Anna Sundlöv
  • Katarina Sjögreen Gleisner

Summary, in English

Peptide receptor radionuclide therapy presents the possibility of tracing and quantifying the uptake of the drug in the body and performing dosimetry, potentially allowing individualization of treatment schemes. However, the details of how neuroendocrine tumors (NETs) respond to different absorbed doses are insufficiently known. Here, we investigated the relationship between tumor-absorbed dose and tumor response in a cohort of patients with NETs treated with [177Lu]Lu-DOTATATE. Methods: This was a retrospective study based on 69 tumors in 32 patients treated within a clinical trial. Dosimetry was performed at each cycle of [177Lu]Lu-DOTATATE, rendering 366 individual absorbed dose assessments. Hybrid planar–SPECT/CT imaging using [177Lu]Lu-DOTATATE was used, including quantitative SPECT reconstruction, voxel-based absorbed dose rate calculation, semiautomatic image segmentation, and partial-volume correction. Changes in tumor volume were used to determine tumor response. The volume for each tumor was manually delineated on consecutive CT scans, giving a total of 712 individual tumor volume assessments. Tumors were stratified according to grade. The relationship between absorbed dose and response was investigated using mixed-effects models and logistic regression. Tumors smaller than 4 cm3 were excluded. Results: In grade 2 NETs, a clear relationship between absorbed dose and volume reduction was observed. Our observations suggest a 90% probability of partial tumor response for an accumulated tumor-absorbed dose of at least 135 Gy. Conclusion: Our findings are in accordance with previous observations regarding the relationship between tumor shrinkage and absorbed dose. Moreover, our data suggest an absorbed dose threshold for partial response in grade 2 NETs. These observations provide valuable insights for the design of dosimetry-guided peptide receptor radionuclide therapy schemes.

Avdelning/ar

  • Medicinsk onkologi
  • Nuclear Medicine Physics
  • Forskningsgruppen för Systemisk strålterapi
  • Medicinsk strålningsfysik, Lund

Publiceringsår

2024-07-01

Språk

Engelska

Sidor

1070-1075

Publikation/Tidskrift/Serie

Journal of Nuclear Medicine

Volym

65

Issue

7

Dokumenttyp

Artikel i tidskrift

Förlag

Society of Nuclear Medicine Inc.

Ämne

  • Cancer and Oncology
  • Other Physics Topics

Aktiv

Published

Forskningsgrupp

  • Nuclear Medicine Physics
  • Systemic Radiation Therapy Group

ISBN/ISSN/Övrigt

  • ISSN: 0161-5505