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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Theranostics,Gallium-67,Precision Medicine
- چکیده:
- چکیده انگلیسی: A limitation to the wider introduction of personalised dosimetry in theranostics is the relative paucity of imaging radionuclides with suitable physical and chemical properties to be paired with a long-lived therapeutic partner. As most of the beta-emitting therapeutic radionuclides emit gamma radiation as well they could potentially be used as the imaging radionuclide as well as the therapeutic radionuclide. However, the downsides are that the beta radiation will deliver a significant radiation dose as part of the treatment planning procedure, and the gamma radiation branching ratio is often quite low. Gallium-67 has been in use in nuclear medicine for over 50 years. However, the tremendous interest in gallium imaging in theranostics in recent times has focused on the PET radionuclide gallium-68. In this article it is suggested that the longer-lived gallium-67, which has desirable characteristics for imaging with the gamma camera and a suitably long half-life to match biological timescales for drug uptake and turnover, has been overlooked, in particular, for treatment planning with radionuclide therapy. Gallium-67 could also allow non-PET facilities to participate in theranostic imaging prior to treatment or for monitoring response after therapy. Gallium-67 could play a niche role in the future development of personalised medicine with theranostics.
- انتشار مقاله: 13-06-1399
- نویسندگان: Dale L Bailey,Dhanusha Sabanathan,Alireza Aslani,Douglas H Campbell,Bradley Walsh,Nigel A Lengkeek
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Dosimetry,Kidney,Lutate,NET
- چکیده:
- چکیده انگلیسی: Objective(s): To investigate and compare quantitative accuracy of kidney absorbed dose measures made from both 2D and 3D imaging in patients receiving 177LuDOTATATE (Lutate) for treatment of neuroendocrine tumours (NETs). Methods: Patients receiving Lutate therapy underwent both whole body planar imaging and SPECT/CT imaging over the kidneys at time points 0.5, 4, 24, and 96-120 hours after injection. Planar data were corrected for attenuation using transmission data, and were converted to units of absolute activity via two methods, using either a calibration standard in the field of view or relative to pre-voiding image total counts. Hand drawn regions of interest were used to generate time activity curves and kidney absorbed dose estimates in OLINDA-EXM. Fully quantitative SPECT data were generated using CT-derived corrections for both scatter and attenuation, before correction for dead time and application of a camera specific sensitivity factor to convert data to units of absolute activity. Volumes of interest were defined for kidney using the co-registered x-ray CT, before time activity curves and absorbed dose measures were generated in OLINDA-EXM, both with and without corrections made to the model for patient specific kidney volumes. Quantitative SPECT data were also used to derive dose maps through dose kernel convolution (DKC), which was treated as the gold standard. Results: A total of 50 studies were analysed, corresponding to various cycles of treatment from 21 patients. Planar absorbed dose estimates were consistently higher than SPECT derived estimates by, on average, a factor of 3. Conclusion: Quantitative SPECT is considered the gold standard approach for organ specific dosimetry however often relies on in house software. As such planar methods for estimating absorbed dose are much more widely available, and in particular, are often the only source of reference in previously published data. For the case of Lutate dosimetry, planar measures may lead to a three-fold increase in measures of kidney absorbed dose.
- انتشار مقاله: 21-06-1396
- نویسندگان: Kathy Willowson,HyunJu Ryu,Price Jackson,Enid Eslick,Anita Singh,Dale Bailey
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Liver,Dosimetry,SIRT,90Y,response
- چکیده:
- چکیده انگلیسی: A 65 year old male with metastatic colorectal cancer (mCRC) in the liver was referred for selective internal radionuclide therapy (SIRT) following a history of extensive systemic chemotherapy. 90Y PET imaging was performed immediately after treatment and used to confirm lesion targeting and measure individual lesion absorbed doses. Lesion dosimetry was highly predictive of eventual response in the follow-up FDG PET performed 8 weeks after therapy. The derived radiation dose map was used to plan a second SIRT procedure aiming to protect healthy liver by keeping absorbed dose below the critical dose threshold, whilst targeting the remaining lesions that had received sub-critical dosing. Again, 90Y PET was performed immediately post-treatment and used to derive absorbed dose measures to both lesions and healthy parenchyma. Additional followup FDG PET imaging again confirmed the role of the 90Y PET dose map as an early predictor of response, and a tool for safe repeat treatment planning.
- انتشار مقاله: 02-06-1395
- نویسندگان: Kathy W,Elizabeth Bernard,Richard Maher,Stephen Clarke,Dale Bailey
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Radionuclide therapy,SPECT, lutetium-177,neuro-endocrine tumours
- چکیده:
- چکیده انگلیسی: Objective(s):Lutetium-177 can be made with high specific activity and with no other isotopes of lutetium present, referred to as “No Carrier Added” (NCA) 177Lu. We have radiolabelled DOTA-conjugated peptide DOTA‐(Tyr3)‐octreotate with NCA 177Lu (“NCA-LuTATE”) and used it in nearly 40 therapeutic administrations for subjects with neuroendocrine tumours or meningiomas. In this paper, we report on our initial studies on aspects of the biodistribution and dosimetry of NCA-LuTATE from gamma camera 2D whole body (WB) and quantitative 3D SPECT (qSPECT) 177Lu imaging.
Methods: Thirteen patients received 39 NCA-LuTATE injections. Extensive WB planar and qSPECT imaging was acquired at approximately 0.5, 4, 24 and 96 h to permit estimates of clearance and radiation dose estimation using MIRD-based methodology (OLINDA-EXM).
Results:The average amount of NCA-Lutate administered per cycle was 7839±520 MBq. Bi-exponential modelling of whole body clearance showed half lives for the fast & slow components of t½=2.1±0.6 h and t½=58.1±6.6 h respectively. The average effective dose to kidneys was 3.1±1.0 Gy per cycle. In eight patients completing all treatment cycles the average total dose to kidneys was 11.7±3.6 Gy.
Conclusions: We have shown that NCA-LuTATE has an acceptable radiation safety profile and is a suitable alternative to Carrier-Added 177Lu formulations. The fast component of the radiopharmaceutical clearance was closely correlated with baseline renal glomerular filtration rate, and this had an impact on radiation dose to the kidneys. In addition, it has less radioactive waste issues and requires less peptide per treatment.
- انتشار مقاله: 12-08-1394
- نویسندگان: Dale Bailey,Thomas M Hennessy,Kathy P Willowson,Eric C Henry,David LH Chan,Alireza Aslani,Paul J Roach
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Oceania Journal of Nuclear Medicine and Biology
- نوع مقاله: Journal Article
- کلمات کلیدی: Lutetium-DOTATATE,Neuroendocrine Tumours,automated synthesis,Peptide Receptor Radionuclide Therapy
- چکیده:
- چکیده انگلیسی: Objective(s): Peptide Receptor Radionuclide Therapy (PRRT) with yttrium-90 (90Y) and lutetium-177 (177Lu)-labelled SST analogues are now therapy option for patients who have failed to respond to conventional medical therapy. In-house production with automated PRRT synthesis systems have clear advantages over manual methods resulting in increasing use in hospital-based radiopharmacies. We report on our one year experience with an automated radiopharmaceutical synthesis system.
Methods: All syntheses were carried out using the Eckert & Ziegler Eurotope’s Modular-Lab Pharm Tracer® automated synthesis system. All materials and methods used were followed as instructed by the manufacturer of the system (Eckert & Ziegler Eurotope, Berlin, Germany). Sterile, GMP-certified, no-carrier added (NCA) 177Lu was used with GMPcertified
peptide. An audit trail was also produced and saved by the system. The quality of the final product was assessed after each synthesis by ITLCSG and HPLC methods.
Results: A total of 17 [177Lu]-DOTATATE syntheses were performed between August 2013 and December 2014. The amount of radioactive [177Lu]-DOTATATE produced by each synthesis varied between 10-40 GBq and was dependant on the number of patients being treated on a given day. Thirteen individuals received a total of 37 individual treatment administrations in this period. There were no issues and failures with the system or the synthesis cassettes. The average radiochemical purity as determined by ITLC was above 99% (99.8 ± 0.05%) and the average radiochemical purity as determined by HPLC technique was above 97% (97.3 ± 1.5%) for this period.
Conclusions: The automated synthesis of [177Lu]-DOTATATE using Eckert & Ziegler Eurotope’s Modular-Lab Pharm Tracer® system is a robust, convenient and high yield approach to the radiolabelling of DOTATATE peptide benefiting from the use of NCA 177Lu and almost negligible radiation exposure of the operators.- انتشار مقاله: 28-11-1393
- نویسندگان: Alireza Aslani,Graeme Snowdon,Dale Bailey,Geoffrey Schembri,Elizabeth A Bailey,Pavlakis Nick,Paul Roach
- مشاهده