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Integrating Early Rapid Post-Peptide Receptor Radionuclide Therapy Quality Assurance Scan into the Outpatient Setting
Sonia Mahajan1, Joseph O'Donoghue2, Wolfgang Weber3
1Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, USA.
Objective:
To understand value of early rapid, quality-assurance (QA), post-therapy whole-body scan (Tx-WBS) in patients receiving peptide receptor radionuclide therapy (PRRT) in outpatient setting.
Methods:
Sixteen patients with metastatic neuroendocrine tumors received PRRT and underwent Tx-WBS after each cycle. Early imaging (3 hour post-injection) was favored. Planar-images obtained on dual-headed gamma camera (speed 30 cm/min) were visually assessed and qualitatively compared with pre-therapy diagnostic scans. Retention% and lesion/spleen (L/S) ratios were calculated.
Results:
Fifty three Tx-WBS were analyzed. No cutaneous contamination, extravasation or unexpected tracer distribution was observed. 46/53 (87%) Tx-WBS in 14/16 (88%) patients demonstrated uptake in metastatic lesions. No significant correlation was seen between L/S ratios and response on follow-up imaging. Qualitative assessment of follow-up images during four-cycles of PRRT provided preliminary estimate of disease course in 11/16 patients; with unexpected findings in 2.
Conclusion:
In daily practice, especially in outpatient setting, an early QA post-PRRT scan proved effective for validating successful treatment and allowing preliminary disease monitoring, at no additional cost.
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