在[177Lu]Lu-DOTATATE受体放射性核酸治疗中的多循环剂量计行为和剂量效应关系
Gunjan Kayal1, Molly E Roseland1, Chang Wang2
1Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan.
概括
使用[177Lu]Lu-DOTATATE治疗神经内分泌瘤 (NETs) 的个性化受体放射性核酸治疗 (PRRT) 显示,在治疗周期中,瘤和脏的吸收剂量 (AD) 不同. 模型预测功能,帮助未来的剂量指导治疗.
科学领域:
- 核医学是一种核医学.
- 在瘤学瘤学.
- 放射性药理学 是一种放射性药理学.
背景情况:
- 转移性神经内分泌瘤 (NETs) 用[177Lu]Lu-DOTATATE受体放射性核素治疗 (PRRT) 进行治疗.
- 精确的剂量测量对于优化PRRT疗效和最大限度地减少毒性至关重要.
- 了解吸收剂量 (AD) 模式及其与治疗结果的相关性对于个性化剂量测量至关重要.
研究的目的:
- 为了研究转移性NET的[177Lu]Lu-DOTATATE PRRT中的药理动力学,剂量测量模式和AD效应相关性.
- 开发未来个性化剂量计指导治疗的策略.
- 评估脏吸收剂量与估计的膜过率 (eGFR) 之间的关系.
主要方法:
- 在接受标准[177Lu]Lu-DOTATATE PRRT的患者身上进行了连续的SPECT/CT成像.
- 脏和瘤分别使用深度学习和基于梯度的SPECT工具进行细分.
- 自动化剂量计工作流包括SPECT-SPECT注册,蒙特卡罗剂量速率图和剂量速率拟合;反应和毒性被评估.
主要成果:
- 瘤累积AD的中位数为2.2 Gy/GBq,脏AD的中位数为0.44 Gy/GBq.
- 瘤与脏AD的比率随着每个周期的减少;脏AD保持相对不变.
- 高度和胰腺NET显示明显较低的AD和有效半衰期 (Teff) 与低度和小肠NET相比.
结论:
- 剂量计行为在治疗周期和NET子组之间有所不同,为个性化PRRT优化提供信息.
- 基于eGFR和脏AD预测功能的模型显示了早期临床使用的潜力.
- 报告的患者子组的药理动力学有助于为用更少的成像点选择剂量计方案的种群参数.
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