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Rivista di Medicina Nucleare e Imaging Molecolare

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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The Quarterly Journal of Nuclear Medicine 2000 December;44(4):325-32

lingua: Inglese

Dosimetry in radionuclide therapies with 90Y-conjugates: the IEO experience

Cremonesi M., Ferrari M., Chinol M., Bartolomei M., Stabin M. G. *, Fiorenza M., Tosi G., Paganelli G.

From the Departments of Medical Physics and Nuclear Medicine European Institute of Oncology (IEO), Milan, Italy
*Department of Radiology and Radiological Sciences Vanderbilt University, Nashville, USA


The ­basis for a suc­cess­ful radio­nu­clide ther­a­py is a ­high and ­stable ­uptake of the radio­phar­ma­ceu­ti­cal in the tar­get tis­sue ­along ­with low activ­ity con­cen­tra­tion in oth­er nor­mal ­organs. The con­tri­bu­tion of dosim­e­try in radio­nu­clide ther­a­py is to pre­dict ­before the treat­ment the ­absorbed dos­es in ­tumor and nor­mal ­organs, to iden­ti­fy the crit­i­cal ­organs, to min­i­mize any pos­sible tox­ic­ity and to eval­u­ate the max­i­mum tol­er­at­ed ­dose. We ­report our expe­ri­ence con­cern­ing phar­ma­cok­i­net­ics and dosim­e­try of two 90Y-ther­a­peu­tic pro­to­cols: 3-­step pre­tar­get­ing radio­im­mu­no­ther­a­py (RIT) accord­ing to the bio­tin-avi­din ­system and recep­tor medi­at­ed radio­nu­clide ther­a­py ­with the som­a­tos­ta­tin ana­logue ­[DOTA-D-Phe1-Tyr3] octreotide named DOT­A­TOC. For the dos­i­met­ric anal­y­sis, anal­o­gous approach­es for the two radio­lab­eled com­pounds due to the sim­i­lar phar­ma­cok­i­net­ic char­ac­ter­is­tics ­were adopt­ed; the ­MIRD for­mal­ism was ­applied, tak­ing ­into ­account ­both the phys­i­cal and the bio­log­i­cal char­ac­ter­is­tics of the radio­con­ju­gate and ­patients’ metab­olism. In ­order to deter­mine bio­log­i­cal clear­ance, seri­al ­blood sam­ples and com­plete ­urine col­lec­tion ­were ­obtained up to 48 ­hours ­after injec­tion; to eval­u­ate bio­dis­trib­u­tion, sev­er­al ­whole ­body ­scans ­were ­acquired. Both ther­a­pies ­showed the advan­ta­geous char­ac­ter­is­tics of a ­fast ­blood clear­ance and a pre­dom­i­nant­ly ­renal excre­tion of the radio­phar­ma­ceu­ti­cals ­thus low­er­ing the irra­di­a­tion of the ­total ­body. Although phar­ma­cok­i­net­ic char­ac­ter­is­tis ­were sim­i­lar, dif­fer­ent crit­i­cal ­organs ­were ­found for the two ther­a­pies; in par­tic­u­lar, ­some con­sid­er­a­tions regard­ing red mar­row, ­spleen and kid­neys ­were ­required. The ­results of our stud­ies indi­cate ­that ­high activ­ities of 90Y-bio­tin (3-­step RIT) and 90Y-DOT­A­TOC can be admin­is­tered ­with accept­able radi­a­tion dos­es to nor­mal ­organs.

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