Improved prediction of haematological toxicity during 177Lu Lu-DOTA-TATE therapy by optimising serial SPECT-CT red marrow dosimetry
Tipping, Jill Page, Emma Calvert, Nicholas Hamilton, David Cullen, D. Price, E. Pells, S. Needham, G. Manoharan, Prakash
Tipping, Jill
Page, Emma
Calvert, Nicholas
Hamilton, David
Cullen, D.
Price, E.
Pells, S.
Needham, G.
Manoharan, Prakash
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Abstract
Aim/Introduction: This research compared red marrow
absorbed dose estimations following Peptide Receptor
Radionuclide Therapy (3D Image Based (IB) versus
Blood Based (BB) methods), and dose correlations with
haematological toxicity. Materials and Methods: Data were
acquired during cycle 1 of [177Lu]Lu-DOTA-TATE therapy
for a cohort of PRRT patients. Red marrow dosimetry was
performed using BB methods and IB methods using serial
SPECT/CT methods, with dose uncertainties estimated.
The effect on total dose (due to self & cross-irradiation)
was assessed for two different cross-irradiation models
(simplistic versus realistic). The strength and significance
of the correlation between dose and post therapy platelet
toxicity were assessed for each dosimetry method. The
effect of exposure to prior treatments on dose toxicity
correlations was also assessed. Results: Early results indicate
that IB methods delivered significantly higher red marrow
absorbed doses than BB methods (mean increase of a
factor of 3 when cross-irradiation was included). Choice
of cross-irradiation model had a significant impact on
total dose magnitude for both BB and IB techniques. Dose
response analysis of these initial results indicate that the
simplistic cross-irradiation model gave the strongest and
most significant dose - toxicity correlations for both IB and
BB methods. The most realistic activity distribution model
produced significant correlations only with IB methods for
therapy naïve patients. Conclusion: Red marrow absorbed
doses measured from serial SPECT were significantly higher
than those from serial blood measurements. IB absorbed
doses produced stronger and more significant correlations
for therapy naïve patients than BB absorbed doses
Affiliation
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Tipping J, Page E, Calvert N, Hamilton D, Cullen D, Price E, et al. Improved prediction of haematological toxicity during 177Lu Lu-DOTA-TATE therapy by optimising serial SPECT-CT red marrow dosimetry. European Journal of Nuclear Medicine and Molecular Imaging. 2020;47(SUPPL 1):S239-S