Santoro Lore, Pitalot L, Trauchessec D, Mora-Ramirez E, Kotzki P O, Bardiès M, Deshayes E
Nuclear Medicine Department, Montpellier Cancer Institute (ICM), Univ. Montpellier, 208 Avenue des Apothicaires, 34298, Montpellier Cedex 5, France.
Centre de Recherche en Cancérologie de Toulouse, Toulouse, France.
EJNMMI Res. 2021 Jan 4;11(1):1. doi: 10.1186/s13550-020-00737-8.
The aim of this study was to compare a commercial dosimetry workstation (PLANET® Dose) and the dosimetry approach (GE Dosimetry Toolkit® and OLINDA/EXM® V1.0) currently used in our department for quantification of the absorbed dose (AD) to organs at risk after peptide receptor radionuclide therapy with [Lu]Lu-DOTA-TATE.
An evaluation on phantom was performed to determine the SPECT calibration factor variations over time and to compare the Time Integrated Activity Coefficients (TIACs) obtained with the two approaches. Then, dosimetry was carried out with the two tools in 21 patients with neuroendocrine tumours after the first and second injection of 7.2 ± 0.2 GBq of [Lu]Lu-DOTA-TATE (40 dosimetry analyses with each software). SPECT/CT images were acquired at 4 h, 24 h, 72 h and 192 h post-injection and were reconstructed using the Xeleris software (General Electric). The liver, spleen and kidneys masses and TIACs were determined using Dosimetry Toolkit® (DTK) and PLANET® Dose. The ADs were calculated using OLINDA/EXM® V1.0 and the Local Deposition Method (LDM) or Dose voxel-Kernel convolution (DK) on PLANET® Dose.
With the phantom, the 3D calibration factors showed a slight variation (0.8% and 3.3%) over time, and TIACs of 225.19 h and 217.52 h were obtained with DTK and PLANET® Dose, respectively. In patients, the root mean square deviation value was 8.9% for the organ masses, 8.1% for the TIACs, and 9.1% and 7.8% for the ADs calculated with LDM and DK, respectively. The Lin's concordance correlation coefficient was 0.99 and the Bland-Altman plot analysis estimated that the AD value difference between methods ranged from - 0.75 to 0.49 Gy, from - 0.20 to 0.64 Gy, and from - 0.43 to 1.03 Gy for 95% of the 40 liver, kidneys and spleen dosimetry analyses. The dosimetry method had a minor influence on AD differences compared with the image registration and organ segmentation steps.
The ADs to organs at risk obtained with the new workstation PLANET® Dose are concordant with those calculated with the currently used software and in agreement with the literature. These results validate the use of PLANET® Dose in clinical routine for patient dosimetry after targeted radiotherapy with [Lu]Lu-DOTA-TATE.
本研究的目的是比较一款商用剂量测定工作站（PLANET® Dose）与我们科室目前用于定量评估肽受体放射性核素治疗[Lu]Lu - DOTA - TATE后靶器官吸收剂量（AD）的剂量测定方法（GE剂量测定工具包®和OLINDA/EXM® V1.0）。
对体模进行评估，以确定SPECT校准因子随时间的变化，并比较两种方法获得的时间积分活度系数（TIACs）。然后，在21例神经内分泌肿瘤患者首次和第二次注射7.2±0.2 GBq的[Lu]Lu - DOTA - TATE后，使用这两种工具进行剂量测定（每个软件进行40次剂量测定分析）。在注射后4小时、24小时、72小时和192小时采集SPECT/CT图像，并使用Xeleris软件（通用电气）进行重建。使用剂量测定工具包®（DTK）和PLANET® Dose确定肝脏、脾脏和肾脏的质量以及TIACs。使用OLINDA/EXM® V1.0和局部沉积法（LDM）或PLANET® Dose上的剂量体素 - 核卷积（DK）计算吸收剂量。
对于体模，3D校准因子随时间有轻微变化（0.8%和3.3%），DTK和PLANET® Dose分别获得的TIACs为225.19小时和217.52小时。在患者中，器官质量的均方根偏差值为8.9%，TIACs为8.1%，使用LDM和DK计算的吸收剂量分别为9.1%和7.8%。林氏一致性相关系数为0.99，Bland - Altman图分析估计，在40次肝脏、肾脏和脾脏剂量测定分析中的95%中，方法之间的吸收剂量值差异范围为-0.75至0.49 Gy、-0.20至0.64 Gy以及-0.43至1.03 Gy。与图像配准和器官分割步骤相比，剂量测定方法对吸收剂量差异的影响较小。
使用新的工作站PLANET® Dose获得的靶器官吸收剂量与使用当前软件计算的结果一致，并且与文献相符。这些结果验证了PLANET® Dose在[Lu]Lu - DOTA - TATE靶向放疗后患者剂量测定的临床常规应用中的有效性。
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