Tian Feng, Liu Huan, Gu Yingying, Zhang Dandan, Tang Lijun
Department of Nuclear Medicine, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, People's Republic of China.
Department of Radiotherapy Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
EJNMMI Phys. 2025 Jul 1;12(1):59. doi: 10.1186/s40658-025-00781-0.
The nuclear medicine treatment based on Lu-PSMA-617 has achieved excellent therapeutic effects on Prostate cancer (PCa), but there is a lack of three-dimensional dosimetry analysis of organs at risk (OARs) and distant metastatic lesions.
This work establishes an accurate and personalized three-dimensional dose calculation method based on Monte Carlo simulation and multi-modal images of PCa patients with skull metastasis, and analyzes the three-dimensional dose distribution of metastatic lesions and OARs in the brain. Results show that due to the targeting characteristics of Lu-PSMA-617, metastatic brain lesions of all patients can receive high radiation doses with the average dose of 0.05 mGy/MBq, and the dose distribution are relatively uniform with the average homogeneity index of 1.23. In addition, the radiation dose received by most OARs are much lower than that of metastatic lesions, but for parotid glands, the dose deposited are only 3.99 times less than that of metastatic lesions due to the high absorption of Lu-PSMA-617.
Therefore, it is necessary to clarify the three-dimensional dose distribution of OARs and metastatic lesions, so as to optimize the activity injected and achieve the precise killing of metastatic lesions and protection of OARs.
基于镥-PSMA-617的核医学治疗对前列腺癌（PCa）取得了优异的治疗效果，但缺乏对危及器官（OARs）和远处转移病灶的三维剂量学分析。
本研究基于蒙特卡罗模拟和颅骨转移PCa患者的多模态图像，建立了准确的个性化三维剂量计算方法，并分析了脑内转移病灶和OARs的三维剂量分布。结果表明，由于镥-PSMA-617的靶向特性，所有患者的脑转移病灶均可接受高辐射剂量，平均剂量为0.05 mGy/MBq，剂量分布相对均匀，平均均匀性指数为1.23。此外，大多数OARs接受的辐射剂量远低于转移病灶，但对于腮腺，由于镥-PSMA-617的高摄取，沉积剂量仅比转移病灶少3.99倍。
因此，有必要明确OARs和转移病灶的三维剂量分布，以优化注射活度，实现对转移病灶的精准杀伤和对OARs的保护。
