Assessment of organ dosimetry for planning repeat treatments of high-dose (131)I-MIBG therapy: (123)I-MIBG versus posttherapy (131)I-MIBG imaging Journal Article

   


Authors: Pandit-Taskar, N.; Zanzonico, P.; Hilden, P.; Ostrovnaya, I.; Carrasquillo, J. A.; Modak, S.
Article Title: Assessment of organ dosimetry for planning repeat treatments of high-dose (131)I-MIBG therapy: (123)I-MIBG versus posttherapy (131)I-MIBG imaging
Abstract: Purpose: To evaluate detailed organ-based radiation-absorbed dose for planning double high-dose treatment with I-131-MIBG. Methods: In a prospective study, 33 patients with high-risk refractory or recurrent neuroblastoma were treated with high-dose I-131-MIBG. Organ dosimetry was estimated from the first I-131-MIBG posttherapy imaging and from subsequent I-123-MIBG imaging prior to the planned second administration. Three serial whole-body scans were performed per patient 2 to 6 days after I-131-MIBG therapy (666 MBq/kg or 18 mCi/kg) and approximately 0.5, 24, and 48 hours after the diagnostic I-123-MIBG dose (370 MBq/kg or 10 mCi/1.73 m(2)). Organ radiation doses were calculated using OLINDA. I-123-MIBG scan dosimetry estimations were used to predict doses for the second I-131-MIBG therapy and compared with I-131-MIBG posttherapy estimates. Results: Mean +/- SD whole-body doses from I-131-MIBG and I-123-MIBG scans were 0.162 +/- 112 and 0.141 +/- 0.068 mGy/MBq, respectively. I-123-MIBG and I-131-MIBG organ doses were variable-generally higher for I-123-MIBG-projected doses than those projected using posttherapy I-131-MIBG scans. Mean +/- SD doses to liver, heart wall, and lungs were 0.487 +/- 0.28, 0.225 +/- 0.20, and 0.40 +/- 0.26, respectively, for I-131-MIBG and 0.885 +/- 0.56, 0.618 +/- 0.37, and 0.458 +/- 0.56, respectively, for (123)IMIBG. Mean ratio of I-123-MIBG to I-131-MIBG estimated radiation dose was 1.81 +/- 1.95 for the liver, 2.75 +/- 1.84 for the heart, and 1.13 +/- 0.93 for the lungs. No unexpected toxicities were noted based on I-123-MIBG-projected doses and cumulative dose limits of 30, 20, and 15 Gy to liver, kidneys, and lungs, respectively. Conclusions: For repeat I-131-MIBG treatment planning, both I-131-MIBG and I-123-MIBG imaging yielded variable organ doses. However, (123)IMIBG-based dosimetry yielded a more conservative estimate of maximum allowable activity andwould be suitable for planning and limiting organ toxicity with repeat high-dose therapies.
Keywords: neuroblastoma; dosimetry; children; therapy; planning; phase-i; criteria; high-risk neuroblastoma; metaiodobenzylguanidine; mibg therapy; refractory neuroblastoma; i-131-mibg; radionuclide therapy; i-123-mibg; inrg task-force; i-131-metaiodobenzylguanidine; whole-body dosimetry
Journal Title: Clinical Nuclear Medicine
Volume: 42
Issue: 10
ISSN: 0363-9762
Publisher: Lippincott Williams & Wilkins  
Date Published: 2017-10-01
Start Page: 741
End Page: 748
Language: English
ACCESSION: WOS:000413417100013
DOI: 10.1097/rlu.0000000000001752
PROVIDER: wos
PUBMED: 28759518
PMCID: PMC5753751
Notes: Article -- Source: Wos
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MSK Authors
  1. Irina Ostrovnaya
    200 Ostrovnaya
  2. Shakeel Modak
    251 Modak
  3. Neeta Pandit-Taskar
    344 Pandit-Taskar
  4. Pat B Zanzonico
    357 Zanzonico
  5. Jorge Carrasquillo
    140 Carrasquillo
  6. Patrick Dale Hilden
    108 Hilden
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