Para-[123I]iodo-L-phenylalanine in patients with pancreatic adenocarcinoma

D. Hellwig; E. Gouverneur; A. Schaefer; J. Raedle; M. Menges; C.-M. Kirsch; S. Samnick

doi:10.3413/nukmed-0152

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2008; 47(05): 220-224
DOI: 10.3413/nukmed-0152

Original Article

Schattauer GmbH

Para-[¹²³I]iodo-L-phenylalanine in patients with pancreatic adenocarcinoma

Tumour uptake, whole-body kinetics, dosimetryPara-[¹²³I]Iod-L-phenylalanin bei Patienten mit Adenokarzinom des PankreasTumorale Aufnahme, Ganzkörperkinetik und Dosimetrie

D. Hellwig

¹Departments of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany

,

E. Gouverneur

¹Departments of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany

,

A. Schaefer

¹Departments of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany

,

J. Raedle

²Departments of Internal Medicine II (Gastroenterology), Saarland University Medical Center, Homburg, Germany

,

M. Menges

²Departments of Internal Medicine II (Gastroenterology), Saarland University Medical Center, Homburg, Germany

,

C.-M. Kirsch

¹Departments of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany

,

S. Samnick

¹Departments of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany

› Author Affiliations

Abstract

Summary

Recently, p-[¹²³I]iodo-L-phenylalanine (IPA) was clinically validated for brain tumour imaging. Preclinical studies demonstrated uptake of IPA into pancreatic adenocarcinoma suggesting its diagnostic application in patients with pancreatic tumours. The aim was to study the tumour uptake of IPA in patients with pancreatic adenocarcinoma and to analyse its biodistribution and dosimetry to assess the radiation dose resulting from its diagnostic use. Patients, methods: Seven patients with pancreatic adenocarcinoma underwent whole-body scintigraphies and SPECT up to 24 h after administration of 250 MBq of IPA. Tumour uptake of IPA was assessed visually. Time activity curves and the corresponding residence times were determined for whole-body, kidneys, liver, spleen, lung, heart content, brain, and testes. Mean absorbed doses for various organs and the effective dose were assessed based on the MIRD formalism using OLINDA/EXM. Results: IPA exhibited no accumulation in proven manifestations of pancreatic adenocarcinomas. IPA was exclusively eliminated by the urine and showed a delayed clearance from blood. Residence times were 0.26 ± 0.09 h for kidneys, 0.38 ± 0.19 h for liver, 0.15 ± 0.07 h for spleen, 0.51 ± 0.20 h for lungs, 0.22 ± 0.07 h for heart content, 0.11 ± 0.05 h for brain, 0.014 ± 0.005 h for testes and 6.4 ± 2.2 h for the remainder. The highest absorbed doses were determined in the urinary bladder wall and in the kidneys. According to the ICRP 60 the effective dose resulting from 250 MBq IPA was 3.6 ± 0.7 mSv. Conclusion: Para-[¹²³I]iodo-L-phenylalanine can be used in diagnostic nuclear medicine with acceptable radiation doses. Besides its proven validity for brain tumour imaging, IPA does not appear to be suitable as tracer for pancreatic cancer.

Zusammenfassung

Kürzlich wurde IPA (p-[¹²³I]Iod-L-phenylalanin) klinisch validiert für die Diagnostik hirneigener Tumoren. Präklinische Studien zeigten eine erhöhte Aufnahme von IPA in Adenokarzinomen des Pankreas, sodass der diagnostische Einsatz bei Patienten mit Pankreaskarzinomen vorgeschlagen wurde. Ziel dieser Arbeit war es, erstmals die tumorale Aufnahme von IPA bei Patienten mit Adenokarzinomen des Pankreas zu untersuchen, die Biodistribution und Dosimetrie von IPA zu analysieren sowie die aus der diagnostischen Anwendung resultierende Strahlenexposition zu erfassen. Patienten, Methoden: Bei sieben Patienten mit Adenokarzinomen des Pankreas wurden Ganzkörperszintigraphien und SPECT-Aufnahmen bis zu 24 Stunden nach intravenöser Applikation von 250 MBq IPA angefertigt. Die tumorale Aufnahme von IPA wurde visuell beurteilt. Zeit- Aktivitätskurven und resultierende Verweilzeiten wurden für den Ganzkörper, Nieren, Leber, Milz, Lunge, Herzinhalt, Gehirn und Hoden gemessen und berechnet. Die mittlere absorbierte Dosis für verschiedene Organe und die effektive Dosis wurden nach dem MIRD-Formalismus mittels OLINDA/ EXM ermittelt. Ergebnisse: IPA zeigte keine erhöhte Aufnahme in bekannte Manifestationen von Adenokarzinomen des Pankreas. Die Elimination von IPA erfolgte ausschließlich renal mit einer verzögerten Clearance aus dem Blut. Die Verweilzeiten waren 0,26±0,09 h für die Nieren, 0,38±0,19 h für die Leber, 0,15±0,07 h für die Milz, 0,51±0,20 h für die Lunge, 0,22±0,07 h für den Herzinhalt, 0,11±0,05 h für das Gehirn, 0,014±0,005 h für die Hoden und 6,4±2,2 h für den Restkörper. Die höchsten Organdosen ergaben sich für Harnblasenwand und Nieren. Gemäß ICRP 60 resultiert aus der Anwendung von 250 MBq IPA eine effektive Dosis von 3,6±0,7 mSv. Schlussfolgerung: IPA kann in der diagnostischen Nuklearmedizin mit einer vertretbaren Strahlenexposition angewendet werden. Im Gegensatz zur klinisch validierten Anwendung bei der Diagnostik hirneigener Tumoren eignet sich IPA nicht zur Darstellung von Adenokarzinomen des Pankreas.

Keywords

Radiopharmaceuticals - amino acids - pancreatic adenocarcinoma - radiation dosimetry

Schlüsselwörter

Radiopharmaka - Aminosäuren - Pankreas-Adenokarzinom - Dosimetrie

Full Text

References

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