Beyond Average : α-Particle Distribution and Dose Heterogeneity in Bone Metastatic Prostate Cancer

© 2024 by the Society of Nuclear Medicine and Molecular Imaging..

α-particle emitters are emerging as a potent modality for disseminated cancer therapy because of their high linear energy transfer and localized absorbed dose profile. Despite great interest and pharmaceutical development, there is scant information on the distribution of these agents at the scale of the α-particle pathlength. We sought to determine the distribution of clinically approved [223Ra]RaCl2 in bone metastatic castration-resistant prostate cancer at this resolution, for the first time to our knowledge, to inform activity distribution and dose at the near-cell scale. Methods: Biopsy specimens and blood were collected from 7 patients 24 h after administration. 223Ra activity in each sample was recorded, and the microstructure of biopsy specimens was analyzed by micro-CT. Quantitative autoradiography and histopathology were segmented and registered with an automated procedure. Activity distributions by tissue compartment and dosimetry calculations based on the MIRD formalism were performed. Results: We revealed the activity distribution differences across and within patient samples at the macro- and microscopic scales. Microdistribution analysis confirmed localized high-activity regions in a background of low-activity tissue. We evaluated heterogeneous α-particle emission distribution concentrated at bone-tissue interfaces and calculated spatially nonuniform absorbed-dose profiles. Conclusion: Primary patient data of radiopharmaceutical therapy distribution at the small scale revealed that 223Ra uptake is nonuniform. Dose estimates present both opportunities and challenges to enhance patient outcomes and are a first step toward personalized treatment approaches and improved understanding of α-particle radiopharmaceutical therapies.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:65

Enthalten in:

Journal of nuclear medicine : official publication, Society of Nuclear Medicine - 65(2024), 2 vom: 01. Feb., Seite 245-251

Sprache:

Englisch

Beteiligte Personen:

Benabdallah, Nadia [VerfasserIn]
Lu, Peng [VerfasserIn]
Abou, Diane S [VerfasserIn]
Zhang, Hanwen [VerfasserIn]
Ulmert, David [VerfasserIn]
Hobbs, Robert F [VerfasserIn]
Gay, Hiram A [VerfasserIn]
Simons, Brian W [VerfasserIn]
Saeed, Muhammad A [VerfasserIn]
Rogers, Buck E [VerfasserIn]
Jha, Abhinav K [VerfasserIn]
Tai, Yuan-Chuan [VerfasserIn]
Malone, Christopher D [VerfasserIn]
Ippolito, Joseph E [VerfasserIn]
Michalski, Jeff [VerfasserIn]
Jennings, Jack W [VerfasserIn]
Baumann, Brian C [VerfasserIn]
Pachynski, Russell K [VerfasserIn]
Thorek, Daniel L J [VerfasserIn]

Links:

Volltext

Themen:

α-particle
223Ra
Autoradiography
Biopsy
Dosimetry
Journal Article
Radiopharmaceuticals

Anmerkungen:

Date Completed 05.02.2024

Date Revised 12.02.2024

published: Electronic

Citation Status MEDLINE

doi:

10.2967/jnumed.123.266571

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366148249