Preparation of 90Sr-90Y generator

International Nuclear Information System (INIS)

Jin Xiaohai; Yu Haibin; Zhang Jinming; Zhang Peixin; Lin Qiongfang

1990-01-01

In recent years, 90 Y has been considered as one of the best radionuclides for tumor radioimmunotherapy when chelated to tumor-associated antibodies. This evaluation is based on the superior properties of this radionuclide (suitable half-life, pure β-ray emitter of intermediate energy, stable daughters, and suitable chemical properties) and because it is available as a radionuclide generator product by decay of its 28a parent 90 Sr. The experimental conditions of 90 Sr- 90 Y generator are described. The elution efficiency of 90 Sr- 90 Y generator reaches 98%. One of the most important problems is the 90 Sr contamination breakthrough from the generator. The level of 90 Sr contamination must be controlled to the clinical standard. The cation exchange resin 732 (100-150 mesh) was successfully used for the separation of 90 Y from 90 Sr. The method used by the authors provides a 90 Y-HAc solution which is very simple and safe for administration to the patients. 90 Y was separated from 90 Sr almost completely, the level of the 90 Sr contamination per 740 MBq 90 Y product was only 0.74 kBq. However the toxicity of 90 Sr is extremely high, the human life-time permissible dose is 74 kBq, then 740 MBq of 90 Y is allowed to be administrated to a patient for 50-100 times

Oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy

DEFF Research Database (Denmark)

Klit, Anders; Tvedskov, Tove Filtenborg; Kroman, Niels

2017-01-01

BACKGROUND: Only a few studies of limited size have examined whether oncoplastic breast surgery delays the onset of adjuvant chemotherapy as compared to conventional breast surgery. We investigated whether oncoplastic breast surgery causes a delay in the onset of adjuvant chemotherapy in comparison...... to lumpectomy and mastectomy. MATERIAL AND METHODS: The study is a population-based cohort study. Within the nationwide registry of the Danish Breast Cancer Group (DBCG), we identified 1798 patients who received adjuvant chemotherapy following mastectomy, lumpectomy or oncoplastic breast surgery for early...... and unilateral invasive breast cancer. Women treated with neoadjuvant chemotherapy were excluded. RESULTS: We found no significant difference between the three groups (mastectomy, lumpectomy, oncoplastic breast surgery) in the time from biopsy to surgery (mean time 17.9, 17.0 and 18.3 days, respectively...

Country report: Syria. Development of {sup 90}Y/{sup 90}Sr Generator and {sup 90}Y Radiopharmaceuticals

Energy Technology Data Exchange (ETDEWEB)

Yassine, Taufik; Mukhallalati, Ch. Heyam, E-mail: atomic@aec.org.sy [Atomic Energy Commission of Syria, Damascus (Syrian Arab Republic)

2010-07-01

The aim of this project is to develop a technique for preparation of {sup 90}Sr-{sup 90}Y generator, we have developed a separation technique for isolation of {sup 90}Y from {sup 90}Sr based on using Sr – Spec resin packed in three columns for separation and purification of {sup 90}Sr-{sup 90}Y .The resulting Y90 is used for therapeutic applications. The first part of this project describe a prototype design for the {sup 90}Sr- {sup 90}Y generator in order to get a very accurate method to obtain the minimum possible {sup 90}Sr Breakthrough. 25 mci of {sup 90}Sr was used in the generator {sup 90}Sr-{sup 90}Y and we obtained the elution yield of {sup 90}Y higher than 88%, Also the eluate was used for preparation of several {sup 90}Y radiopharmaceuticals such as {sup 90}YEDTMP and {sup 90}Y-DOTA-HR{sub 3}. And the work is continues to investigate more radiopharmaceuticals applications in the second part of this project such as {sup 90}Y– FHMA. In this part of the co-coordination research programmer, A protocol based on results of this studies was developed to prepare and operate a higher activity generator (50-100mci), the resulting elution yield was approximately 94% of {sup 90}Y . The elute was used in preparation of new {sup 90}Y radiopharmaceuticals. The monoclonal antibodies is still evolving by conjugate Rituximab to The macrocyclic bifunctional chelating agent,(p-SCN-Bn-DOTA)S-2-(4-Isothiocyanatobenzyle)-1,4,7,10- tetraazacyclododecane-tetraaceticacid to obtain the inmunoconjugate DOTA-Rituximub in simple way and then investigating the radio labeling conditions with {sup 90}Y. (author)

90Y microsphere therapy: does 90Y PET/CT imaging obviate the need for 90Y Bremsstrahlung SPECT/CT imaging?

Science.gov (United States)

Zade, Anand A; Rangarajan, Venkatesh; Purandare, Nilendu C; Shah, Sneha A; Agrawal, Archi R; Kulkarni, Suyash S; Shetty, Nitin

2013-11-01

Transarterial radioembolization using Y microspheres is a novel therapeutic option for inoperable hepatic malignancies. As these spheres are radiolucent, real-time assessment of their distribution during the infusion process under fluoroscopic guidance is not possible. Bremsstrahlung radiations arising from 90Y have conventionally been used for imaging its biodistribution. Recent studies have proved that sources of 90Y also emit positrons, which can further be used for PET/computed tomography (CT) imaging. This study aimed to assess the feasibility of 90Y PET/CT imaging in evaluating microsphere distributions and to compare its findings with those of Bremsstrahlung imaging. Thirty-five sessions of 90Y microsphere transarterial radioembolization were performed on 30 patients with hepatic malignancies. 90Y PET/CT imaging was performed within 3 h of therapy. Bremsstrahlung imaging was also performed for each patient. The imaging findings were compared for concordance in the distribution of microspheres. Exact one-to-one correspondence between 90Y PET/CT imaging and 90Y Bremsstrahlung imaging was observed in 97.14% of cases (i.e. in 34/35 cases). Discordance was observed only in one case in which 90Y PET/CT imaging resolved the microsphere uptake in the inferior vena cava tumor thrombus, which was, however, not visualized on Bremsstrahlung imaging. There is good concordance in the imaging findings of 90Y PET/CT and 90Y Bremsstrahlung imaging. 90Y PET/CT imaging scores over the conventionally used Bremsstrahlung imaging in terms of better resolution, ease of technique, and comparable image acquisition time. This makes it a preferred imaging modality for assessment of the distribution of 90Y microspheres.

Country report: Thailand. Development of Sr-90/ Y-90 Generator and Development of Radiopharmaceuticals Using Y-90

International Nuclear Information System (INIS)

Nipavan, Poramatikul

2010-01-01

The research project has been conducted at Thailand Institute of Nuclear Technology in accordance to the 1st RCM plan during the IAEA meeting in Warsaw. The objectives of the project include the following 5 specific aims: 1. Development of Sr-90/Y-90 ion-exchange chromatography generator 2. Development of Sr-90/Y-90 extraction chromatography generator 3. Development of quality control technique 4. Development of herapeutic radiopharmaceuticals Y-90 particulates/colloids 5. Development of Re-188 DMSA–bis-phosphonates Currently we have achieved specific aims 1 to 3. The specific aims 4 and 5 are during investigation. For specific aim 4, we are during the process to extract high purity 90 Y from 90 Sr/ 90 Y generator that will yield the starting 90 Y for the production of Y-90 particulates and colloids. For the 5 th specific aim, we are on hold to receive the starting agent, bis- Phosphonates, from Dr. Blower group. Therefore, this progress report will cover our work focusing on specific aims 1 to 3

Country report: Thailand. Development of Sr-90/ Y-90 Generator and Development of Radiopharmaceuticals Using Y-90

Energy Technology Data Exchange (ETDEWEB)

Nipavan, Poramatikul [Nuclear Research and Development Group, Thailand Institute of Nuclear Technology (Public Organization), Bangkok (Thailand)

2010-07-01

The research project has been conducted at Thailand Institute of Nuclear Technology in accordance to the 1st RCM plan during the IAEA meeting in Warsaw. The objectives of the project include the following 5 specific aims: 1. Development of Sr-90/Y-90 ion-exchange chromatography generator 2. Development of Sr-90/Y-90 extraction chromatography generator 3. Development of quality control technique 4. Development of herapeutic radiopharmaceuticals Y-90 particulates/colloids 5. Development of Re-188 DMSA–bis-phosphonates Currently we have achieved specific aims 1 to 3. The specific aims 4 and 5 are during investigation. For specific aim 4, we are during the process to extract high purity {sup 90}Y from {sup 90}Sr/{sup 90}Y generator that will yield the starting {sup 90}Y for the production of Y-90 particulates and colloids. For the 5{sup th} specific aim, we are on hold to receive the starting agent, bis- Phosphonates, from Dr. Blower group. Therefore, this progress report will cover our work focusing on specific aims 1 to 3.

Use of 177Lu-dotatate in the treatment of iodine refractory thyroid carcinomas.

Science.gov (United States)

Oliván-Sasot, P; Falgás-Lacueva, M; García-Sánchez, J; Vera-Pinto, V; Olivas-Arroyo, C; Bello-Arques, P

In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131 Iodine ( 131 I), and TSH suppression. However, the treatment with 131 I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131 I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177 Lu-DOTATATE, showing an excellent clinical and analytical response. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Development of an electrochemical 90Sr-90Y generator for separation of 90Y suitable for targeted therapy

International Nuclear Information System (INIS)

Chakravarty, Rubel; Pandey, Usha; Manolkar, Remani B.; Dash, Ashutosh; Venkatesh, Meera; Pillai, M.R. Ambikalmajan

2008-01-01

90 Y of high specific activity and very high radionuclidic purity (>99.998%) is essential for targeted therapy. Since the current methods used for the preparation of 90 Y from 90 Sr are not adaptable for use in a central/hospital radiopharmacy, a simple 90 Sr- 90 Y generator system based on electrochemical separation technique was developed. Methods: Two-cycle electrolysis procedure was developed for separation of 90 Y from 90 Sr in nitrate solution. The first electrolysis was performed for 90 min in 90 Sr(NO 3 ) 2 feed solution at pH 2-3 at a potential of -2.5V with 100-200 mA current using platinum electrodes. The second electrolysis was performed for 45 min in 3 mM HNO 3 at a potential of -2.5V with 100 mA current. In this step, the cathode from the first electrolysis containing 90 Y was used as anode along with a fresh circular platinum electrode as cathode. The 90 Y deposited on the circular cathode after the second electrolysis was dissolved in acetate buffer to obtain 90 Y acetate, suitable for radiolabeling. Results: >96% recovery of 90 Y could be achieved in each cycle, with an overall decay corrected yield of >90%. The recovered 90 Y had high radionuclidic purity with barely 30.2±15.2 kBq (817±411 nCi) of 90 Sr per 37 GBq (1 Ci) of 90 Y (0.817±0.411 ppm). Consistent and repeated separation could be demonstrated using up to 1.85 GBq (50 mCi) of 90 Sr. The generator was named 'Kamadhenu,' the eternally milk-yielding Indian mythological cow. Conclusions: A technique suitable for adaptation at central radiopharmacies for obtaining therapeutic quantities of pure 90 Y has been developed

Development of 90Sr-90Y generators

International Nuclear Information System (INIS)

Barrio, Graciela

2007-01-01

Yttrium-90 is a radioisotope of great interest in the field of Nuclear Medicine. It is considered one of the most important and most used radionuclides for radioimmunotherapeutical applications, especially promising for the treatment of certain types of cancer. Another important application of 90 Y is radio synovectomy. This radionuclide has a half-life of 64 hours, emits long range beta particles (maximum energy of 2.3 MeV) and decays, without intermediate nuclides, to a stable daughter. 90 Y may be obtained carrier-free, generated by the decay of its parent 90 Sr (half-life=28 years). 90 Sr is a product from uranium fission, and due to its long half-life, can be indefinitely used, which is certainly advantageous. It is present in great amounts, and needs to be processed and purified in order to be used as raw material for the generators. Generators of 90 Sr- 90 Y may thus be used during various months, due to 90 Sr long half-life. Several methods for the separation of 90 Y from 90 Sr by solvent extraction and ion exchange have been reported in literature. Thanks to its simplicity, ion exchange techniques have been more commonly used for this generator system. The main objective of this work was to develop a methodology for the preparation of 90 Sr- 90 Y generators, using cationic exchange resins. In such method, 90 Sr is strongly adsorbed in the resin and 90 Y is eluted by a 0.003 M EDTA solution. According to the quality control carried out, results showed that elution yields are greater than 65%, thus confirming the efficiency of the separation method used.

Long-term results of PRRT in advanced bronchopulmonary carcinoid

Energy Technology Data Exchange (ETDEWEB)

Mariniello, Annapaola; Bodei, Lisa; Baio, Silvia Melania; Gilardi, Laura; Colandrea, Marzia; Papi, Stefano; Grana, Chiara Maria [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Tinelli, Carmine [IRCCS Foundation Policlinico San Matteo, Epidemiology and Biometric Unit, Pavia (Italy); Valmadre, Giuseppe [Presidio Ospedaliero E. Morelli AOVV, Sondalo (Italy); Fazio, Nicola [European Institute of Oncology, Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Milan (Italy); Galetta, Domenico [European Institute of Oncology, Thoracic Surgery Division, Milan (Italy); Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy)

2016-03-15

Peptide receptor radionuclide therapy (PRRT) for the treatment of neuroendocrine tumours (NET) has been explored for almost two decades, but there are still few trials that have exclusively investigated well-differentiated and moderately differentiated NET arising from the respiratory tree. Thus, the aim of this study was to explore the outcome in patients affected by bronchopulmonary carcinoid (BPC) following PRRT. We retrospectively analysed 114 patients with advanced stage BPC consecutively treated with PRRT at the European Institute of Oncology, Milan, from 1997 to 2012 and followed until October 2014. The objective responses, overall survival (OS) and progression-free survival (PFS) were rated, and three different PRRT protocols ({sup 90}Y-DOTATOC vs. {sup 177}Lu-DOTATATE vs. {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE) were compared with regard to their efficacy and tolerability. The median OS (evaluated in 94 of the 114 patients) was 58.8 months. The median PFS was 28.0 months. The {sup 177}Lu-DOTATATE protocol resulted in the highest 5-year OS (61.4 %). Morphological responses (partial responses + minor responses) were obtained in 26.5 % of the cohort and were associated with longer OS and PFS. The {sup 90}Y-DOTATOC + {sup 177}Lu-DOTATATE protocol provided the highest response rate (38.1 %). Adverse events were mild in the majority of patients. However, haematological toxicity negatively affected survival. No severe (grade 3/4) serum creatinine increase was observed. Patients treated with {sup 90}Y-DOTATOC alone more frequently showed a mild/moderate decrease in renal function. In patients treated with chemotherapy before PRRT had a shorter OS and PFS, and a higher risk of developing nephrotoxicity. In a large cohort of patients with advanced BPC treated in a ''real-world'' scenario and followed up for a median of 45.1 months (range 2 - 191 months), PRRT proved to be promising in prolonging survival and delaying disease progression. Despite

Development of {sup 90}Sr-{sup 90}Y generators; Desenvolvimento de geradores de {sup 90}Sr-{sup 90}Y

Energy Technology Data Exchange (ETDEWEB)

Barrio, Graciela, E-mail: gracielabarrio@gmail.co [Pontificia Univ. Catolica de Sao Paulo (PUC-SP), SP (Brazil). Dept. de Fisica; Osso Junior, Joao Alberto, E-mail: jaossoj@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2007-07-01

Yttrium-90 is a radioisotope of great interest in the field of Nuclear Medicine. It is considered one of the most important and most used radionuclides for radioimmunotherapeutical applications, especially promising for the treatment of certain types of cancer. Another important application of {sup 90}Y is radio synovectomy. This radionuclide has a half-life of 64 hours, emits long range beta particles (maximum energy of 2.3 MeV) and decays, without intermediate nuclides, to a stable daughter. {sup 90}Y may be obtained carrier-free, generated by the decay of its parent {sup 90}Sr (half-life=28 years). {sup 90}Sr is a product from uranium fission, and due to its long half-life, can be indefinitely used, which is certainly advantageous. It is present in great amounts, and needs to be processed and purified in order to be used as raw material for the generators. Generators of {sup 90}Sr-{sup 90}Y may thus be used during various months, due to {sup 90}Sr long half-life. Several methods for the separation of {sup 90}Y from {sup 90}Sr by solvent extraction and ion exchange have been reported in literature. Thanks to its simplicity, ion exchange techniques have been more commonly used for this generator system. The main objective of this work was to develop a methodology for the preparation of {sup 90}Sr-{sup 90}Y generators, using cationic exchange resins. In such method, {sup 90}Sr is strongly adsorbed in the resin and {sup 90}Y is eluted by a 0.003 M EDTA solution. According to the quality control carried out, results showed that elution yields are greater than 65%, thus confirming the efficiency of the separation method used.

Routine surgery in addition to chemotherapy for treating spinal tuberculosis

NARCIS (Netherlands)

Jutte, PC; Van Loenhout-Rooyackers, JH; Loenhout-Rooyackers, J.H.

2006-01-01

Background Tuberculosis is generally curable with chemotherapy, but there is controversy in the literature about the need for surgical intervention in the one to two per cent of people with tuberculosis of the spine. Objectives To compare chemotherapy plus surgery with chemotherapy alone for

(68)Ga-DOTATATE PET in juvenile angiofibroma.

Science.gov (United States)

Gronkiewicz, Zuzanna; Kukwa, Wojciech; Krolicki, Leszek; Cyran-Chlebicka, Agata; Pawlak, Dariusz; Stankiewicz, Czeslaw; Krzeski, Antoni; Górnicka, Barbara; Wolosz, Dominika; Kunikowska, Jolanta

2016-06-01

As somatostatin receptors (SSTRs) may be overexpressed in rapidly growing vessels, the aim of this study was the analysis of in vivo and in vitro SSTR2A expression in juvenile angiofibroma (JA). A group of six male adolescents with a diagnosis of primary, recurrent/residual JA was enrolled in the study. All patients underwent (68)Ga-DOTATATE PET/computed tomography (CT) followed by immunohistochemical staining for SSTR expression. (68)Ga-DOTATATE PET/CT showed accumulation in areas matching the pathologic tissue in the nasopharynx of all patients studied with SUVmax of 5.1 ± 0.9 (ranging from 3.6 to 6.4). In all cases, the immunohistochemical examination showed a presence of SSTR2A with a high staining index. In vitro SSTR2A cytoplasm expression was found to be high in all tumor specimens. However, the uptake of (68)Ga-DOTATATE was weak in the PET/CT studies. We postulate that the intracellular localization of the SSTR2A in JA may cause this discrepancy.

Malignant cliomas treated after surgery by combination chemotherapy and delayed irradiation. Pt. 1

International Nuclear Information System (INIS)

Poisson, M.; Mashaly, R.; Pertuiset, B.F.; Metzger, J.

1979-01-01

Forty-six patients with gliomas were introduced after surgery into a therapeutic programme of six cycles of combination chemotherapy with VM 26 and CCNU, followed by delayed irradiation six months after surgery with an average dose of 5,800 rads. After irradiation the same preradiation chemotherapy was readministered for an average of four cycles. The results were compared to those from another group of 28 patients treated only by the same chemotherapy (CRC and C groups successively). Twelve patients (26%) died before irradiation in the CRC groups, six patients (13%) had recurrences at the time of irradiation, and 28 patients (61%) had no clinical or radiological signs of recurrence at the time of irradiation. For the total of treated patients the median survival after surgery was 17 months, and 46% of the patients were surviving at 18 months. The percentage of survivors at 18 months was significantly more elevated in the group treated by combination chemotherapy and delayed irradiation than in a control group treated by the same combination chemotherapy alone. This result suggests that in approximately 50% of cases combination chemotherapy after surgery, and delayed irradiation six months after surgery, cumulated their effects on survival time. (author)

Postradiation sarcomas: importance of surgery

International Nuclear Information System (INIS)

Lagrange, J.L.; Ramaioli, A.; Chateau, M.C.; Pignol, J.P.; Marchal, C.; Resbeut, M.; Richaud, P.; Rambert, P.; Tortechaux, J.; Seng, S.H.; La Fontan, B. de; Reme-Saumon, M.; Roullet, B.; Bof, J.; Coindre, J.M.

1997-01-01

Purpose: To evaluate the role of surgery in the treatment of Post-radiation sarcomas Materials. Post-radiation sarcomas is a rare entity and large series have rarely been reported. In order to improve knowledge about this entity the Radiotherapist group of the French Cancer Centres (FNCLCC) decided to collect retrospectively the cases treated in their institutions. In order to be sure of the histology, all the cases were reviewed by a panel of pathologists of the FNCLCC Pathologist group. A total of 129 cases of sarcomas, and 108 were reviewed; analysis of 8 is in progress, and no material was obtained in the other 11 cases. The diagnosis of sarcomas was confirmed in 80 cases. All patients (60 F, 20 M) have received radiation therapy (median dose 50 Gy; 9-110 Gy) for the treatment of the primary tumor. At this time the age was 44 years (6-83 y). Diagnoses included: breast C. 42%, Lymphomas 11.5%, gynaecological C. 10% benign lesions 5% miscellaneous. Sarcomas developed after a mean interval of 12 years (3-64 y), in bone in 30% of the cases and in soft tissue in 70%. The majority of lesions (90%) developed in the irradiated field (dose received was between 50 Gy and 60 Gy). Histologically there were 29% Malignant HistiocytofibroSarcomas, 19% OsteoSarcomas, 15% FibroSarcomas, 9% LipoSarcomas, 6% LeiomyoSarcomas, miscellaneous sarcomas 22%. Treatment included: Surgery 28 cases, Surgery+Chemotherapy 17 cases, Chemotherapy only 16 cases, Radiation therapy only 1 case, surgery + Radiation therapy 5 cases, Radiation therapy +chemotherapy 6 cases, Surgery + Radiation therapy + Chemotherapy 7 cases, no treatment 5 cases. Results. The outcome is known for all but 3 patients. 51 patients have died (44 of their sarcoma, 4 of the primary tumour, 2 of other cause and 1 iatrogenic). Median survival is 23 months (95% confidence interval 16-29 mo) but 9 patients survived 5 yr or more. Median survival was 43 mo for patients treated by surgery (28p), 6 mo for chemotherapy group (16 p

The role of adjuvant platinum-based chemotherapy in esophagogastric cancer patients who received neoadjuvant chemotherapy prior to definitive surgery.

Science.gov (United States)

Saunders, John H; Bowman, Christopher R; Reece-Smith, Alex M; Pang, Vincent; Dorrington, Matthew S; Mumtaz, Errum; Soomro, Irshad; Kaye, Philip; Madhusudan, Srinivasan; Parsons, Simon L

2017-06-01

For patients with operable esophagogastric cancer, peri-operative chemotherapy confers a significant overall survival benefit compared to surgery alone, however only 30-40% of patients demonstrate histopathological response. It is unclear whether those with no neoadjuvant chemotherapy response should go onto receive adjuvant chemotherapy, as no further benefit may be conferred. Esophagogastric cancers were prospectively captured with associated histopathological tumor regression grades following neoadjuvant chemotherapy. This cohort was then interrogated for clinico-pathological and survival outcomes. Following neoadjuvant chemotherapy and surgery, patients with chemotherapy responsive cancers, who were administered adjuvant chemotherapy gained a significant overall survival benefit. Multivariate Cox analysis, demonstrated a final adjusted hazard ratio for adjuvant therapy of 0.509; (95%CI 0.28-0.93); P = 0.028. In contrast, patients with non-responsive tumors, who underwent adjuvant chemotherapy, did not show any survival benefit. Chemotherapy toxicity was prevalent and contributed to only half of patients receiving adjuvant chemotherapy. These results suggest the benefit of the adjuvant portion of chemotherapy is limited to those who demonstrate a histopathological response to neoadjuvant chemotherapy. The administration of the adjuvant portion of chemotherapy to patients without a response to neoadjuvant chemotherapy may not provide any survival benefit, while potentially causing increased morbidity. © 2017 Wiley Periodicals, Inc.

Yttrium-90 resin microspheres and their use in the treatment of intrahepatic cholangiocarcinoma.

Science.gov (United States)

Filippi, Luca; Schillaci, Orazio; Cianni, Roberto; Bagni, Oreste

2018-04-01

Intrahepatic cholangiocarcinoma (ICC) is a severe and rapidly progressive hepatic tumor. Surgery is often impracticable due to locally advanced presentation. On the other hand, chemotherapy has demonstrated only limited effectiveness. For these reasons, liver-directed therapies have been successfully applied for treating ICC. In particular, radioembolization with Yttrium-90 ( 90 Y)-labeled spheres has been reported to be a promising therapeutic approach for this neoplasia. Two commercial forms of 90 Y-labeled spheres are available: glass (TheraSphere ® ) and resin (SIR-Spheres ® ) microspheres. The aim of the present paper is to review the existing literature on the use of the resin microspheres for the treatment of unresectable and chemorefractory ICC, focusing on the methodology, clinical applications and side effects.

Development of techniques for rapid analysis of 90Sr breakthrough and 90Y activity from a 90Sr-90Y generator

International Nuclear Information System (INIS)

Chism, S.E.; Goodwin, D.A.; Meares, C.F.

1986-01-01

Recently there has been interest in labelling monoclonal antibodies with therapeutic amounts of a pure beta emitting isotope. 90 Y offers many desirable features and may be conveniently and economically obtained from a 90 Sr- 90 Y generator. A potential hazard with this system is breakthrough of the parent 90 Sr which has a half life of 28 years and is an extremely toxic bone seeking isotope. Therefore it is essential that the daughter be completely separated from its parent. We have devised two simple techniques which allow us to monitor rapidly the amount of 90 Sr breakthrough and quantitate the 90 Y activity over a 5 log range. (author)

Progress of 90Y generator preparation

International Nuclear Information System (INIS)

Yin Bangshun; Li Mingqi; Deng Qimin; Cheng Zuoyong

2009-01-01

90 Y is an important radionuclide in radioimmunotherapy. The medical 90 Y is mainly obtained from 90 Y generator through methods of precipitation,coprecipitation, electrodeposition, solvent extraction, chromatography and so on. The progress of 90 Y generator, the advantages and disadvantages of different types of 90 Y generator, and the tendency of 90 Y generator preparation were described respectively. Comprehensive analysis showed that inorganic ion-exchange chromatography will be the main tendency of future 90 Y generator preparation. (authors)

Formulation of DOTATATE Cold Kit for Preparation of Ga-68 Radiopharmaceutical

International Nuclear Information System (INIS)

Sriwiang, W.; Duangta, T.; Kaeopookum, P.; Wongsanit, S.

2014-01-01

Radiolabeled somatostatin analogs of peptide receptors targeting tumor cells have become a common practice in the diagnosis and treatment of certain types of cancer. The aim of this research was to develop the cold kit to be label with Ga-68 radionuclide for neuroendocrine tumor imaging. DOTATATE peptide for somatostatin receptor was formulated with NaOAc and ascorbic acid into lyophilized form. Radiochemical purity (RCP) of 68 Ga-DOTATATE labeled complex prepared from the cold kit was determined during storage period of 5 months and evaluated before clinical application to EANM guideline. The %RCP of the labeled peptide was more than 95% throughout period of storage with Ge-68 breakthrough less than 0.001%. The peptide content calculated from peak area of standard DOTATATE calibration curve using HPLC at uv 220 nm was found to be 15.3±4.62 μg. The specific activity of 68 Ga-DOTATATE, which depended on activities eluted from generator, was 34.7 - 52 MBq/nmol-peptide. The pH of the Ga-68 radiopharmaceutical kit after dilution with phosphate-buffered saline was 5.0 - 5.3. These results demonstrated that preparing of 68 Ga-DOTATATE radiopharmaceutical from lyophilized kit presented in this study was suitable and convenient method obtaining high radiochemical purity of short half-life Ga-68 radionuclide.

Hanford isotope project strategic business analysis yttrium-90 (Y-90)

International Nuclear Information System (INIS)

1995-10-01

The purpose of this analysis is to address the short-term direction for the Hanford yttrium-90 (Y-90) project. Hanford is the sole DOE producer of Y-90, and is the largest repository for its source in this country. The production of Y-90 is part of the DOE Isotope Production and Distribution (IP and D) mission. The Y-90 is ''milked'' from strontium-90 (Sr-90), a byproduct of the previous Hanford missions. The use of Sr-90 to produce Y-90 could help reduce the amount of waste material processed and the related costs incurred by the clean-up mission, while providing medical and economic benefits. The cost of producing Y-90 is being subsidized by DOE-IP and D due to its use for research, and resultant low production level. It is possible that the sales of Y-90 could produce full cost recovery within two to three years, at two curies per week. Preliminary projections place the demand at between 20,000 and 50,000 curies per year within the next ten years, assuming FDA approval of one or more of the current therapies now in clinical trials. This level of production would incentivize private firms to commercialize the operation, and allow the government to recover some of its sunk costs. There are a number of potential barriers to the success of the Y-90 project, outside the control of the Hanford Site. The key issues include: efficacy, Food and Drug Administration (FDA) approval and medical community acceptance. There are at least three other sources for Y-90 available to the US users, but they appear to have limited resources to produce the isotope. Several companies have communicated interest in entering into agreements with Hanford for the processing and distribution of Y-90, including some of the major pharmaceutical firms in this country

Hanford isotope project strategic business analysis yttrium-90 (Y-90)

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-10-01

The purpose of this analysis is to address the short-term direction for the Hanford yttrium-90 (Y-90) project. Hanford is the sole DOE producer of Y-90, and is the largest repository for its source in this country. The production of Y-90 is part of the DOE Isotope Production and Distribution (IP and D) mission. The Y-90 is ``milked`` from strontium-90 (Sr-90), a byproduct of the previous Hanford missions. The use of Sr-90 to produce Y-90 could help reduce the amount of waste material processed and the related costs incurred by the clean-up mission, while providing medical and economic benefits. The cost of producing Y-90 is being subsidized by DOE-IP and D due to its use for research, and resultant low production level. It is possible that the sales of Y-90 could produce full cost recovery within two to three years, at two curies per week. Preliminary projections place the demand at between 20,000 and 50,000 curies per year within the next ten years, assuming FDA approval of one or more of the current therapies now in clinical trials. This level of production would incentivize private firms to commercialize the operation, and allow the government to recover some of its sunk costs. There are a number of potential barriers to the success of the Y-90 project, outside the control of the Hanford Site. The key issues include: efficacy, Food and Drug Administration (FDA) approval and medical community acceptance. There are at least three other sources for Y-90 available to the US users, but they appear to have limited resources to produce the isotope. Several companies have communicated interest in entering into agreements with Hanford for the processing and distribution of Y-90, including some of the major pharmaceutical firms in this country.

Current Status and Future Directions of Targeted Peptide Radionuclide Therapy

International Nuclear Information System (INIS)

Valkema, R.

2009-01-01

yr, hypertension and diabetes. Especially patients with a combination of more than two of the above mentioned risk factors may be prone to renal toxicity with PRRT. Bone marrow toxicity can be direct toxicity (grade 3-4 HGB, WBC, PLT, mostly reversible) or late stochastic effects (development of myelodysplasia and/or leukemia). Risk factors are previous chemotherapy, impaired renal function (creatinine clearance < 60 mL/min) and possibly age. With the current schedule of 4 cycles of 7.4 GBq Lu-DOTATATE each at 8-week intervals, and careful monitoring of relevant parameters, severe side effects occur only in about 1% of patients. For Y-DOTATOC and possibly Y-DOTATATE (NB: no dosimetry studies known) a cumulative activity of 13.3 GBq (360 mCi) fractionated in at least 3 to 4 cycles at 8-week intervals seems a safe schedule. Future developments: an FDA and EMEA approval of Y-DOTATOC and Lu-DOTATATE for PRRT is highly needed to establish this therapy modality. To achieve approval controlled clinical studies are required. The therapeutic window for sst-targeted PRRT can be widened to improve efficacy and/or decrease toxicity. Currently the addition of capacetabine as radiosensitizer to Lu- DOTATATE is investigated in a controlled trial. Patients who relapse after previous response to PRRT receive 2 additional cycles of Lu-DOTATATE. In patients with a single inoperable tumor, PRRT can be applied to shrink the tumor and to offer the patient surgery with curative intent afterwards. Animal experiments have shown that Lu-DOTATATE may prevent that liver tumors will develop after infusion of tumor cells in the portal vein; thus, Lu-DOTATATE may have a role in neo-adjuvant therapy

90Sr content in 90Y-labeled SIR-spheres and Zevalin.

Science.gov (United States)

Metyko, John; Erwin, William; Poston, John; Jimenez, Sandra

2014-11-01

Three different 90Y internally administered radionuclide therapies are currently used in both standard-of-care and clinical trial procedures atMD Anderson Cancer Center. TheraSphere and SIR-Spheres therapies utilize 90Y-labeled microspheres, while Zevalin is an 90Y-labeled radioimmunotherapeutic agent. Several publications have indicated radionuclidic impurities resulting from 90Y production methods. The 90Y in SIR-Spheres and Zevalin are produced from a 90Sr/90Y generator, which leaves measurable quantities of 90Sr in the final product. TheraSphere 90Y is produced in a nuclear reactor which results in a large number of impurities, most notably 88Y and 91Y. Product information sheets reference these impurities with specific limits given. These limits represent a tiny fraction of the total product activity, and in the case of TheraSphere and SIR-Spheres gamma-emitting impurities, this has been verified in the literature. An analysis of 90Sr impurities in SIR-Spheres and Zevalin is presented in this paper. Impurity quantities were found to be within the vendors’ documented limits.

Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial.

Science.gov (United States)

Cats, Annemieke; Jansen, Edwin P M; van Grieken, Nicole C T; Sikorska, Karolina; Lind, Pehr; Nordsmark, Marianne; Meershoek-Klein Kranenbarg, Elma; Boot, Henk; Trip, Anouk K; Swellengrebel, H A Maurits; van Laarhoven, Hanneke W M; Putter, Hein; van Sandick, Johanna W; van Berge Henegouwen, Mark I; Hartgrink, Henk H; van Tinteren, Harm; van de Velde, Cornelis J H; Verheij, Marcel

2018-05-01

. Chemoradiotherapy consisted of 45 Gy in 25 fractions of 1·8 Gy, for 5 weeks, five daily fractions per week, combined with capecitabine (575 mg/m 2 orally twice daily on radiotherapy days) and cisplatin (20 mg/m 2 intravenously on day 1 of each 5 weeks of radiation treatment). The primary endpoint was overall survival, analysed by intention-to-treat. The CRITICS trial is registered at ClinicalTrials.gov, number NCT00407186; EudraCT, number 2006-004130-32; and CKTO, 2006-02. Between Jan 11, 2007, and April 17, 2015, 788 patients were enrolled and randomly assigned to chemotherapy (n=393) or chemoradiotherapy (n=395). After preoperative chemotherapy, 372 (95%) of 393 patients in the chemotherapy group and 369 (93%) of 395 patients in the chemoradiotherapy group proceeded to surgery, with a potentially curative resection done in 310 (79%) of 393 patients in the chemotherapy group and 326 (83%) of 395 in the chemoradiotherapy group. Postoperatively, 233 (59%) of 393 patients started chemotherapy and 245 (62%) of 395 started chemoradiotherapy. At a median follow-up of 61·4 months (IQR 43·3-82·8), median overall survival was 43 months (95% CI 31-57) in the chemotherapy group and 37 months (30-48) in the chemoradiotherapy group (hazard ratio from stratified analysis 1·01 (95% CI 0·84-1·22; p=0·90). After preoperative chemotherapy, in the total safety population of 781 patients (assessed together), there were 368 (47%) grade 3 adverse events; 130 (17%) grade 4 adverse events, and 13 (2%) deaths. Causes of death during preoperative treatment were diarrhoea (n=2), dihydropyrimidine deficiency (n=1), sudden death (n=1), cardiovascular events (n=8), and functional bowel obstruction (n=1). During postoperative treatment, grade 3 and 4 adverse events occurred in 113 (48%) and 22 (9%) of 233 patients in the chemotherapy group, respectively, and in 101 (41%) and ten (4%) of 245 patients in the chemoradiotherapy group, respectively. Non-febrile neutropenia occurred more frequently during

Development of 90Sr/90Y Generator Systems Based on SLM Techniques for Radiolabelling of Therapeutic Biomolecules with 90Y. Chapter 14

International Nuclear Information System (INIS)

Thu, N.T.; Van Dong, D.; Van Cuong, B.; Van Khoa, C.; Cam Hoa, V.T.

2015-01-01

Yttrium-90 is one of the most useful radionuclides for radioimmunotherapeutic applications, especially for labelling peptides and antibodies. Studies were carried out to develop a 90 Sr/ 90 Y generator system based on the SLM technique. Two stages of 90 Sr/ 90 Y generator systems were developed at different activity levels of 5, 20, 50 and 100 mCi and operated with semiautomation in sequential mode. In the first stage of the system, PC88A based SLM was used, which transported 90 Y from a nitric acid medium containing 0.01–4M HNO 3 . In the second stage, the 90 Y from the first stage was transferred to the first compartment of the second stage using carbamoylmethyl phosphine oxide (CMPO) based SLM where 1M acetic acid was used as the receiving phase for 90 Y. Quality control was carried out for the products of 90 Y using EPC with paper chromatography and Tec control chromatography. Peptides and antibodies were labelled using the 90 Y product obtained from the generator developed in house. (author)

68Ga-DOTATATE PET/CT imaging of indeterminate pulmonary nodules and lung cancer.

Directory of Open Access Journals (Sweden)

Ronald Walker

Full Text Available 18F-FDG PET/CT is widely used to evaluate indeterminate pulmonary nodules (IPNs. False positive results occur, especially from active granulomatous nodules. A PET-based imaging agent with superior specificity to 18F-FDG for IPNs, is badly needed, especially in areas of endemic granulomatous nodules. Somatostatin receptors (SSTR are expressed in many malignant cells including small cell and non-small cell lung cancers (NSCLCs. 68Ga-DOTATATE, a positron emitter labeled somatostatin analog, combined with PET/CT imaging, may improve the diagnosis of IPNs over 18F-FDG by reducing false positives. Our study purpose was to test this hypothesis in our region with high endemic granulomatous IPNs.We prospectively performed 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT scans in the same 30 patients with newly diagnosed, treatment-naïve lung cancer (N = 14 or IPNs (N = 15 and one metastatic nodule. 68Ga-DOTATATE SUVmax levels at or above 1.5 were considered likely malignant. We analyzed the scan results, correlating with ultimate diagnosis via biopsy or 2-year chest CT follow-up. We also correlated 68Ga-DOTATATE uptake with immunohistochemical (IHC staining for SSTR subtype 2A (SSTR2A in pathological specimens.We analyzed 31 lesions in 30 individuals, with 14 (45% being non-neuroendocrine lung cancers and 1 (3% being metastatic disease. McNemar's result comparing the two radiopharmaceuticals (p = 0.65 indicates that their accuracy of diagnosis in this indication are equivalent. 68Ga-DOTATATE was more specific (94% compared to 81% and less sensitive 73% compared to 93% than 18F-FDG. 68Ga-DOTATATE uptake correlated with SSTR2A expression in tumor stroma determined by immunohistochemical (IHC staining in 5 of 9 (55% NSCLCs.68Ga-DOTATATE and 18F-FDG PET/CT had equivalent accuracy in the diagnosis of non-neuroendocrine lung cancer and 68Ga-DOTATATE was more specific than 18F-FDG for the diagnosis of IPNs. IHC staining for SSTR2A receptor expression correlated with

Standard test of labelling efficiency for quality control of no carrier added 90YCl3

International Nuclear Information System (INIS)

Beran, M.; Eigner Henke, K.; Srank, J.; Melichar, F.

2007-01-01

Particle emitting radionuclides (e.g. beta-emitters 90 Y and 177 Lu, alpha-emitter 211 At, Auger electron emitter 165 Er or positron emitter 86 Y) are beeing more and more frequently used in research and clinical practice for imaging and targeted therapy in nuclear medicine. This radiometals, altogether three valent lanthanides or actinides with high specific radioactivity, coupled to biomolecule carriers (peptides or monoclonal antibodies) through chelating link (e.g. DTPA or DOTA) are targeted against specific antigens and receptors of diseased tissues in order to obtain their image or to cause their radiation ablation. The radionuclide precursor 90 YCl 3 (solution of hard β-emitter 90 Y in a diluted HCl) with high purity and specific activity is already commercially produced and successfully used in nuclear medicine, e.g. for radioimmunotherapy of Lymphoma. Specification and purity of our product obtained by extraction 90 Sr/ 90 Y generator (using technology of centrifuge extractors with di-2-ethylhexylphosphoric acid) is examined and compared to other similar products in this contribution. A standard method for determination of labelling efficiency of the precursor with DOTA Octreotide (DOTATATE) using ITLC/SG chromatography is also described and proposed for quality assesment. (Author)

Clinical PET of Neuroendocrine Tumors Using 64Cu-DOTATATE: First-in-Humans Study

DEFF Research Database (Denmark)

Pfeifer, Andreas Klaus; Knigge, Ulrich Peter; Mortensen, Jann

2012-01-01

MBq of 64Cu-DOTATATE, with the liver being the organ with the highest absorbed radiation dose (0.16 mGy/MBq). Conclusion: This first-in-humans study supports the clinical use of 64Cu-DOTATATE for SRI with excellent imaging quality, reduced radiation burden, and increased lesion detection rate when...... administration. Tissue radioactivity concentrations for normal organs and lesions were quantified, and standardized uptake values were calculated for the early (1 h) and delayed (3 h) scans. Using the data for 5 patients, we assessed the radiation dose with OLINDA/EXM software. Furthermore, the clinical...... performance of 64Cu-DOTATATE with respect to lesion detection was compared with conventional SRI. Results: SRI with 64Cu-DOTATATE produced images of excellent quality and high spatial resolution. Images were characterized by high and stable tumor-to-background ratios over an imaging time window of at least 3...

Clinical cases with Gallium Dotatate 68

International Nuclear Information System (INIS)

Castro, R.

2012-01-01

This presentation is about the benefit's of PET - CT with 68 Ga Dotatate for the diagnosis and treatment. This technique is used for the staging, re staging, detection of primitive unknown tumors, selection of candidates for metabolic radium therapy and evaluation of treatment response

Risk factors for positive margins in conservative surgery for breast cancer after neoadjuvant chemotherapy.

Science.gov (United States)

Bouzón, Alberto; Acea, Benigno; García, Alejandra; Iglesias, Ángela; Mosquera, Joaquín; Santiago, Paz; Seoane, Teresa

2016-01-01

Breast conservative surgery after neoadjuvant chemotherapy intends to remove any residual tumor with negative margins. The purpose of this study was to analyze the preoperative clinical-pathological factors influencing the margin status after conservative surgery in breast cancer patients receiving neoadjuvant chemotherapy. A retrospective study of 91 breast cancer patients undergoing neoadjuvant chemotherapy (92 breast lesions) during the period 2006 to 2013. A Cox regression analysis to identify baseline tumor characteristics associated with positive margins after breast conservative surgery was performed. Of all cases, 71 tumors were initially treated with conservative surgery after neoadjuvant chemotherapy. Pathologic exam revealed positive margins in 16 of the 71 cases (22.5%). The incidence of positive margins was significantly higher in cancers with initial size >5cm (P=.021), in cancers with low tumor grade (P=.031), and in patients with hormone receptor-positive cancer (P=.006). After a median follow-up of 45.2 months, 7 patients of the 71 treated with conservative surgery had disease recurrence (9.8%). There was no significant difference in terms of disease-free survival according to the margin status (P=.596). A baseline tumor size >5cm, low tumor grade and hormone receptor-positive status increase the risk for surgical margin involvement in breast conservative surgery after neoadjuvant chemotherapy. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

99mTc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET. A case of metastatic duodenal carcinoid

International Nuclear Information System (INIS)

Hubalewska-Dydejczyk, A.; Fross-Baron, K.; Huszno, B.; Sowa-Staszczak, A.; Szybinski, P.; Mikolajczak, R.

2005-01-01

Somatostatin receptor scintigraphy (SRS) has become a routine imaging method for the diagnostics of neuroendocrine tumours (NET). 99mT c-EDDA/HYNIC-octreotate (Polatom, Poland) is a new radiotracer with high affinity for SSTR2 and similar physiological biodistribution to 111I n-Octreoscan. We present a case of a 47-year-old man with disseminated duodenal carcinoid. The patient had been operated due to the tumour mass detected in pancreatic head area. Histopathology revealed carcinoid of the duodenal wall with local lymph node and liver metastases. The patient was qualified for chemotherapy stopped due to severe leucopenia. 99mT c EDDA/HYNIC-octreotate scintigraphy was performed for staging and to determine SSTR status of the tumour before planned 90Y -DOTATATE therapy. The multiple metastatic lesions were detected all over the body. The high quality images with high target/non target ratio were obtained. 99mT c-MDP scintigraphy confirmed multiple bone metastases. On the basis of SRS result the patient was qualified for 90Y -DOTA-TATE therapy. In conclusion, 99mT c EDDA/HYNIC-octreotate can be regarded as a promising tracer for staging and to determine SSTR status of NET. (author)

Validation of an extraction paper chromatography (EPC) technique for estimation of trace levels of 90Sr in 90Y solutions obtained from 90Sr/90Y generator systems

International Nuclear Information System (INIS)

Usha Pandey; Yogendra Kumar; Ashutosh Dash

2014-01-01

While the extraction paper chromatography (EPC) technique constitutes a novel paradigm for the determination of few Becquerels of 90 Sr in MBq quantities of 90 Y obtained from 90 Sr/ 90 Y generator, validation of the technique is essential to ensure its usefulness as a real time analytical tool. With a view to explore the relevance and applicability of EPC technique as a real time quality control (QC) technique for the routine estimation of 90 Sr content in generator produced 90 Y, a systematic validation study was carried out diligently not only to establish its worthiness but also to broaden its horizon. The ability of the EPC technique to separate trace amounts of Sr 2+ in the presence of large amounts of Y 3+ was verified. The specificity of the technique for Y 3+ was demonstrated with 90 Y obtained by neutron irradiation. The method was validated under real experimental conditions and compared with a QC method described in US Pharmacopeia for detection of 90 Sr levels in 90 Y radiopharmaceuticals. (author)

Time-to-administration in postoperative chemotherapy for colorectal cancer: does minimally-invasive surgery help?

Science.gov (United States)

Amore Bonapasta, Stefano; Checcacci, Paolo; Guerra, Francesco; Mirasolo, Vita M; Moraldi, Luca; Ferrara, Angelo; Annecchiarico, Mario; Coratti, Andrea

2016-06-01

The optimal delay in the start of chemotherapy following rectal cancer surgery has not yet been identified. However, postponed adjuvant therapy has been proven to be connected with a significant survival detriment. We aimed to investigate whether the time to initiation of adjuvant treatment can be influenced by the application of minimally invasive surgery rather than traditional open surgery. By comprehensively evaluating the available inherent literature, several factors appear to be associated with delayed postoperative chemotherapy. Some of them are strictly related to surgical short-term outcomes. Laparoscopy results in shortened length of hospital stay, reduced surgical morbidity and lower rate of wound infection compared to conventional surgery. Probably due to such advantages, the application of minimally-invasive surgery to treat rectal malignancies seems to impact favorably the possibility to start adjuvant chemotherapy within an adequate timeframe following surgical resection, with potential improvement in patient survival.

Extractive {sup 90}Y generator

Energy Technology Data Exchange (ETDEWEB)

Kodina, G.E. [State Scientific Center, Moscow (Russian Federation). Institute of Giophysics; Korpusov, G.V.; Filyanin, A.T. [Russian Academy of Sciences, Moscow (Russian Federation). Institute of Physical Chemistry

1997-10-01

The generator for {sup 90}Y production is made up of two units - an extractive unit and a unit for deep purification. Contrary to the well-known methods of {sup 90}Y separation two mineral acids are used in the developed technology. The solutions of nitric acid are used for preliminary separation of {sup 90}Y and the solutions of hydrochloric acid are used for the deep purification of {sup 90}Y from {sup 90}Sr and stripping. The optimum conditions for carrying out this technology were found. The following results are reported: the carry-over of the stationary phase is excluded in this generator; the separation time is 30-60 minutes; the yield of the final product is not less than 95%; impurity of {sup 90}Sr is not more than 10{sup -9-}-{sup -10}%; the content of the chemical (nonactive) impurities is not more than the allowed one for radiopharmaceuticals 4 refs., 4 tabs., 5 figs.

Rectum neoplasms treatment advanced with radio and chemotherapy before - surgery

International Nuclear Information System (INIS)

Luongo Cespedes, A.; Aguiar Vitacca, S.

1993-01-01

In Uruguay the colorectal neoplasms has a can rate of mobility. The surgery has 13-26% local recurrence. The irradiation before surgery has demonstrated to improve the resect and the local control.The objective of this protocol it is to decrease the percentage of local relapse , using radiotherapy(RT) before surgery and concomitant chemotherapy that potencies the effect of the RT, improvement this way the therapeutic quotient (AU) [es

Treatment of asymptomatic metastatic cancer to the liver from primary colon and rectal cancer by the intraarterial administration of chemotherapy and radioactive isotopes

International Nuclear Information System (INIS)

Ariel, I.M.; Padula, G.

1982-01-01

Forty patients with asymptomatic metastatic cancer to the liver discovered at the time of laparotomy were treated by combined intrahepatic arterial chemotherapy and internal irradiation in the form of 90 Y microspheres. One group of 25 patients were treated by a catheter inserted at the time of operation and received 100 mCi; of 90 Y microspheres and 5-fluorouracil on a continuing basis. They survived an average of 26 mo (varying from 9 to 60 mo). The second series of 15 patients referred after surgery were treated by the percutaneous insertion of the catheter into the hepatic artery and received a bolus of combined chemotherapy consisting of PlatinolTM, Methotrexate, and 5-fluorouracil. They survived an average of 31 mo, which varied from 12 to 60 mo. The dose of 100 mCi of 90 Y was well tolerated by the liver. Prospective studies are in progress, limiting the treatment to the internal irradiation to determine its precise role in the overall treatment of metastatic cancer to the liver

The importance of second-look surgery following radio-chemotherapy for advanced ovarian cancer

International Nuclear Information System (INIS)

Janisch, H.; Gerstner, G.

1980-01-01

Fifteen patients with advanced, initially inoperable ovarian cancer (stages III and IV) were subjected to second-look surgery between May 1976 and August 1979 following combined radio-chemotherapy. Each case had shown a distinct reduction in tumour size and a demarcation of the foreign issue, which is considered to be prerequisite for second-look surgery. The diagnostic goal of the operation was to verify the success of the preceding radio-chemotherapeutic treatment by means of exact determination of the extent of the residual tumour. The subsequent therapeutic regimen can, if necessary, be modified accordingly. The therapeutic goal is complete surgical removal of the tumour, if at all possible, since the success of subsequent chemotherapy is dependent on the achievement of this aim. The mean interval between initial and second-look surgery was three and a half months. Tumour tissue of varying extent was found in 14 out of 15 cases. In 12 cases total extirpation of the internal genitals was successfully carried out, tumour resection was performed twice, and only of third-look surgery, when after two years of radio-chemotherapy and secondary removal of the internal genitals abdominal tumour diagnosis this patient is now undergoing further chemotherapeutic treatment. We believe that this very case illustrates the importance of second-look surgery and of consistent continuation with radio-chemotherapy in cases of advanced inoperable ovarian cancer. (author)

Experimental autoabsorption curve 90Sr in SrCO3. Efficiency calculation to detection of 90Sr, 90Y and 90Sr + 90Y in a beta gas proportional counter

International Nuclear Information System (INIS)

Gasco, C.; Alvarez, A.

1987-01-01

Strontium-90 has been determined by radiochemical separation techniques in environmental samples. These techniques, of course, cannot separate the two strontium radionuclides from each other of from stable strontium. Consequently the end product of the chemical separation contains all strontium isotopes in SrCO 3 . The beta particules emitted by 90 Sr are absorbed by the SrCO 3 precipitate. This is the main source of error in the activity measurement. It has been prepared sources of 90 Sr in SrCO 3 in order to determinate the counting efficiency and autoabsorption curve. Also detection efficiencies have been calibrated using known activities of 90 Y and equilibrium mixture of 90 Sr+ 90 Y in the same geometry than our samples. The activity of 90 Sr by ingrowth of 90 Y has been calculated by our computer program. (author). 2 figs., 3 refs

Ga-68-DOTA-TATE PET/CT for discrimination of tumors of the optic pathway.

Science.gov (United States)

Klingenstein, Annemarie; Haug, Alexander R; Miller, Christina; Hintschich, Christoph

2015-02-01

Symptomatic tumors of the optic nerve pathway may endanger vision. They are difficult to classify by imaging alone and biopsy may damage visual function. Tumor pathology influences treatment decision and a diagnostic tool with a high sensitivity and specificity would therefore be invaluable. We hypothesized that Ga-68-DOTA-TATE PET/CT may help in discriminating optic nerve tumors as uptake of somatostatin is elevated in meningiomas. Ga-68-DOTA-TATE PET/CT was used to examine 13 patients with ambiguous, symptomatic lesions of the optic pathway for treatment planning. The presence or absence of meningioma was validated by histopathology or supplementary diagnostic work-up. Ga-68-DOTA-TATE PET/CT identified 10 meningiomas (en plaque = 1, optic nerve sheath = 4, sphenoidal = 5) correctly via increased SSTR (somatostatin receptor) expression (mean SUVmax (maximum standardized uptake value) = 14.3 ± 15.4). 3 tumors did not show elevated Ga-68-DOTA-TATE uptake (SUVmax = 2.1 ± 1.0). Subsumizing all clinical-radiological follow-up tools available, these lesions were classified as an intracerebral metastasis of an advanced gastric carcinoma, histologically proven inflammatory collagenous connective tissue and presumed leukemic infiltration of a newly diagnosed chronic lymphocytic leukemia. In this case series, Ga-68-DOTA-TATE PET/CT demonstrated both a sensitivity and specificity of 100%. Yet, the golden standard of histopathology was only available in a subset of patients included. Ga-68-DOTA-TATE PET/CT proved to be a valuable diagnostic tool for the correct classification of equivocal, symptomatic tumors of the anterior optic pathway requiring therapy. PET/CT results influenced therapy decision essentially in all cases.

90Sr-90Y radionuclide generator based on ionex chromatography. Part 1 - project

International Nuclear Information System (INIS)

Miler, V.; Budsky, F.; Malek, Z.

2003-09-01

This part contains a proposal for the generator column design, materials to be used (chemicals, ionexes) and technological procedures. The proposal was inspired by the 90 Sr- 90 Y generator operated by Zfk Rossendorf. The aim was to develop and launch a generator for the preparation of carrier-free 90 Y in the form of [ 90 Y] chloride solution in dilute hydrochloric acid. The separation of Y from Sr is based on ionex chromatography by sorbing the two radionuclides on a catex. While Sr remains sorbed, 90 Y is eluted with lithium citrate. During this process, 90 Y is bonded in a citrate complex which, having a negative charge, is subsequently trapped by an anex. A guard column is inserted before the anex column to trap any traces of 90 Sr. 90 Y is eluted from the anex in the yttrium chloride form by using dilute hydrochloric acid. The product from the generator can be used for the preparation of [ 90 Y] - Fe colloid injection or [ 90 Y] - yttrium citrate injection for intra-articular application or for the development of monoclonal antibodies and peptides

Vascular Endothelial-Targeted Therapy Combined with Cytotoxic Chemotherapy Induces Inflammatory Intratumoral Infiltrates and Inhibits Tumor Relapses after Surgery

Directory of Open Access Journals (Sweden)

Brendan F. Judy

2012-04-01

Full Text Available Surgery is the most effective therapy for cancer in the United States, but disease still recurs in more than 40% of patients within 5 years after resection. Chemotherapy is given postoperatively to prevent relapses; however, this approach has had marginal success. After surgery, recurrent tumors depend on rapid neovascular proliferation to deliver nutrients and oxygen. Phosphatidylserine (PS is exposed on the vascular endothelial cells in the tumor microenvironment but is notably absent on blood vessels in normal tissues. Thus, PS is an attractive target for cancer therapy after surgery. Syngeneic mice bearing TC1 lung cancer tumors were treated with mch1N11 (a novel mouse chimeric monoclonal antibody that targets PS, cisplatin (cis, or combination after surgery. Tumor relapses and disease progression were decreased 90% by combination therapy compared with a 50% response rate for cis alone (P = .02. Mice receiving postoperative mch1N11 had no wound-related complications or added systemic toxicity in comparison to control animals. Mechanistic studies demonstrated that the effects of mch1N11 were associated with a dense infiltration of inflammatory cells, particularly granulocytes. This strategy was independent of the adaptive immune system. Together, these data suggest that vascular-targeted strategies directed against exposed PS may be a powerful adjunct to postoperative chemotherapy in preventing relapses after cancer surgery.

Vascular endothelial-targeted therapy combined with cytotoxic chemotherapy induces inflammatory intratumoral infiltrates and inhibits tumor relapses after surgery.

Science.gov (United States)

Judy, Brendan F; Aliperti, Louis A; Predina, Jarrod D; Levine, Daniel; Kapoor, Veena; Thorpe, Philip E; Albelda, Steven M; Singhal, Sunil

2012-04-01

Surgery is the most effective therapy for cancer in the United States, but disease still recurs in more than 40% of patients within 5 years after resection. Chemotherapy is given postoperatively to prevent relapses; however, this approach has had marginal success. After surgery, recurrent tumors depend on rapid neovascular proliferation to deliver nutrients and oxygen. Phosphatidylserine (PS) is exposed on the vascular endothelial cells in the tumor microenvironment but is notably absent on blood vessels in normal tissues. Thus, PS is an attractive target for cancer therapy after surgery. Syngeneic mice bearing TC1 lung cancer tumors were treated with mch1N11 (a novel mouse chimeric monoclonal antibody that targets PS), cisplatin (cis), or combination after surgery. Tumor relapses and disease progression were decreased 90% by combination therapy compared with a 50% response rate for cis alone (P = .02). Mice receiving postoperative mch1N11 had no wound-related complications or added systemic toxicity in comparison to control animals. Mechanistic studies demonstrated that the effects of mch1N11 were associated with a dense infiltration of inflammatory cells, particularly granulocytes. This strategy was independent of the adaptive immune system. Together, these data suggest that vascular-targeted strategies directed against exposed PS may be a powerful adjunct to postoperative chemotherapy in preventing relapses after cancer surgery.

Development of methodology for the preparation of 90Sr-90Y generators

International Nuclear Information System (INIS)

Barrio, Graciela; Osso, Joao A.

2008-01-01

Among the more attractive radionuclides for therapeutic applications is yttrium-90. Its relatively short half-life (64.0h), maximum beta energy (2.28 MeV) make it well suited for a variety of applications, ranging from the radiolabeling of antibodies for tumor therapy to the production of radiolabeled particles for the treatment of liver malignancies. Yttrium-90 results from the decay of strontium-90 (28y) and decays to a stable daughter ( 90 Zr) and has no γ-ray, what makes this nuclide very attractive for therapeutic applications. 90 Y is produced through a generator system, from the decay of 90 Sr. Before it can safely employed in clinical applications, the 90 Y must be made essentially free of 90 Sr, an isotope known to cause bone marrow suppression. The objective of this work is to develop 90 Sr- 90 Y generator using a cation exchange method resin. This method was the most effects for the separation of 90 Y and 90 Sr. 90 Sr is strongly adsorbed in the resin and 90 Y is eluted in 0.003M EDTA. The generator efficiency and radionuclide control results were also evaluated using 85 Sr (γ-ray emitter). The generator was developed, using AG 50WX8 exchange resin converted to the Na+ form and then conditioned with 0.003M EDTA solution (pH=4.8). The quality control showed that 90 Y had no 8 '5Sr impurities, inside the detection limits of the detector. The results presented here are very promising, showing that the methodology is able to separate the two nuclides, with low quantities of 90 Sr impurity and satisfactory elution yields. (author)

Treatment results of non-pilocytic cerebral astrocytomas in adults treated by surgery, radiation therapy and chemotherapy

International Nuclear Information System (INIS)

Matsutani, Masao; Nishikawa, Ryo; Sugiyama, Satoshi; Fujimaki, Takamitsu; Nakamura, Osamu

1999-01-01

Non-pilocytic cerebral astrocytomas in adults are oncopathologically defined as well-differentiated carcinoma of the brain. They grow invasively and can not be cured by extensive surgery followed by radiation therapy. We performed multidisciplinary treatments consisting of surgery, radiation therapy and chemotherapy in 26 adult patients with non-pilocytic cerebral astrocytomas. The 5- and 10-year survival rates of the patients were 90.9% and 75.6%, respectively; these were better than reported survival rates of patients treated by postoperative radiation therapy alone. Precise analysis of clinical findings of astrocytic tumors suggested that glioblastomas growing superficially might be derived from preexisting astrocytomas. This hypothesis proposes that multidisciplinary treatments for astrocytomas in early stages could cure the disease and could ultimately decrease a number of glioblastomas. (author)

68Ga DOTATATE PET/CT of Synchronous Meningioma and Prolactinoma.

Science.gov (United States)

Basu, Sandip; Ranade, Rohit; Hazarika, Suman

2016-03-01

Ga DOTATATE PET/CT in noninvasive characterization of synchronous pituitary neoplasm and meningioma in a 38-year-old man is illustrated. The patient presented with an MRI-detected lobulated enhancing sellar-suprasellar mass with erosion of bony sella measuring 4.5 × 3.5 × 3.4 cm (with differential diagnosis with germ cell tumor) and a right parafalcine mass (2.7 × 2.6 cm) suggesting meningioma. Ga DOTATATE PET/CT demonstrated intense uptake in both lesions, suggesting the sellar mass to be pituitary macroadenoma. The finding of high serum prolactin and normal LH, FSH, cortisol, and testosterone levels suggested diagnosis of prolactinoma, and the patient was started on cabergoline.

Peptide receptor radionuclide therapy with {sup 90}Y-DOTATOC in recurrent meningioma

Energy Technology Data Exchange (ETDEWEB)

Bartolomei, Mirco; Bodei, Lisa; De Cicco, Concetta; Grana, Chiara Maria; Baio, Silvia Melania; Arico, Demetrio; Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Cremonesi, Marta [European Institute of Oncology, Division of Medical Physics, Milan (Italy); Botteri, Edoardo [European Institute of Oncology, Division of Epidemiology and Biostatistics, Milan (Italy); Sansovini, Maddalena [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Radiometabolic Medicine Division, Meldola (Italy)

2009-09-15

Meningiomas are generally benign and in most cases surgery is curative. However, for high-grade histotypes or partially resected tumours, recurrence is fairly common. External beam radiation therapy (EBRT) is usually given in such cases but is not always effective. We assessed peptide receptor radionuclide therapy (PRRT) using {sup 90}Y-DOTATOC in a group of patients with meningioma recurring after standard treatments in all of whom somatostatin receptors were strongly expressed on meningioma cell surfaces. Twenty-nine patients with scintigraphically proven somatostatin subtype 2 receptor-positive meningiomas were enrolled: 14 had benign (grade I), 9 had atypical (grade II) and 6 had malignant (grade III) disease. Patients received intravenous {sup 90}Y-DOTATOC for 2-6 cycles for a cumulative dose in the range of 5-15 GBq. Clinical and neuroradiological evaluations were performed at baseline, during and after PRRT. The treatment was well tolerated in all patients. MRI 3 months after treatment completion showed disease stabilization in 19 of 29 patients (66%) and progressive disease in the remaining 10 (34%). Better results were obtained in patients with grade I meningioma than in those with grade II-III, with median time to progression (from beginning PRRT) of 61 months in the low-grade group and 13 months in the high-grade group. PRRT with {sup 90}Y-DOTATOC can interfere with the growth of meningiomas. The adjuvant role of this treatment, soon after surgery, especially in atypical and malignant histotypes, deserves further investigation. (orig.)

90Y of high purity for medical applications

International Nuclear Information System (INIS)

Castillo, A.X.; Alvarez, E.O.; Olive, K.I.

2001-01-01

Several 90 Sr/ 90 Y-generator systems have been developed and used to produce 90 Y. The most important parameter of the 90 Y to be assayed is 90 Sr content. In addition, when labelling monoclonal antibodies for therapy trace metal quantities accompanying 90 Y (Fe 3+ , Zn 2+ , Cu 2+ , ZrO 2+ , etc.) are to be kept as low as possible in order to obtain high labelling efficiencies. Generally generators' lifetime is limited due to the 90 Sr breakthrough which increases in eluates as a result of the radiolytic degradation of the resin used as support. In the study a described procedure for 90 Y purification from metal contamination is modified in order to lower the amount of 90 Sr present in eluates from generators. As a result a very low 90 Sr content is always assured ( 90 Sr/ 90 Y -6 ). (author)

68Ga-autoclabeling of DOTA-TATE and DOTA-NOC

DEFF Research Database (Denmark)

Blom, Elisabeth; Koziorowski, Jacek

2012-01-01

A new method combining (68)Ga-labeling and steam sterilization, here called autoclabeling, has been evaluated for two somatostatin receptor binding tracers used for positron emission tomography (PET) imaging of neuroendocrine tumors; DOTA-TATE and -NOC....

Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer.

Science.gov (United States)

Kelsen, David P; Winter, Katryn A; Gunderson, Leonard L; Mortimer, Joanne; Estes, Norman C; Haller, Daniel G; Ajani, Jaffer A; Kocha, Walter; Minsky, Bruce D; Roth, Jack A; Willett, Christopher G

2007-08-20

We update Radiation Therapy Oncology Group trial 8911 (USA Intergroup 113), a comparison of chemotherapy plus surgery versus surgery alone for patients with localized esophageal cancer. The relationship between resection type and between tumor response and outcome were also analyzed. The chemotherapy group received preoperative cisplatin plus fluorouracil. Outcome based on the type of resection (R0, R1, R2, or no resection) was evaluated. The main end point was overall survival. Disease-free survival, relapse pattern, the influence of postoperative treatment, and the relationship between response to preoperative chemotherapy and outcome were also evaluated. Two hundred sixteen patients received preoperative chemotherapy, 227 underwent immediate surgery. Fifty-nine percent of surgery only and 63% of chemotherapy plus surgery patients underwent R0 resections (P = .5137). Patients undergoing less than an R0 resection had an ominous prognosis; 32% of patients with R0 resections were alive and free of disease at 5 years, only 5% of patients undergoing an R1 resection survived for longer than 5 years. The median survival rates for patients with R1, R2, or no resections were not significantly different. While, as initially reported, there was no difference in overall survival for patients receiving perioperative chemotherapy compared with the surgery only group, patients with objective tumor regression after preoperative chemotherapy had improved survival. For patients with localized esophageal cancer, whether or not preoperative chemotherapy is administered, only an R0 resection results in substantial long-term survival. Even microscopically positive margins are an ominous prognostic factor. After a R1 resection, postoperative chemoradiotherapy therapy offers the possibility of long-term disease-free survival to a small percentage of patients.

Comparison of neoadjuvant chemotherapy versus upfront surgery with or without chemotherapy for patients with clinical stage III esophageal squamous cell carcinoma.

Science.gov (United States)

Matsuda, S; Tsubosa, Y; Sato, H; Takebayashi, K; Kawamorita, K; Mori, K; Niihara, M; Tsushima, T; Yokota, T; Onozawa, Y; Yasui, H; Takeuchi, H; Kitagawa, Y

2017-02-01

Neoadjuvant chemotherapy (NAC) and chemoradiotherapy have been shown to extend postoperative survival, and preoperative therapy followed by esophagectomy has become the standard treatment worldwide for patients with esophageal squamous cell carcinoma (ESCC). The Japan Clinical Oncology Group 9907 study showed that NAC significantly extended survival in advanced ESCC, but the survival benefit for patients with clinical stage III disease remains to be elucidated. We compared the survival rates of NAC and upfront surgery in patients with clinical stage III ESCC. Consecutive patients histologically diagnosed as clinical stage III (excluding cT4) ESCC were eligible for this retrospective study. Between September 2002 and April 2007, upfront transthoracic esophagectomy was performed initially and, for patients with positive lymph node (LN) metastasis in a resected specimen, adjuvant chemotherapy using cisplatin and 5-fluororouracil every 3 weeks for two cycles was administered (Upfront surgery group). Since May 2007, a NAC regimen used as adjuvant chemotherapy followed by transthoracic esophagectomy has been administered as the standard treatment in our institution (NAC group). Patient characteristics, clinicopathological factors, treatment outcomes, post-treatment recurrence, and overall survival (OS) were compared between the NAC and upfront surgery groups. Fifty-one and 55 patients were included in the NAC and upfront surgery groups, respectively. The R0 resection rate was significantly lower in the NAC group than in the upfront surgery group (upfront surgery, 98%; NAC, 76%; P = 0.003). In the upfront surgery group, of 49 patients who underwent R0 resection and pathologically positive for LN metastasis, 22 (45%) received adjuvant chemotherapy. In the NAC group, 49 (96%) of 51 patients completed two cycles of NAC. In survival analysis, no significant difference in OS was observed between the NAC and upfront surgery groups (NAC: 5-year OS, 43.8%; upfront surgery: 5

Breast fibroadenoma with increased activity on 68Ga-DOTATATE PET/CT

Science.gov (United States)

Papadakis, Georgios Z.; Millo, Corina; Sadowski, Samira M.; Karantanas, Apostolos H.; Bagci, Ulas; Patronas, Nicholas J.

2016-01-01

Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor (NET), who on follow-up imaging tests underwent whole-body PET/CT study using 68Ga-DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface over-expression of somatostatin receptors (SSTRs) by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of 68Ga-DOTATATE avid breast lesions which could mimic malignancy in NET patients. PMID:27879489

Breast Fibroadenoma With Increased Activity on 68Ga DOTATATE PET/CT.

Science.gov (United States)

Papadakis, Georgios Z; Millo, Corina; Sadowski, Samira M; Karantanas, Apostolos H; Bagci, Ulas; Patronas, Nicholas J

2017-02-01

Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor who on follow-up imaging tests underwent whole-body PET/CT study using Ga DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface overexpression of somatostatin receptors by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of Ga DOTATATE-avid breast lesions that could mimic malignancy in neuroendocrine tumor patients.

Meningiomas: A Comparative Study of 68Ga-DOTATOC, 68Ga-DOTANOC and 68Ga-DOTATATE for Molecular Imaging in Mice

Science.gov (United States)

Soto-Montenegro, María Luisa; Peña-Zalbidea, Santiago; Mateos-Pérez, Jose María; Oteo, Marta; Romero, Eduardo; Morcillo, Miguel Ángel; Desco, Manuel

2014-01-01

Purpose The goal of this study was to compare the tumor uptake kinetics and diagnostic value of three 68Ga-DOTA-labeled somatostatin analogues (68Ga-DOTATOC, 68Ga-DOTANOC, and 68Ga-DOTATATE) using PET/CT in a murine model with subcutaneous meningioma xenografts. Methods The experiment was performed with 16 male NUDE NU/NU mice bearing xenografts of a human meningioma cell line (CH-157MN). 68Ga-DOTATOC, 68Ga-DOTANOC, and 68Ga-DOTATATE were produced in a FASTLab automated platform. Imaging was performed on an Argus small-animal PET/CT scanner. The SUVmax of the liver and muscle, and the tumor-to-liver (T/L) and tumor-to-muscle (T/M) SUV ratios were computed. Kinetic analysis was performed using Logan graphical analysis for a two-tissue reversible compartmental model, and the volume of distribution (Vt) was determined. Results Hepatic SUVmax and Vt were significantly higher with 68Ga-DOTANOC than with 68Ga-DOTATOC and 68Ga-DOTATATE. No significant differences between tracers were found for SUVmax in tumor or muscle. No differences were found in the T/L SUV ratio between 68Ga-DOTATATE and 68Ga-DOTATOC, both of which had a higher fraction than 68Ga-DOTANOC. The T/M SUV ratio was significantly higher with 68Ga-DOTATATE than with 68Ga-DOTATOC and 68Ga-DOTANOC. The Vt for tumor was higher with 68Ga-DOTATATE than with 68Ga-DOTANOC and relatively similar to that of 68Ga-DOTATOC. Conclusions This study demonstrates, for the first time, the ability of the three radiolabeled somatostatin analogues tested to image a human meningioma cell line. Although Vt was relatively similar with 68Ga-DOTATATE and 68Ga-DOTATOC, uptake was higher with 68Ga-DOTATATE in the tumor than with 68Ga-DOTANOC and 68Ga-DOTATOC, suggesting a higher diagnostic value of 68Ga-DOTATATE for detecting meningiomas. PMID:25369268

Meningiomas: a comparative study of 68Ga-DOTATOC, 68Ga-DOTANOC and 68Ga-DOTATATE for molecular imaging in mice.

Directory of Open Access Journals (Sweden)

María Luisa Soto-Montenegro

Full Text Available The goal of this study was to compare the tumor uptake kinetics and diagnostic value of three (68Ga-DOTA-labeled somatostatin analogues ((68Ga-DOTATOC, (68Ga-DOTANOC, and (68Ga-DOTATATE using PET/CT in a murine model with subcutaneous meningioma xenografts.The experiment was performed with 16 male NUDE NU/NU mice bearing xenografts of a human meningioma cell line (CH-157MN. (68Ga-DOTATOC, (68Ga-DOTANOC, and (68Ga-DOTATATE were produced in a FASTLab automated platform. Imaging was performed on an Argus small-animal PET/CT scanner. The SUVmax of the liver and muscle, and the tumor-to-liver (T/L and tumor-to-muscle (T/M SUV ratios were computed. Kinetic analysis was performed using Logan graphical analysis for a two-tissue reversible compartmental model, and the volume of distribution (Vt was determined.Hepatic SUVmax and Vt were significantly higher with (68Ga-DOTANOC than with (68Ga-DOTATOC and (68Ga-DOTATATE. No significant differences between tracers were found for SUVmax in tumor or muscle. No differences were found in the T/L SUV ratio between (68Ga-DOTATATE and (68Ga-DOTATOC, both of which had a higher fraction than (68Ga-DOTANOC. The T/M SUV ratio was significantly higher with (68Ga-DOTATATE than with (68Ga-DOTATOC and (68Ga-DOTANOC. The Vt for tumor was higher with (68Ga-DOTATATE than with (68Ga-DOTANOC and relatively similar to that of (68Ga-DOTATOC.This study demonstrates, for the first time, the ability of the three radiolabeled somatostatin analogues tested to image a human meningioma cell line. Although Vt was relatively similar with (68Ga-DOTATATE and (68Ga-DOTATOC, uptake was higher with (68Ga-DOTATATE in the tumor than with (68Ga-DOTANOC and (68Ga-DOTATOC, suggesting a higher diagnostic value of (68Ga-DOTATATE for detecting meningiomas.

Labeling of monoclonal antibody conjugates with 90Y

International Nuclear Information System (INIS)

Motta-Hennessy, Cecilia; Sharkey, R.M.; Goldenberg, D.M.

1991-01-01

An anti-carcinoembryonic antigen (CEA) antibody, NP-4, was labeled with 90 Y using p-isothiocyanatobenzyl DTPA (SCN-Bz-DTPA) and its derivatives 1-(p-isothiocyanatobenzyl)-3-methyl-DTPA (1B3M), 2-(p-isothiocyanatobenzyl)-4-methyl-DTPA (1M3B), 1-(2)-methyl-4-isothiocyanatobenzyl-DTPA (MX-DTPA) as the chelating agents. The 90 Y conjugates were purified from unbound 90 Y by two different methods, HPLC or acrylamide size exclusion gel chromatography, in order to evaluate the best purification method. Labeling efficiency, reaction kinetics and immunoreactivity were compared to the same antibodies labeled with [ 111 In]citrate. Labeling efficiency, as determined by either HPLC or ITLC (instant thin layer chromatography), was consistently higher by ITLC than HPLC for 90 Y-labeled MAb, but equal for 111 In-labeled MAbs. Discrepancies between the 2 methods were linked to impurities in the 90 Y that remained at the origin of ITLC plates. After purification by acrylamide gel filtration, recovery was 50-60% of loaded 90 Y activity, but was more than 87% for the 111 In compounds. Using HPLC, the recovery measured 85% for 90 Y-labeled MAb and more than 93% for 111 In-labeled conjugates. Immunoreactivity of the [ 90 Y]MAb was comparable to the 111 In-labeled conjugates. These studies indicate that HPLC purification of the [ 90 Y] MAbs improves recovery of activity, and suggests that impurities found in the 90 Y and metal-binding properties of acrylamide may have contributed to the poor recoveries from acrylamide gels. (author)

Chemotherapy synergizes with radioimmunotherapy targeting La autoantigen in tumors.

Directory of Open Access Journals (Sweden)

Fares Al-Ejeh

Full Text Available To date, inefficient delivery of therapeutic doses of radionuclides to solid tumors limits the clinical utility of radioimmunotherapy. We aim to test the therapeutic utility of Yttrium-90 ((90Y-radio-conjugates of a monoclonal antibody, which we showed previously to bind specifically to the abundant intracellular La ribonucleoprotein revealed in dead tumor cells after DNA-damaging treatment.Immunoconjugates of the DAB4 clone of the La-specific monoclonal antibody, APOMAB, were prepared using the metal chelator, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA, and then radiolabeled with (90Y. Mice bearing established subcutaneous tumors were treated with (90Y-DOTA-DAB4 alone or after chemotherapy. Non-radiosensitizing cyclophosphamide/etoposide chemotherapy was used for the syngeneic EL4 lymphoma model. Radiosensitizing cisplatin/gemcitabine chemotherapy was used for the syngeneic Lewis Lung carcinoma (LL2 model, and for the xenograft models of LNCaP prostatic carcinoma and Panc-1 pancreatic carcinoma. We demonstrate the safety, specificity, and efficacy of (90Y-DOTA-DAB4-radioimmunotherapy alone or combined with chemotherapy. EL4 lymphoma-bearing mice either were cured at higher doses of radioimmunotherapy alone or lower doses of radioimmunotherapy in synergy with chemotherapy. Radioimmunotherapy alone was less effective in chemo- and radio-resistant carcinoma models. However, radioimmunotherapy synergized with radiosensitizing chemotherapy to retard significantly tumor regrowth and so prolong the survival of mice bearing LL2, LNCaP, or Panc-1 subcutaneous tumor implants.We report proof-of-concept data supporting a unique form of radioimmunotherapy, which delivers bystander killing to viable cancer cells after targeting the universal cancer antigen, La, created by DNA-damaging treatment in neighboring dead cancer cells. Subsequently we propose that DAB4-targeted ionizing radiation induces additional cycles of tumor cell death

Separation of 90Sr from Purex high level waste and development of a 90Sr-90Y generator

International Nuclear Information System (INIS)

Ramanujam, A.; Dhami, P.S.; Chitnis, R.R.; Achuthan, P.V.; Kannan, R.; Gopalakrishnan, V.; Balu, K.

2000-04-01

90 Y (T 1/2 =64.2 h) finds several applications in nuclear medicine. It is formed from the decay of 90 Sr which has a long half-life of 28.8 years. 90 Sr can be used as a long-lasting source for the production of carrier-free 90 Y. 90 Sr itself is abundantly available in high level waste (HLW) of PUREX origin. The present studies deal with the separation of pure 90 Sr from HLW and the subsequent separation of 90 Y from 90 Sr. Actinides and some of the fission products like lanthanides, zirconium, molybdenum and cesium were first removed from the HLW using methods based on solvent extraction and ion-exchange studied earlier in our laboratory. The resulting waste solution was used as a feed for the present process. The separation of 90 Sr from HLW was based on radiochemical method which involved a repeated scavenging with ferric hydroxide followed by strontium carbonate precipitation. The separation of 90 Y from 90 Sr was achieved by membrane separation technique. A compact generator is developed for this separation using a commercially available polytetrafluoroethylene (PTFE) membrane, impregnated with indigenously synthesised 2-ethylhexyl 2-ethylhexyl phosphonic acid (KSM-17). Generator system overcomes the drawbacks associated with conventional solvent extraction and ion-exchange based generators. The product is in chloride form and is suitable for complexation studies. After gaining an operating experience of ∼3 years in generating carrier-free 90 Y at 2 mCi level for initial studies in radiotherapeutic applications, the process was scaled up for the production of about 12 mCi of 90 Y to be used for animal studies before its application to patients. Radiochemical and chemical purity of the product was critically assayed by radiometry, ICP-AES, etc. The process is amenable for further scaling up. (author)

Radical surgery after chemotherapy: a new therapeutic strategy to envision in grade II glioma.

Science.gov (United States)

Duffau, Hugues; Taillandier, Luc; Capelle, Laurent

2006-11-01

While surgery is proned in low-grade glioma (LGG), the invasion of functional areas frequently prevents a complete resection. We report the first case of a patient operated on for a left frontal LGG, diagnosed because of seizures, with partial resection due to an invasion of the controlateral hemisphere. Chemotherapy enabled a regression of this controlateral extension. Postchemotherapy surgery performed with intraoperative functional mapping then allowed a complete resection, without sequelae. The patient has a normal socio-professional life, with no seizure. No other treatment was given. There was no recurrence, with a follow-up of 2 years since the second surgery (3.5 years since the first symptom). We propose a new therapeutic strategy in unresectable LGG, with preoperative chemotherapy, to make a radical surgery possible in a second step, while preserving the quality of life.

{sup 90}Y Production and Its Biodistribution in Mice; Pembuatan {sup 90}Y dan Biodistribusinya ke Mencit

Energy Technology Data Exchange (ETDEWEB)

Tri-Murni,; Cahyana,; Triyanto,; Djoharly,; Abidin,; Dede-K,; Karyadi, [Center for Development of Radioisotope and Radiopharmacentical(Indonesia)

2001-11-15

Yttrium - 90 is radioisotope emitting pure {beta} with maximum energy of 2.27 MeV while its average {beta} energy is 0.93 MeV. {sup 90}Y radioisotope was produced utilizing G.A Siwabessy reactor employing thermal neutron capture process. In nuclear medicine this radioisotope is utilized for bone mettastase palliative and curative therapies. Parameters in this research were the weight of natural Y{sub 2}O{sub 3} target, irradiation time in the reactor, radiochemical purity and specific activity. The end product of the process is YCl{sub 3}, in saline solution. Then sterility of the {sup 90}Y radioisotope so produced is tested and its biodistribution analysis results in mice organs show that the percentage of this radioisotope in the liver is much higher than the ones in heart, kidneys, lung and intestine. Therefore it is concluded that {sup 90}Y radioisotope in the form of YCl{sub 3} can be utilized as a radiopharmaceutical in nuclear medicine. (author)

Genetically modified vaccines augment the efficacy of cancer surgery and chemotherapy

Czech Academy of Sciences Publication Activity Database

Bubeník, Jan

2009-01-01

Roč. 55, č. 6 (2009), s. 199-200 ISSN 0015-5500 Institutional research plan: CEZ:AV0Z50520514 Keywords : genetically modified vaccines * cancer surgery and chemotherapy Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 0.924, year: 2009

Using Cherenkov Counting For Fast Determination of 90Sr/90Y Activity in Milk

International Nuclear Information System (INIS)

Tsroya, S.; Dolgin, B.; German, U.; Pelled, O.; Alfassi, Z. B.

2014-01-01

90Sr is one of the main long-lived fission products, and it is transferred into human body primarily by food, with milk being a substantial contributor. Due to its biochemical similarity to calcium, most strontium is efficiently incorporated into bone tissues. 90Sr is characterized by a long physical half life (28.8 y) and decays by beta particles with an Emax of 0.546 MeV to 90Y. This daughter isotope has a half life of 64 h and decays into 90Zr by beta particles with an Emax of 2.284 MeV. The milk components produce a high turbidity and light attenuation, causing a significant decrease of the counting efficiency in liquid scintillation counting (LSC) systems, mostly used for beta emitters detection. Most methods proposed in the past are time-consuming, as they are based on several stages of chemical and physical treatments, including precipitation, ashing, ion exchange and extraction (Wikins et al., 1984, Porter et al, 1961, Kimura et al., 1979). When measuring 90Sr/90Y activity by Cherenkov counting, most of the Cherenkov radiation is produced by 90Y (about 98.6%), due to the much higher energy of its beta particles relative to these from 90Sr. The counting efficiency varies strongly with color quenching, at a greater extent than in standard liquid scintillation counting (L'Annunziata, 2012), and therefore the quench correction is critical. The ‘‘external source area ratio’’ (ESAR) quench correction method was applied to measure 90Sr/90Y activities in aqueous samples with a wide range of quenching levels (Tsroya et al., 2009). This method was proved to be superior to all other quench correction methods (Tsroya et al., 2012) and is applicable also for determination of 90Sr/90Y in human urine (Tsroya et al., 2013). In the present work the applicability of the ESAR method to measurement of 90Sr/90Y activities in milk and some of its products was investigated

Utilization of a novel electrochemical {sup 90}Sr/{sup 90}Y generator for the preparation of {sup 90}Y-labeled RGD peptide dimer in clinically relevant dose

Energy Technology Data Exchange (ETDEWEB)

Chakraborty, Sudipta; Chakravarty, Rubel; Pillai, Maroor Raghavan Ambikalmajan; Dash, Ashutosh [Bhabha Atomic Research Centre, Mumbai (India). Radiopharmaceuticals Div.; Sarma, Haladhar Dev [Bhabha Atomic Research Centre, Mumbai (India). Radiation Biology and Health Sciences Div.

2014-09-01

The work reported in this paper provides a systematic study towards the development of an optimized strategy for preparation of a clinically relevant dose of {sup 90}Y-labeled dimeric RGD peptide derivative, DOTA-E[c(RGDfK)]{sub 2} [DOTA-(RGD){sub 2}] for in vivo targeted therapy utilizing {sup 90}Y obtained from a novel electrochemical {sup 90}Sr/{sup 90}Y generator. The performance of the generator was evaluated to ensure its suitability for providing {sup 90}Y in adequate quantity and purity required for formulation of clinically relevant dose for PRRT. {sup 90}Y-DOTA-(RGD){sub 2} was synthesized in high yield (86.2 ± 2.5%) and radiochemical purity (98.4 ± 0.5%) using clinically relevant dose (∝ 3.8 GBq) of {sup 90}Y. In vitro stability studies revealed that the radiolabeled conjugate retained its radiochemical purity in normal saline and human serum. Preliminary biodistribution studies carried out in C57/BL6 mice bearing melanoma tumors showed that the preparation exhibited significant tumor uptake (5.30 ± 0.78% of injected activity at 30 min post-injection) with good tumor to background ratio. The optimized radiolabeling protocol seems to be an attractive strategy which is largely viewed as a springboard to realize scope of developing {sup 90}Y labeled cyclic RGD peptides for targeted therapy of tumors over-expressing integrin-α{sub ν}β{sub 3} receptors. (orig.)

Physiological and tumoral uptake of 68Ga-DOTATATE. Standardized uptake values and challenges in interpretation

International Nuclear Information System (INIS)

Kuyumcu, Serkan; Oezkan, Zeynep Goezde; Sanli, Yasemin; Yilmaz, Ebru; Mudun, Ayse; Adalet, Isik; Unal, Seher

2013-01-01

The objective of this study is to determine the range of standardized uptake value (SUV) max of 68Ga-DOTA-tyr3-octreotate (DOTATATE) in normal organs and tumoral lesions and establish uptake unrelated to neuroendocrine tumors (NET). One hundred and twenty patients (57 men, 63 women), who underwent 68 Ga-DOTATATE positron emission tomography (PET)/CT imaging in our institution were analyzed. Patients were indicated for 68 Ga-DOTATATE PET/CT imaging to detect primary tumor or metastasis of suspected or previously known NET, to determine somatostatin receptor (SSTR) positivity and to detect occult source of ectopic Cushing syndrome. Normal range of uptake was calculated for the organs that were proven to have no pathology by either conventional radiological imaging or clinical follow-up, using SUV max as a semiquantitative measure. Uptake and tumor to background (T/B) ratios of tumoral lesions in liver, pancreas, bone, brain and lymph nodes were calculated. Uptakes due to lesions unrelated to NET were also documented. Significant uptake was found in spleen, kidneys, adrenal glands, liver and pituitary gland with mean SUV max of 24.67, 14.30, 13.73, 9.12 and 9.74 respectively. Uptake was measured separately for the pancreatic head and body separately, however, besides a slightly heterogeneous uptake; the difference was not statistically significant. Uptake in the tumoral lesions had high (T/B) ratios with mean SUV max of 28.72, 25.21, 18.28, 34.73 and 12.59 for liver, pancreas, bone, brain and lymph nodes, respectively. Incidental benign tumoral lesions were detected in 3 patients (2.5%) which were meningioma and fibrous dysplasia demonstrating significant and breast fibroadenoma demonstrating mild 68 Ga-DOTATATE uptake. Non-neoplastic processes were detected in 4 patients (14.1%), including postsurgical inflammation, reactive lymph nodes, arthritis and demonstrated faint to mild 68 Ga-DOTATATE uptake, with the exception of significant uptake in accessory spleen. 68 Ga-DOTATATE

Lu-177 DOTA-TATE for peptide receptor radionuclide therapy (PRRT): organ-, tumor- and blood kinetics

International Nuclear Information System (INIS)

Wehrmann, C.; Senftleben, S.; Baum, R.P.

2007-01-01

liver metastases). The resulting dose to the red marrow was 0.2+/-0.1Sv. Conclusions: The relatively low organ doses compared to Y-90 labelled peptides for PRRT correlate with the low clinical toxicity of the radiopharmaceutical. The effective treatment of patients with neuroendocrine tumors using Lu-177 DOTA-TATE is confirmed by the mean absorbed tumor doses. Individual patient dosimetry should be performed due to the large interindividual variations concerning the organ and tumor doses. (author)

Imaging benign pathology and variants with uptake in 68ga-Dotatate PET/CT studies

International Nuclear Information System (INIS)

Servente, L.; Bianco, C.; Gigirey, V.; Alonso, O.

2017-01-01

Purpose: To evaluate the physiological, anatomical variants and benign lesions in positron emission computed tomography (PET/CT) studies with 68Ga-DOTATATE.Materials and methods: We retrospectively reviewed PET/CT reports scanned with 68Ga-DOTATATE and selected those that contained words in the report related to anatomical, physiological variants and benign tumors. The degree of 68Ga-DOTATATE uptake was evaluated qualitatively and quantitatively by measuring the standarized uptake max value (SUVmax value). The anatomical location, SUVmax value and morphological CT image findings were recorded. All cases had clinical and imaging follow-up. Results: From a total of 772 PET/CT reports, 28 patients were obtained with 33 benign variants or tumors, 14 females and 14 males with a median age of 63 years. Uptake patterns were classified into four groups: anatomic and physiological variants (15), dependent on osteoblastic activity (4), dependent on inflammatory activity (10) and non-neuro-endocrine benign tumors (4).Discussion: Somatostatin receptors are overexpressed not only in the neuroendocrine system but also in other tissues. Physiological, anatomical variants and benign tumors expressing these receptors may be misleading. In the present work the frequency of this finding is 5.1%.Conclusion: Physiological variants and benign lesions (tumor and inflammatory) can accumulate 68Ga-DOTATATE since their tissues can express somatostatin receptors. The semiologic analysis of the tomographic component of this hybrid method enhances the diagnostic efficacy, optimizing PET/CT study performance. (authors) [es

Comparing Intra-Arterial Chemotherapy Combined With Intravesical Chemotherapy Versus Intravesical Chemotherapy Alone: A Randomised Prospective Pilot Study for T1G3 Bladder Transitional Cell Carcinoma After Bladder-Preserving Surgery

Energy Technology Data Exchange (ETDEWEB)

Chen, Junxing, E-mail: Junxingchen@hotmail.com; Yao, Zhijun, E-mail: yaozhijun1985@qq.com; Qiu, Shaopeng, E-mail: qiushp@mail.sysu.edu.cn; Chen, Lingwu, E-mail: chenlingwu@hotmail.com [First Affiliated Hospital of Sun Yat-Sen University, Department of Urology (China); Wang, Yu, E-mail: zsyyjr@163.com; Yang, Jianyong, E-mail: yangjianyong_2011@163.com; Li, Jiaping, E-mail: jpli3s@126.com [First Affiliated Hospital of Sun Yat-Sen University, Department of Interventional Oncology (China)

2013-12-15

Purpose: To compare the efficacy of intra-arterial chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone for T1G3 bladder transitional cell carcinoma (BTCC) followed by bladder-preserving surgery. Materials and Methods: Sixty patients with T1G3 BTCC were randomly divided into two groups. After bladder-preserving surgery, 29 patients (age 30-80 years, 24 male and 5 female) received intra-arterial chemotherapy in combination with intravesical chemotherapy (group A), whereas 31 patients (age 29-83 years, 26 male and 5 female) were treated with intravesical chemotherapy alone (group B). Twenty-nine patients were treated with intra-arterial epirubicin (50 mg/m{sup 2}) + cisplatin (60 mg/m{sup 2}) chemotherapy 2-3 weeks after bladder-preserving surgery once every 4-6 weeks. All of the patients received the same intravesical chemotherapy: An immediate prophylactic was administered in the first 6 h. After that, therapy was administered one time per week for 8 weeks and then one time per month for 8 months. The instillation drug was epirubicin (50 mg/m{sup 2}) and lasted for 30-40 min each time. The end points were tumour recurrence (stage Ta, T1), tumour progression (to T2 or greater), and disease-specific survival. During median follow-up of 22 months, the overall survival rate, tumour-specific death rate, recurrence rate, progression rate, time to first recurrence, and adverse reactions were compared between groups. Results: The recurrence rates were 10.3 % (3 of 29) in group A and 45.2 % (14 of 31) in group B, and the progression rates were 0 % (0 of 29) in group A and 22.6 % (7 of 31) in group B. There was a significant difference between the two groups regarding recurrence (p = 0.004) and progression rates (p = 0.011). Median times to first recurrence in the two groups were 15 and 6.5 months, respectively. The overall survival rates were 96.6 and 87.1 %, and the tumour-specific death rates were 0 % (0 of 29) and 13.5 % (4 of 31

Efficacy of adjuvant chemotherapy after surgery when considered over all cancer types: a synthesis of meta-analyses.

Science.gov (United States)

Bowater, Russell J; Abdelmalik, Sally M E; Lilford, Richard J

2012-10-01

Despite a large number of clinical trials having been conducted to assess the efficacy of adjuvant chemotherapy after surgery for various cancers, whether it is best to use this treatment remains a generally contentious issue for many common cancers. The purpose of this study was to ascertain whether any general conclusions can be drawn about the efficacy or inefficacy of this treatment within different cancer classifications. Meta-analyses of randomized, controlled trials (RCTs) of adjuvant chemotherapy after surgery were synthesized over as many types of cancer as possible. Data sources were Medline, Embase, and the Cochrane library. Eligible meta-analyses were meta-analyses of RCTs for any type of cancer that compared surgery followed by adjuvant chemotherapy with surgery followed by no adjuvant chemotherapy. The literature search found 25 meta-analyses for 15 cancer types that satisfied the criteria necessary for detailed analysis within this study. The estimates of relative risk for all cause mortality were reported as being less than one (indicating adjuvant chemotherapy is beneficial) by all meta-analyses apart from a meta-analysis for colorectal cancer metastasized to the liver. Moreover, 15 of these meta-analyses also reported that the 95% confidence interval for this relative risk is less than one (indicating statistical significance at the 5% level). The results for all cancer types included in this study except for cancer metastasized to the liver can be thought of as supporting each other through the idea of there being a common treatment effect or at least a common range of effect across all (or most) of these cancer types. For example, with regard to cancer types where the evidence in favor of adjuvant chemotherapy after surgery is only moderately strong, the results of this study may encourage more clinicians to regard the use of this treatment as standard practice.

Use of Intra-Arterial Chemotherapy and Embolization Before Limb Salvage Surgery for Osteosarcoma of the Lower Extremity

International Nuclear Information System (INIS)

Zhang Huojun; Yang Jijin; Lu Jianping; Lai Chaojen; Sheng Jin; Li Yuxiao; Hao Qiang; Zhang Shunmin; Gupta, Sanjay

2009-01-01

We report our experience with the use of intra-arterial chemotherapy and embolization before limb salvage surgery in patients with osteosarcoma of the lower extremity. We evaluated the effect of this procedure on the degree of tumor necrosis and on the amount of blood loss during surgery. We reviewed the medical records of all patients who received intra-arterial chemotherapy and embolization before undergoing limb salvage surgery for osteosarcoma of the lower extremity at our institution between January 2003 and April 2008. Patient demographic, tumor characteristics, treatment details, postembolization complications, and surgical and pathological findings were recorded for each patient. We evaluated the operative time, estimated blood loss (EBL), and volume of blood transfusion during surgery and in the postoperative period in all patients in the study group. The same parameters were recorded for 65 other patients with lower extremity osteosarcoma who underwent limb salvage operation at our institution without undergoing preoperative intervention. The study included 47 patients (25 males and 22 females). Angiography showed that the tumors were hypervascular. Intra-arterial chemotherapy and embolization were performed successfully, resulting in a substantial reduction or complete disappearance of tumor stain in all patients. No major complications were encountered. At the time of surgery, performed 3-7 days after embolization, a fibrous edematous band around the tumor was observed in 43 of the 47 patients, facilitating surgery. The goal of limb salvage was achieved successfully in all cases. Percentage tumor necrosis induced by treatment ranged from 70.2% to 94.2% (average, 82.9%). EBL during surgery, EBL from drains in the postoperative period, total EBL, and transfusion volumes were significantly lower in the 47 study patients compared to the 65 patients who underwent surgery without preoperative treatment with intra-arterial chemotherapy and embolization. The

Survival and neurologic outcome of infants with medulloblastoma treated with surgery and MOPP chemotherapy. A preliminary report.

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Baram, T Z; van Eys, J; Dowell, R E; Cangir, A; Pack, B; Bruner, J M

1987-07-15

The results of treatment of infants with medulloblastoma using surgery and chemotherapy, without the use of radiation therapy, are reported. Both survival and outcome, in terms of growth, neurologic deficit, and intelligence are compared with the same parameters in children treated conventionally. Although preliminary, our results suggest that chemotherapy combined with surgery is a valid option for the treatment of infants with this type of neoplasm.

A special mini-extrapolation chamber for calibration of 90Sr+90Y sources

International Nuclear Information System (INIS)

Oliveira, Mercia L; Caldas, Linda V E

2005-01-01

90 Sr+ 90 Y applicators are commonly utilized in brachytherapy, including ophthalmic procedures. The recommended instruments for the calibration of these applicators are extrapolation chambers, which are ionization chambers that allow the variation of their sensitive volume. Using the extrapolation method, the absorbed dose rate at the applicator surface can be determined. The aim of the present work was to develop a mini-extrapolation chamber for the calibration of 90 Sr+ 90 Y beta ray applicators. The developed mini-chamber has a 3.0 cm outer diameter and is 11.3 cm in length. An aluminized polyester foil is used as the entrance window while the collecting electrode is made of graphited polymethylmethacrylate. This mini-chamber was tested in 90 Sr+ 90 Y radiation beams from a beta particle check source and with a plane ophthalmic applicator, showing adequate results

Verification dosimetry of intravascular 90Sr/90Y source trains

International Nuclear Information System (INIS)

Sharma, S.D.; Shanta, A.; Tripathi, U.B.; Bhatt, B.C.

2001-01-01

90 Sr/ 90 Y source trains (Novoste Beta-Cath System) are currently under clinical trials in India and abroad for intracoronary brachytherapy for prevention of restenosis. Each source train of the Beta-Cath system is supplied with a source certificate giving dose rate at the reference distance of 2 mm from the centerline of the source train. It is essential that the user should check dose rates of brachytherapy sources before its application on the patients. Dose rates and depth dose measurements for 90 Sr/ 90 Y source trains of active length 40 mm using radiochromic films in a tissue equivalent phantom have been carried out. The objectives of these measurements were (1) to verify the dose rates stated in the source certificate, and (2) to obtain relative depth dose data for treatment planning. This paper presents the results of these measurements

Labeling of monoclonal antibody conjugates with sup 90 Y

Energy Technology Data Exchange (ETDEWEB)

Motta-Hennessy, Cecilia; Sharkey, R.M.; Goldenberg, D.M. (Center for Molecular Medicine and Immunology, Newark, NJ (USA))

1991-01-01

An anti-carcinoembryonic antigen (CEA) antibody, NP-4, was labeled with {sup 90}Y using p-isothiocyanatobenzyl DTPA (SCN-Bz-DTPA) and its derivatives 1-(p-isothiocyanatobenzyl)-3-methyl-DTPA (1B3M), 2-(p-isothiocyanatobenzyl)-4-methyl-DTPA (1M3B), 1-(2)-methyl-4-isothiocyanatobenzyl-DTPA (MX-DTPA) as the chelating agents. The {sup 90}Y conjugates were purified from unbound {sup 90}Y by two different methods, HPLC or acrylamide size exclusion gel chromatography, in order to evaluate the best purification method. Labeling efficiency, reaction kinetics and immunoreactivity were compared to the same antibodies labeled with ({sup 111}In)citrate. Labeling efficiency, as determined by either HPLC or ITLC (instant thin layer chromatography), was consistently higher by ITLC than HPLC for {sup 90}Y-labeled MAb, but equal for {sup 111}In-labeled MAbs. Discrepancies between the 2 methods were linked to impurities in the {sup 90}Y that remained at the origin of ITLC plates. After purification by acrylamide gel filtration, recovery was 50-60% of loaded {sup 90}Y activity, but was more than 87% for the {sup 111}In compounds. Using HPLC, the recovery measured 85% for {sup 90}Y-labeled MAb and more than 93% for {sup 111}In-labeled conjugates. Immunoreactivity of the ({sup 90}Y)MAb was comparable to the {sup 111}In-labeled conjugates. These studies indicate that HPLC purification of the ({sup 90}Y) MAbs improves recovery of activity, and suggests that impurities found in the {sup 90}Y and metal-binding properties of acrylamide may have contributed to the poor recoveries from acrylamide gels. (author).

Combination of chemotherapy, radiotherapy and surgery in the treatment of oral cancer

International Nuclear Information System (INIS)

Ayyagiri, S.; Gupta, B.D.; Dutta, T.K.

1980-01-01

In locally advanced oral cancer, the main modalities of treatment, e.g. surgery and radiotherapy, most often fail to control the disease when used singly. A combination policy of surgery and radiotherapy achieves adequate control of the disease. In order to improve the results in advanced oral cancer, chemotherapy given prior to and during radiation treatment and judicious combination of surgery offer the best possible approach in the management. The experience in the combination policy in the treatment of oral cancer in Northern India is dealt with. (auth.)

Targeting post-infarct inflammation by PET imaging: comparison of 68Ga-citrate and 68Ga-DOTATATE with 18F-FDG in a mouse model

International Nuclear Information System (INIS)

Thackeray, James T.; Bankstahl, Jens P.; Walte, Almut; Wittneben, Alexander; Bengel, Frank M.; Wang, Yong; Korf-Klingebiel, Mortimer; Wollert, Kai C.

2015-01-01

Imaging of inflammation early after myocardial infarction (MI) is a promising approach to the guidance of novel molecular interventions that support endogenous healing processes. 18 F-FDG PET has been used, but may be complicated by physiological myocyte uptake. We evaluated the potential of two alternative imaging targets: lactoferrin binding by 68 Ga-citrate and somatostatin receptor binding by 68 Ga-DOTATATE. C57Bl/6 mice underwent permanent coronary artery ligation. Serial PET imaging was performed 3 - 7 days after MI using 68 Ga-citrate, 68 Ga-DOTATATE, or 18 F-FDG with ketamine/xylazine suppression of myocyte glucose uptake. Myocardial perfusion was evaluated by 13 N-ammonia PET and cardiac geometry by contrast-enhanced ECG-gated CT. Mice exhibited a perfusion defect of 30 - 40 % (of the total left ventricle) with apical anterolateral wall akinesia and thinning on day 7 after MI. 18 F-FDG with ketamine/xylazine suppression demonstrated distinct uptake in the infarct region, as well as in the border zone and remote myocardium. The myocardial standardized uptake value in MI mice was significantly higher than in healthy mice under ketamine/xylazine anaesthesia (1.9 ± 0.4 vs. 1.0 ± 0.1). 68 Ga images exhibited high blood pool activity with no specific myocardial uptake up to 90 min after injection (tissue-to-blood contrast 0.9). 68 Ga-DOTATATE was rapidly cleared from the blood, but myocardial SUV was very low (0.10 ± 0.03). Neither 68 Ga nor 68 Ga-DOTATATE is a useful alternative to 18 F-FDG for PET imaging of myocardial inflammation after MI in mice. Among the three tested approaches, 18 F-FDG with ketamine/xylazine suppression of cardiomyocyte uptake remains the most practical imaging marker of post-infarct inflammation. (orig.)

Radiochemistry, pre-clinical studies and first clinical investigation of 90Y-labeled hydroxyapatite (HA) particles prepared utilizing 90Y produced by (n,γ) route

International Nuclear Information System (INIS)

Vimalnath, K.V.; Chakraborty, Sudipta; Rajeswari, A.; Sarma, H.D.; Nuwad, Jitendra; Pandey, Usha; Kamaleshwaran, K.; Shinto, Ajit; Dash, Ashutosh

2015-01-01

Introduction: The scope of using no carrier added (NCA) 90 Y [T 1/2 = 64.1 h, E β(max) = 2.28 MeV] obtained from 90 Sr/ 90 Y generator in radiation synovectomy (RSV) is widely accepted. In the present study, the prospect of using 90 Y produced by (n,γ) route in a medium flux research reactor for use in RSV was explored. Methods: Yttrium-90 was produced by thermal neutron irradiation of Y 2 O 3 target at a neutron flux of ~ 1 × 10 14 n/cm 2 .s for 14 d. The influence of various experimental parameters were systematically investigated and optimized to arrive at the most favorable conditions for the formulation of 90 Y labeled hydroxyapatite (HA) using HA particles of 1–10 μm size range. An optimized kit formulation strategy was developed for convenient one-step compounding of 90 Y-HA, which is easily adaptable at hospital radiopharmacy. The pre-clinical biological evaluation of 90 Y-HA particles was studied by carrying out biodistribution and bioluminiscence imaging studies in Wistar rats. The first clinical investigation using the radiolabeled preparation was performed on a patient suffering from chronic arthritis in knee joint by administering 185 MBq 90 Y-HA formulated at the hospital radiopharmacy deploying the proposed strategy. Results: Yttrium-90 was produced with a specific activity of 851 ± 111 MBq/mg and radionuclidic purity of 99.95 ± 0.02%. 90 Y-labeled HA particles (185 ± 10 MBq doses) were formulated in high radiochemical purity (> 99%) and excellent in vitro stability. The preparation showed promising results in pre-clinical studies carried out in Wistar rats. The preliminary results of the first clinical investigation of 90 Y-HA preparation in a patient with rheumatoid arthritis in knee joints demonstrated the effectiveness of the formulation prepared using 90 Y produced via (n,γ) route in the management of the disease. Conclusion: The studies revealed that effective utilization of 90 Y produced via (n,γ) route in a medium flux research

Vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving chemotherapy and conservative surgery.

Science.gov (United States)

Mabuchi, Yasushi; Yahata, Tamaki; Kobayashi, Aya; Tanizaki, Yuko; Minami, Sawako; Ino, Kazuhiko

2015-06-01

Vaginal carcinoma is a rare gynecological malignancy that is usually treated by radiation therapy and/or surgery combined with chemotherapy. Here, we report a case of invasive vaginal carcinoma in a young woman who underwent fertility-sparing treatment involving neoadjuvant chemotherapy and conservative surgery. A 36-year-old non-parous woman had a solid tumor in the vagina. Positron emission tomography/computed tomography showed a tumor in the vagina with high FDG uptake (SUV = 17.33) but no metastatic lesions. The patient was diagnosed with vaginal squamous cell carcinoma, FIGO stage I, T1N0M0. Because she wished to retain her fertility, neoadjuvant chemotherapy consisting of irinotecan hydrochloride and nedaplatin was initiated. After four courses of chemotherapy, partial vaginectomy was carried out and the pathological diagnosis of the residual lesion was VAIN 3. Following two further courses of the same chemotherapy, she obtained complete response, and has shown no evidence of disease for 14 months. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Favorable Response of Metastatic Merkel Cell Carcinoma to Targeted 177Lu-DOTATATE Therapy: Will PRRT Evolve to Become an Important Approach in Receptor-Positive Cases?

Science.gov (United States)

Basu, Sandip; Ranade, Rohit

2016-06-01

This report illustrates an excellent partial response of Merkel cell carcinoma with multiple bilobar hepatic metastases to a single cycle of peptide receptor radionuclide therapy (PRRT) with (177)Lu-DOTATATE. This response, coupled with minimal side effects, warrants consideration of this therapy early in the disease course (rather than at an advanced stage after failure of other therapies) if the metastatic lesions exhibit adequate tracer avidity on somatostatin receptor-based imaging. Our patient showed progression of systemic disease after having undergone a second surgery and adjuvant radiotherapy to the head and neck, as well as chemotherapy, and hence was considered a candidate for PRRT. In a pretreatment study, the metastatic lesions demonstrated avidity to both somatostatin receptors and (18)F-FDG. Three months after the first cycle of treatment, when the patient was being evaluated for a second cycle, both imaging parameters showed evidence of a partial response that included nearly complete resolution of the two previously seen lesions. In view of the relatively good tolerability, minimal side effects, and targeted nature of the treatment, PRRT may evolve to become the first-line therapy for metastatic Merkel cell carcinoma and should be examined further in a larger number of patients. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

The Efficacy of Dextran-40 as a Venous Thromboembolism Prophylaxis Strategy in Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Science.gov (United States)

Foster, Jason M; Sleightholm, Richard; Watley, Duncan; Wahlmeier, Steven; Patel, Asish

2017-02-01

The incidence of venous thromboembolism (VTE) in peritoneal malignancies can approach 30 to 50 per cent without prophylaxis. Prophylaxis in cytoreductive surgeries (CRS) presents a challenge to preoperative heparin-based therapy because of an increased risk of coagulopathy and potential for bleeding. Herein, we report the large series of CRS and hyperthermic intraperitoneal chemotherapy receiving dextran-40 prophylaxis. Retrospective chart review of peritoneal malignancies patients undergoing CRS at University of Nebraska Medical Center identified 69 individuals who received dextran-40 between 2010 and 2013. The incidences of VTEs, perioperative bleeding, complications, morbidity, and mortality were determined in-hospital and at 90 days. Of the 69 patients treated, the 30-day VTE rate was 8.7 per cent, and no pulmonary embolisms, bleeding, anaphylactoid reaction, or mortality were observed with dextran usage. The specific VTE events included three upper extremity and three lower extremity VTEs. No additional VTE events were identified between 30 and 90 days. In conclusion, dextran-40 prophylaxis was not associated with any perioperative bleeding events, and the observed incidence of VTE was comparable to reported heparin-based prophylaxis in CRS/hyperthermic intraperitoneal chemotherapy patients. This data supports further exploration of dextran-40 as a VTE prophylactic agent in complex surgical oncology cases.

Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

International Nuclear Information System (INIS)

MacLeod, C.; O'Donnell, A.; Tattersall, M.H.N.; Dalrymple, C.; Firth, I.

2001-01-01

Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

Study of radionuclide 90Sr-90Y on cell proliferation and apoptosis in benign prostatic hyperplasia

International Nuclear Information System (INIS)

Zhang Tong; Wei Wei; Zou Benjie; Liu Fang; Xu Zhishun

2003-01-01

Objective: To investigate the effect of 90 Sr- 90 Yon cell proliferation and apoptosis in benign prostatic hyperplasia. Methods: The apoptosis and expression of Ki-67 in benign prostatic hyperplasia (BPH) before and after irradiation 90 Sr- 90 Y were detected by transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and immunohistochemical technique, respectively. Results: The proliferation index (PI) of BPH after 90 Sr- 90 Y irradiation was much lower than that before irradiation, but there was no significant change in apoptosis index (AI). Conclusion: Irradiation with 90 Sr- 90 Y could restrain cell proliferation of BPH, but could not induce apoptosis

Internal Dosimetry in therapy with 90Y

International Nuclear Information System (INIS)

Torres, Leonel; Vergara, Alex; García, Leonardo

2016-01-01

Introduction: 90 Y has shown satisfactory results in the therapy of multiple oncological diseases. This radionuclide has been widely used in therapy of diseases such as NHL (Zevalin), TNE ( 90 Y-DOTATOC), liver cancer, etc. Its safe and effective use presupposes the availability of accurate dosimetry methods and reproducible.El objective of this work is to standardize and optimize images use procedures that allow for dosimetric estimates braking during therapy of malignant diseases 90 Y. Materials and Methods: To quantify the activity in absolute units from scans correction methods that consider the peculiarities of the bremsstrahlung of 90 Y were proposed. acquisition parameters such as the selection of the collimator and the definition of energy windows as well as methods of scatter correction, attenuation, interactions of radiation with the collimator (septal penetration and degradation of information with distance) were considered and sensitivity or calibration factor was estimated. They were evaluated and calibrated parameters for dosimetry at the level of organ and estimates of distributions 3D dose, using experimental measurements with SPECT Mediso Nucline ™ Spirit DH-V system and simulations were performed using the Monte Carlo method, using the SIMIND v5 software .0. Results: The optimum position-energy window width and collimator to be used is determined from the relationship between total photons and primary photons (T / P), calculated with SIMIND. The results were favorable to employ HEGP collimator and energy window between 90-170kev. the sensitivity of the system for the selected collimator (HEGP for 90 Y) was estimated. He was evaluated and determined the MTF order to correct dispersive plane images, the source-detector and interactions of radiation with the collimator distance, using filtering methods (Wiener filter), including empirical estimates of the SNR component. Similarly the procedure for the use of transmission maps obtained from

Comparison of Survival Rate in Primary Non-Small-Cell Lung Cancer Among Elderly Patients Treated With Radiofrequency Ablation, Surgery, or Chemotherapy

International Nuclear Information System (INIS)

Lee, Heon; Jin, Gong Yong; Han, Young Min; Chung, Gyung Ho; Lee, Yong Chul; Kwon, Keun Sang; Lynch, David

2012-01-01

Purpose: We retrospectively compared the survival rate in patients with non-small-cell lung cancer (NSCLC) treated with radiofrequency ablation (RFA), surgery, or chemotherapy according to lung cancer staging. Materials and Methods: From 2000 to 2004, 77 NSCLC patients, all of whom had WHO performance status 0–2 and were >60 years old, were enrolled in a cancer registry and retrospectively evaluated. RFA was performed on patients who had medical contraindications to surgery/unsuitability for surgery, such as advanced lung cancer or refusal of surgery. In the RFA group, 40 patients with inoperable NSCLC underwent RFA under computed tomography (CT) guidance. These included 16 patients with stage I to II cancer and 24 patients with stage III to IV cancer who underwent RFA in an adjuvant setting. In the comparison group (n = 37), 13 patients with stage I to II cancer underwent surgery; 18 patients with stage III to IV cancer underwent chemotherapy; and 6 patients with stage III to IV cancer were not actively treated. The survival curves for RFA, surgery, and chemotherapy in these patients were calculated using Kaplan–Meier method. Results: Median survival times for patients treated with (1) surgery alone and (2) RFA alone for stage I to II lung cancer were 33.8 and 28.2 months, respectively (P = 0.426). Median survival times for patients treated with (1) chemotherapy alone and (2) RFA with chemotherapy for stage III to IV cancer were 29 and 42 months, respectively (P = 0.03). Conclusion: RFA can be used as an alternative treatment to surgery for older NSCLC patients with stage I to II inoperable cancer and can play a role as adjuvant therapy with chemotherapy for patients with stage III to IV lung cancer.

Rapid determination of 90Sr impurities in freshly 'generator eluted'90Y for radiopharmaceutical preparation

International Nuclear Information System (INIS)

Bonardi, Mauro L.; Martano, Luigi; Groppi, Flavia; Chinol, Marco

2009-01-01

90 Y is one of the most useful radionuclides for radioimmunotherapeutic applications and has a half-life (t 1/2 =64.14 h) suitable for most therapeutic applications, beta particles of high energy and decays to a stable daughter. It is significant that 90 Y is available conveniently and inexpensively from a radionuclide 'generator' by decay of its parent, 90 Sr. Nevertheless, current and planned clinical applications with [ 90 Y] labelled compounds employ activity levels that cannot be readily obtained from an in-house generator, but from commercial sources. We have evaluated Eichrom's Sr-resin, either as an 'in-house' generator or as a fast QC method for analysis of 90 Y solutions. In particular, for the development as a generator, we investigated the percentage of the radio-Sr in the first 8 M HNO 3 eluate: in this fraction the concentration of 90 Sr must be smaller than 10 -5 % (recommendations of the International Commission on Radiological Protection). For evaluation as a rapid QC method, we analyzed the concentration of 90 Y in all the fractions containing 'only' radio-Sr: 90 Y should not be present in these eluates. After the collection of β - and γ spectra and analysis of them, we concluded that commercial Sr-resin minicolumn cannot give us the results expected; we developed an in-house system loaded with 4 mL of Sr-resin which gave better results as a generator and a rapid QC method.

{sup 177}Lu-DOTATATE therapy in patients with neuroendocrine tumours: 5 years' experience from a tertiary cancer care centre in India

Energy Technology Data Exchange (ETDEWEB)

Danthala, Madhav; Raghavendra Rao, M. [HCG Oncology Hospitals, Bangalore, Karnataka (India); Kallur, K.G.; Prashant, G.R.; Rajkumar, K. [HCG Oncology Hospitals, Department of Nuclear Medicine, Bangalore, Karnataka (India)

2014-07-15

The choice of an appropriate treatment option in patients with inoperable or metastatic neuroendocrine tumours (NETs) is limited, and approximately 50 % of patients have advanced NET at diagnosis, and 65 % die within 5 years. Treatment with {sup 177}Lu-DOTATATE ({sup 177}Lu-[DOTA{sup 0},Tyr{sup 3}] octreotate) is a promising new option in the treatment of metastatic NETs. Patients with metastatic NET who underwent {sup 177}Lu-DOTATATE during the period 2009 to 2013 were included in this retrospective study. Follow-up imaging studies including a {sup 68}Ga-DOTANOC PET/CT scan and a posttherapy {sup 177}Lu-DOTATATE scan were compared with baseline imaging to determine response to treatment. Progression-free survival (PFS) was calculated using the Kaplan-Meier method and Cox regression analysis was also done. Ten patients (25 %) had a minimal response, 13 (32.5 %) had a partial response and 9 (22.5 %) had stable disease. Progressive disease was seen in 8 patients (20 %), including 6 patients who died during or after the treatment period. The estimated mean PFS in those who received one or two cycles of {sup 177}Lu-DOTATATE was 8.3 months (95 % CI 6.2 to 10.3 months) compared to an estimated mean PFS of 45.6 months (95 % CI 40.9 to 50.2 months) in those who received more than two cycles of {sup 177}Lu-DOTATATE (log-rank Mantel-Cox Χ {sup 2} = 8.01, p = 0.005). Our study showed that treatment with {sup 177}Lu-DOTATATE should be considered in the management of NETs, considering the limited success of alternative treatment modalities. Treatment response and PFS is determined primarily by the dose delivered and best results are obtained when more than two cycles of {sup 177}Lu-DOTATATE are given, with careful monitoring for possible side effects. (orig.)

Blood clearance and occupational exposure for {sup 177}Lu-DOTATATE compared to {sup 177}Lu-PSMA radionuclide therapy

Energy Technology Data Exchange (ETDEWEB)

Abuqbeitah, Mohammad; Demir, Mustafa; Uslu-Besli, Lebriz; Yeyin, Nami; Soenmezoglu, Kerim [Istanbul University, Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul (Turkey)

2018-03-15

The main target of this work is to examine blood clearance and external exposure for {sup 177}Lu-DOTATATE compared with new emerging {sup 177}Lu-PSMA therapy. Blood clearance and radiation exposure of 31 patients treated with 5.5 ± 1.1 GBq {sup 177}Lu-DOTATATE were compared to those of 23 patients treated with 7.4 GBq {sup 177}Lu-PSMA. Dose rates were measured at several distances and time points up to 120 h after treatment. Blood samples were collected conjunctively after infusion. Caregiver's cumulative dose was measured by means of an OSL (optically stimulated luminescence) dosimeter for 4-5 days and medical staff's dose was also estimated using electronic personal dosimeters. Finger dose was determined via ring TLD (Thermoluminescence Dosimeter) for radiopharmacists and nurses. Dose rates due to {sup 177}Lu-DOTATATE at a distance of 1 m, 4 h and 6 h after infusion, were 3.0 ± 2.8 and 2 ± 1.9 μSv/(h GBq), respectively, while those due to {sup 177}Lu-PSMA were 3.1 ± 0.8 and 2.2 ± 0.9 μSv/(h GBq). Total effective dose of 17 caregivers was 100-200 μSv for {sup 177}Lu-DOTATATE therapy. Mean effective doses to nurses and radiopharmacists were 5 and 4 μSv per patient, respectively, while those for physicists and physicians were 2 μSv per patient. For {sup 177}Lu-DOTATATE, effective half-life in blood and early elimination phase were 0.31 ± 0.13 and 4.5 ± 1 h, while they were found as 0.4 ± 0.1 and 5 ± 1 h, respectively, for {sup 177}Lu-PSMA. The first micturition time following {sup 177}Lu-DOTATATE infusion was noted after 36 ± 14 min, while the second and third voiding times were after 74 ± 9 and 128 ± 41 min, respectively. It is concluded that blood clearance and radiation exposure for {sup 177}Lu-DOTATATE are very similar to those for {sup 177}Lu-PSMA, and both treatment modalities are reasonably reliable for outpatient treatment, since the mean dose rate [2.1 μSv/(h GBq)] decreased below the dose rate that allows release of the patient

Peptide receptor radionuclide therapy (PRRT) using Lu-177 DOTA-NOC and Lu-177 DOTA-TATE: Comparative results

International Nuclear Information System (INIS)

Wehrmann, C.; Senftleben, S.; Baum, R.P.

2007-01-01

Full text: Aim: One of the few treatment options for inoperable neuroendocrine tumors (NET) is peptide receptor radiotherapy with somatostatin analogues. DOTA-NOC shows the highest affinity to the somatostatin receptors (sstr) 3 and 5 and a very high affinity to sstr 2. We compared the dosimetric parameters uptake, half-life (kinetics) and mean absorbed organ and tumor doses of 177 Lu DOTANOC and 177 Lu DOTA-TATE. Methods: 139 patients with neuroendocrine tumors with high sstr expression (verified by Ga-68 DOTA-NOC PET/CT) were studied. 130 patients (57m, 73f; aged 60±11a) were treated with 2.5-7.4 GBq Lu-177 DOTA-TATE and 9 patients (3m, 6f, aged 64±10a) with 3.6-7.4 GBq Lu-177 DOTA-NOC. Whole-body scans were performed after 0.5h, 3h, 24h, 48h, 72h and 96h p.i. Blood samples from 23 patients were obtained after therapy. By means of geometric mean and after background correction, ROI results were used to calculate the estimated absorbed organ and tumor doses according to the MIRD-scheme (OLINDA software). Results: Lu-177 DOTA-NOC showed a higher uptake as compared to Lu-177 DOTATATE (=100%): for whole-body about 38% and in normal tissue 36%, in the spleen 17% and in the kidneys 18%. The tumor uptake was about 5% higher for DOTA-TATE. The effective half-life for whole-body was comparable for both peptides (t1/2a NOC 2.9h vs. TATE 2.4h and t1/2b NOC 54h vs. TATE 56h). In normal tissue, t1/2a was similar (NOC 3.3h; TATE 2.6h) but the t1/2b was longer for DOTA-TATE (NOC 43h; TATE 48h). t1/2b was longer for DOTA-NOC in the spleen (NOC 81h; TATE 72h) and in the kidney (NOC 68.1h; TATE 65h). The mean absorbed dose in the kidney (TATE 5Sv; NOC 6Sv) and spleen (TATE 7Sv; NOC 8Sv) was higher for DOTA-NOC. In the tumor, the t1/2b was higher for DOTA-TATE (NOC 65h; TATE 77h). For DOTA-TATE the whole-body dose was lower (0.27Sv) as compared to DOTA-NOC (0.38 Sv) (significant by unpaired sign test). The estimated mean absorbed tumor doses were 47+/-66 Sv for DOTA-TATE and 35

Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel

International Nuclear Information System (INIS)

Samim, Morsal; Veenendaal, Linde M. van; Braat, Manon N.G.J.A.; Hoven, Andor F. van den; Bosch, Maurice A.A.J. van den; Lam, Marnix G.E.H.; Hillegersberg, Richard van; Sangro, Bruno; Kao, Yung Hsiang; Liu, Dave; Louie, John D.; Sze, Daniel Y.; Rose, Steven C.; Brown, Daniel B.; Ahmadzadehfar, Hojjat; Kim, Edward

2017-01-01

Guidelines on how to adjust activity in patients with a history of liver surgery who are undergoing yttrium-90 radioembolisation ( 90 Y-RE) are lacking. The aim was to study the variability in activity prescription in these patients, between centres with extensive experience using resin microspheres 90 Y-RE, and to draw recommendations on activity prescription based on an expert consensus. The variability in activity prescription between centres was investigated by a survey of international experts in the field of 90 Y-RE. Six representative post-surgical patients (i.e. comparable activity prescription, different outcome) were selected. Information on patients' disease characteristics and data needed for activity calculation was presented to the expert panel. Reported was the used method for activity prescription and whether, how and why activity reduction was found indicated. Ten experts took part in the survey. Recommendations on activity reduction were highly variable between the expert panel. The median intra-patient range was 44 Gy (range 18-55 Gy). Reductions in prescribed activity were recommended in 68% of the cases. In consensus, a maximum D Target of 50 Gy was recommended. With a current lack of guidelines, large variability in activity prescription in post-surgical patients undergoing 90 Y-RE exists. In consensus, D Target ≤50 Gy is recommended. (orig.)

Postoperative radiotherapy after laser surgery with or without chemotherapy in head and neck evolved cancers

International Nuclear Information System (INIS)

Ryll, L.; Pradier, O.; Nitsche, M.; Christiansen, H.; Hess, C.

2007-01-01

We compared concurrent combination chemoradiotherapy and adjuvant radiotherapy after laser surgery in patients with stage 3/4 non metastatic squamous cell head and neck cancer. Combination chemotherapy and concurrent irradiation after laser surgery was not superior to surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, the collective is small, and the follow-up to short to conclude. (authors)

Malignant gliomas treated after surgery by combination chemotherapy and delayed radiation therapy. Pt. 2

International Nuclear Information System (INIS)

Poisson, M.; Mashaly, R.; Pertuiset, B.F.; Metzger, J.

1979-01-01

34 patients operated on for malignant gliomas were successively treated by combination chemotherapy with VM 26 and CCNU and conventional radiation therapy with an average dosage of 5,800 rads, six months after surgery. The general and haematological tolerance of delayed irradiation after chemotherapy was satisfactory. Twelve patients developed neurological complications during or after irradiation. The complications were early in 10 cases, and delayed in 2. They were probably due to tumour growth in five cases, and secondary to irradiation in seven. In four of the seven cases the preradiation chemotherapy seemed to potentiate the radiation effect on the central nervous system. (author)

Relationship between surgery, chemotherapy, irradiation and immunological state in patients of laryngeal cancer

International Nuclear Information System (INIS)

Krajina, Z.; Kosokovic, F.; Bolanca, S.; Bumber, Z.

1980-01-01

The relationship between surgery, chemotherapy irradiation and the immunological state in patients of laryngeal cancer with or without metastasis was investigated. The lymphocyte reaction to PHA (Phytohaemagglutinin) stimulation and T-lymphocyte count was examined before and immediately after the therapy in 66 patients divided into three groups. From the results the authors conclude that surgical treatment, partial or total laryngectomy, with or without radical Neckdissection influence the immunological state of the patients at least chemotherapy more and irradiation at most. (orig.) [de

Wilms' tumour: a comparison of surgical aspects in patients with or without pre-operative chemotherapy

International Nuclear Information System (INIS)

Safdar, C.A.; Aslam, M.; Awan, S.H.; Ahmed, I.; Badshah, S.

2006-01-01

To compare the technical aspects of Wilms' tumour (WT) surgery in patients with and without pre-operative chemotherapy. Patients of WT, presenting between January 1999 and December 2001, were treated, using the NWTSG protocol, with primary surgery (group I). Between January 2001 and December 2004, WT patients were treated according to SIOP protocol, with pre-operative chemotherapy followed by surgery (group II). Volume reduction with chemotherapy, duration of surgery, rupture of tumour, extent of excision, adherence and damage to surrounding structures, blood loss, complications, stay in hospital and event-free survival (EFS) were compared in the two groups. Out of 22 patients in group I, 19 (86.4%) underwent primary surgery. Of the 23 patients in group II, 21 (91.3%) received pre-operative chemotherapy followed by surgery. Average volume reduction in this group was 54% with chemotherapy. Difference in duration of surgery and blood loss was significantly low in group II (p=0.003 and p<0.001, respectively). In group I, rupture (6 vs 2), adherence (14 vs 10) and damage to surrounding structures (5 vs 2) were more. Complete macroscopic excision was possible in 90.5% of WT in group II as compared to 73.7% in group I. Immediate postoperative complications and length of hospital stay were similar in both groups. There was no difference in EFS. (author)

Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review.

Science.gov (United States)

Bartel, Ricardo; Gonzalez-Compta, Xavier; Cisa, Enric; Cruellas, Francesc; Torres, Alberto; Rovira, Aleix; Manos, Manel

2017-10-20

Olfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/-adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature. A retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution. 9 patients were included. Mean follow-up of 52.5 months (range 10-107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%. Neoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites.

Science.gov (United States)

Sadowski, Samira M; Neychev, Vladimir; Millo, Corina; Shih, Joanna; Nilubol, Naris; Herscovitch, Peter; Pacak, Karel; Marx, Stephen J; Kebebew, Electron

2016-02-20

Gastro-entero-pancreatic neuroendocrine tumors (GEPNETs) are increasing in incidence, and accurate staging is important for selecting the appropriate treatment. (68)Ga-DOTATATE imaging is a promising approach for detecting GEPNETs and could help in selecting optimal therapeutic strategies. The aim of this study was to prospectively determine the clinical utility of (68)Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) in detecting unknown primary and metastatic GEPNETs. One hundred thirty-one patients were enrolled in a prospective study of patients undergoing (68)Ga-DOTATATE PET/CT, (111)In-pentetreotide single-photon emission computed tomography (SPECT)/CT and multiphasic CT scan, and/or magnetic resonance imaging in a blinded fashion with comprehensive biochemical testing. The primary outcome measure was the detection of lesions by each imaging study. (68)Ga-DOTATATE PET/CT imaging detected 95.1% of lesions (95% CI, 92.4% to 96.8%) with an average maximum standardized uptake value of 65.4 ± 47 (range, 6.9 to 244), anatomic imaging detected 45.3% of lesions (95% CI, 37.9% to 52.9%), and (111)In-pentetreotide SPECT/CT detected 30.9% of lesions (95% CI, 25.0% to 37.5%), with a significant difference between imaging modalities (P < .001). In four of 14 patients (28.6%), (68)Ga-DOTATATE PET/CT found a previously unknown primary tumor, and detected primary GEPNET, lymph node, and distant metastases correctly in 72 of 113 lesions (63.7%) when compared with histopathology, with 22.1% and 38.9% detected by using (111)In-pentetreotide SPECT/CT and anatomic imaging, respectively. On the basis of findings with (68)Ga-DOTATATE PET/CT, 43 of 131 patients (32.8%) had a change in management recommendation. In patients with carcinoid symptoms but negative biochemical testing, (68)Ga-DOTATATE PET/CT detected lesions in 65.2% of patients, 40% of which were detected neither by anatomic imaging nor by (111)In-pentetreotide SPECT/CT. (68)Ga-DOTATATE PET

Comparative analysis of hepatopulmonary shunt obtained from pretherapy 99mTc MAA scintigraphy and post-therapy 90Y Bremsstrahlung imaging in 90Y microsphere therapy.

Science.gov (United States)

Jha, Ashish Kumar A; Zade, Anand A; Rangarajan, Venkatesh; Purandare, Nilendu; Shah, Sneha A; Agrawal, Archi; Kulkarni, Suyash S; Shetty, Nitin

2012-05-01

(99m)Tc macroaggregate albumin (MAA) scintigraphy is routinely used to estimate the hepatopulmonary shunt (HPS) of (90)Y microspheres because of their comparable average particle sizes (20-30 µm). However, the MAA particle size can vary from 10 to 90 µm. Therefore, HPS computed from (99m)Tc MAA scintigraphy may not accurately represent the HPS of (90)Y microspheres. In view of this, the present study was undertaken to investigate the accuracy of (99m)Tc MAA scintigraphy in estimating the HPS of (90)Y microspheres. Nineteen sessions of transarterial radioembolization using (90)Y therasphere were carried out in 17 patients for hepatic malignancies (both primary and secondary). For each session of therapy, a pretherapeutic (99m)Tc MAA scintigraphy and post-therapeutic (90)Y Bremsstrahlung scintigraphy were performed. The HPSs obtained from these images were compared. The mean HPS fractions calculated from the pretherapeutic (99m)Tc MAA study and the post-therapeutic (90)Y Bremsstrahlung images were 4.77 ± 2.81 and 4.52 ± 2.5%, respectively. The coefficient of correlation (r) was 0.96. (99m)Tc MAA scintigraphy accurately predicts the HPS of (90)Y microspheres.

Development of activity standard for 90Y microspheres

CSIR Research Space (South Africa)

Mo, L

2005-08-01

Full Text Available 90Y is a therapeutic radiopharmaceuticals used in the treatment of liver cancer following implantation via a catheter in the hepatic artery, 90Y microspheres are embolised in the microvasculature of liver cancer where they irradiate the tumour by a...

Intraperitoneal chemotherapy for advanced ovarian and peritoneal cancers in patients following interval debulking surgery or primary cytoreductive surgery: Tom Baker Cancer Centre experience from 2006 to 2009.

Science.gov (United States)

Nelson, Gregory; Lucero, Carlos Aspe; Chu, Pamela; Nation, Jill; Ghatage, Prafull

2010-03-01

To describe our experience with cisplatin- and paclitaxel-based IP chemotherapy in patients treated initially with either neoadjuvant chemotherapy and interval debulking surgery (IDS) or primary cytoreductive surgery (PCRS). We performed a retrospective review of the records of 67 patients (38 IDS, 29 PCRS) enrolled in the intraperitoneal (IP) chemotherapy program at the Tom Baker Cancer Centre between 2006 and 2009. Information pertaining to patient demographics, IP chemotherapy toxicity, and catheter complications was extracted, and the median time to recurrence was calculated. Most patients in the study were aged 50 to 70 years and had a diagnosis of stage III serous ovarian cancer. Overall, 295/393 IP cycles (75%) were successfully administered. The proportion of patients completing six cycles of chemotherapy in the IDS and PCRS groups was 53% and 59%, respectively. Frequent (> 25%) Grade 1 to 2 chemotherapy toxicities included fatigue, peripheral neuropathy, and nausea. Catheter complications were observed in 34% of patients (23/67). The recurrence rates for patients completing four or more cycles of IP chemotherapy in the IDS and PCRS groups were 58% and 35%, respectively, with the median time to recurrence approximately one year. Although IP chemotherapy is well tolerated in both IDS and PCRS patients, the median time to recurrence is shorter than expected.

Targeting post-infarct inflammation by PET imaging: comparison of {sup 68}Ga-citrate and {sup 68}Ga-DOTATATE with {sup 18}F-FDG in a mouse model

Energy Technology Data Exchange (ETDEWEB)

Thackeray, James T. [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Hannover Medical School, Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover (Germany); Bankstahl, Jens P.; Walte, Almut; Wittneben, Alexander; Bengel, Frank M. [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Wang, Yong; Korf-Klingebiel, Mortimer; Wollert, Kai C. [Hannover Medical School, Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover (Germany)

2014-08-12

Imaging of inflammation early after myocardial infarction (MI) is a promising approach to the guidance of novel molecular interventions that support endogenous healing processes. {sup 18}F-FDG PET has been used, but may be complicated by physiological myocyte uptake. We evaluated the potential of two alternative imaging targets: lactoferrin binding by {sup 68}Ga-citrate and somatostatin receptor binding by {sup 68}Ga-DOTATATE. C57Bl/6 mice underwent permanent coronary artery ligation. Serial PET imaging was performed 3 - 7 days after MI using {sup 68}Ga-citrate, {sup 68}Ga-DOTATATE, or {sup 18}F-FDG with ketamine/xylazine suppression of myocyte glucose uptake. Myocardial perfusion was evaluated by {sup 13}N-ammonia PET and cardiac geometry by contrast-enhanced ECG-gated CT. Mice exhibited a perfusion defect of 30 - 40 % (of the total left ventricle) with apical anterolateral wall akinesia and thinning on day 7 after MI. {sup 18}F-FDG with ketamine/xylazine suppression demonstrated distinct uptake in the infarct region, as well as in the border zone and remote myocardium. The myocardial standardized uptake value in MI mice was significantly higher than in healthy mice under ketamine/xylazine anaesthesia (1.9 ± 0.4 vs. 1.0 ± 0.1). {sup 68}Ga images exhibited high blood pool activity with no specific myocardial uptake up to 90 min after injection (tissue-to-blood contrast 0.9). {sup 68}Ga-DOTATATE was rapidly cleared from the blood, but myocardial SUV was very low (0.10 ± 0.03). Neither {sup 68}Ga nor {sup 68}Ga-DOTATATE is a useful alternative to {sup 18}F-FDG for PET imaging of myocardial inflammation after MI in mice. Among the three tested approaches, {sup 18}F-FDG with ketamine/xylazine suppression of cardiomyocyte uptake remains the most practical imaging marker of post-infarct inflammation. (orig.)

Calibration of the 90Sr+90Y ophthalmic and dermatological applicators with an extrapolation ionization minichamber

International Nuclear Information System (INIS)

Antonio, Patrícia L.; Oliveira, Mércia L.; Caldas, Linda V.E.

2014-01-01

90 Sr+ 90 Y clinical applicators are used for brachytherapy in Brazilian clinics even though they are not manufactured anymore. Such sources must be calibrated periodically, and one of the calibration methods in use is ionometry with extrapolation ionization chambers. 90 Sr+ 90 Y clinical applicators were calibrated using an extrapolation minichamber developed at the Calibration Laboratory at IPEN. The obtained results agree satisfactorily with the data provided in calibration certificates of the sources. - Highlights: • 90 Sr+ 90 Y clinical applicators were calibrated using a mini-extrapolation chamber. • An extrapolation curve was obtained for each applicator during its calibration. • The results were compared with those provided by the calibration certificates. • All results of the dermatological applicators presented lower differences than 5%

Enrichment and determination of small amounts of 90Sr/90Y in water samples

International Nuclear Information System (INIS)

Mundschenk, H.

1979-01-01

Small amounts of 90 Sr/ 90 Y can be concentrated from large volumes of surface water (100 l) by precipitation of the phosphates, using bentonite as adsorber matrix. In the case of samples containing no or nearly no suspended matter (tap water, ground water, sea water), the daughter 90 Y can be extracted directly by using filter beds impregnated with HDEHP. The applicability of both techniques is demonstrated under realistic conditions. (orig.) 891 HP/orig. 892 MKO [de

Dosimetric comparison of electron beam and 90Sr+90Y applicator for keloids treatment

International Nuclear Information System (INIS)

Coelho, Talita S.; Tada, Ariane; Antonio, Patricia L.; Yoriyaz, Helio; Fernandes, Marco A.R.

2009-01-01

Studies have been shown that among several methods that have been used for the treatment of keloids the surgical excision followed by the adjuvant radiotherapy presents the lowest relapsed rate of the injury. In this work a comparative dosimetric study has been performed using a 4 MeV electron beam from a Varian Clinac 2100C linear accelerator at the radiotherapy service of the Hospital das Clinicas of UNESP-HC, Botucatu-SP and an Amershan 90 Sr+ 90 Y brachytherapy applicator with 1491 MBq of activity. Percentage depth dose curves from ionization chamber measurements and through Monte Carlo simulation have been obtained and compared. Dose measurements have been obtained using parallel plates ionization chamber (Esradin A12) and extrapolation mini-chamber developed at IPEN. The dose calculations have been obtained using the well-known Monte Carlo radiation transport code MCNP-4C. Maximum dose differences obtained between measured/calculated values for 90 Sr+ 90 Y applicator and for the electron beam were, respectively: 7.8 % and 8.0%. The profiles of the depth and superficial tissue dose distribution produced by the electron beam revealed themselves flatter and more homogeneous than those produced by the 90 Sr+ 90 Y applicator, especially to wider fields, which cannot be obtained with beta therapy applicators because of their geometric limitations. In conclusion this present work has shown that 90 Sr+ 90 Y applicators could be efficient for small and very superficial lesions but in most cases electron beam sources are more adequate especially for large and deeper lesions. (author)

Recommendations for radioembolisation after liver surgery using yttrium-90 resin microspheres based on a survey of an international expert panel

Energy Technology Data Exchange (ETDEWEB)

Samim, Morsal [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Veenendaal, Linde M. van; Braat, Manon N.G.J.A.; Hoven, Andor F. van den; Bosch, Maurice A.A.J. van den; Lam, Marnix G.E.H. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Hillegersberg, Richard van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); Sangro, Bruno [Clinica Universidad de Navarra-IDISNA and CIBEREHD, Liver Unit, Pamplona (Spain); Kao, Yung Hsiang [Cabrini Hospital, Department of Nuclear Medicine, Melbourne (Australia); Liu, Dave [Vancouver General Hospital, University of British Columbia, Department of Radiology, Vancouver, British Columbia (Canada); Louie, John D.; Sze, Daniel Y. [Stanford University Medical Center, Division of Interventional Radiology, Stanford (United States); Rose, Steven C. [University of California, Department of Radiology, San Diego (United States); Brown, Daniel B. [Vanderbilt University, Medical Center North, Department of Radiology, Nashville (United States); Ahmadzadehfar, Hojjat [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Kim, Edward [Icahn School of Medicine at Mount Sinai, Division of Vascular and Interventional Radiology, New York (United States)

2017-12-15

Guidelines on how to adjust activity in patients with a history of liver surgery who are undergoing yttrium-90 radioembolisation ({sup 90}Y-RE) are lacking. The aim was to study the variability in activity prescription in these patients, between centres with extensive experience using resin microspheres {sup 90}Y-RE, and to draw recommendations on activity prescription based on an expert consensus. The variability in activity prescription between centres was investigated by a survey of international experts in the field of {sup 90}Y-RE. Six representative post-surgical patients (i.e. comparable activity prescription, different outcome) were selected. Information on patients' disease characteristics and data needed for activity calculation was presented to the expert panel. Reported was the used method for activity prescription and whether, how and why activity reduction was found indicated. Ten experts took part in the survey. Recommendations on activity reduction were highly variable between the expert panel. The median intra-patient range was 44 Gy (range 18-55 Gy). Reductions in prescribed activity were recommended in 68% of the cases. In consensus, a maximum D{sub Target} of 50 Gy was recommended. With a current lack of guidelines, large variability in activity prescription in post-surgical patients undergoing {sup 90}Y-RE exists. In consensus, D{sub Target} ≤50 Gy is recommended. (orig.)

Development of Technology for the Preparation of 90Sr/90Y Generators at the Radiopharmacy Directory of IPEN/CNEN-SP

International Nuclear Information System (INIS)

Barrio, Graciela

2010-01-01

90 Y (T /2 = 2,67 d; Eβmax = 2,28 MeV) is a radionuclide with efficacy established for various cancer therapies, labeling biomolecules and treating of radiosinovectomy. Due to its nuclear properties, is obtained through the decay of 90 Sr T /2 = 28 y in the form of a generator. Several types of 90 Sr/ 90 Y generators were developed, and the most employed are the cation exchange resins, where Sr and Y are adsorbed and 90 Y is selectively eluted with acetate or EDTA. The disadvantage of this type of generator is the radiolysis, which degrades its use. The electrochemical generator is a proposed solution because there is no significant effect of radiation. In this concept, the difference between the electrochemical potentials of the elements Sr and Y is used to obtain a rapid separation of 90 Y from 90 Sr. The production of 90 Y via colloid formation is the simplest method for the separation, based on the colloid formation of Y in high alkaline pH, which can be filtered and separated from Sr, and subsequently dissolved in HCl. The objective of this work was the development of technologies for the preparation of 90 Sr/ 90 Y generators, and three technologies were developed: generators using cation resins columns, generators through colloid formation and electrochemical generators. Radionuclidic quality control of 90 Y was also evaluated by liquid scintillation, radionuclide identity, extraction paper chromatography (EPC) using complexing agents for 90 Y and by Optical Emission Spectrometry with Inductively Coupled Plasma (ICP-OES). The results showed that generators using cation resins have the best results related to the elution efficiency (∼83%), the reproducibility and radionuclidic purity. The electrochemical generator showed a potential for development, having the advantage of not suffering the effects of radiolysis of the pair 90 Sr/ 90 Y as the resin. A comparison and evaluation of the methods of the radionuclidic quality control showed that the EPC is very

Synovectomy of the knee with 90Y

International Nuclear Information System (INIS)

Spooren, P.F.M.J.; Rasker, J.J.; Arens, R.P.J.H.; Ziekenhuis Ziekenzorg, Enschede

1985-01-01

In 33 patients with chronic arthritis of the knee, 48 knees were treated with an intra-articular injection of 5 mCi yttrium silicate 90 Y. There were 27 patients with rheumatoid arthritis (RA) and 6 with osteoarthrosis (OA); the mean follow-up period was 33 months. At clinical investigation after 1 year, no signs of pain or swelling were found in 15 knees. In most cases, pain and swelling improved subjectively, with a mean duration of 11 months; in 20 knees, the improvement lasted more than 22 months. When radiographs showed severse destruction, 90 Y treatment was unsuccessful, but an important new finding was that most patients with mild or moderate radiological abormalities appeared to have a long-lasting improvement. The result did not correlate with erythrocyte sedimentation rate (ESR), haemoglobin or Rose titre at the time of injection or at follow up, suggesting that the result of the treatment is more dependent on local factors than on the disease activity. The results of 90 Y treatment in 6 OA knees with persistent swelling were promising regarding swelling, even in patients with moderate radiological abnormalities. The main side-effect was a sometimes painful swelling of the knee, which was always successfully treated with an intra-articular corticosteroid injection. In 90 Y-treated knees, the incidence of unstable joints was not significantly higher than in non-treated knees. In conclusion, 90 Y synovectomy may be a succesful treatment for patients older than 50 years with chronic arthritis of the knee due to RA and probably also OA, even when moderate radiological abnormalities are present. (orig.)

68Ga/177Lu-labeled DOTA-TATE shows similar imaging and biodistribution in neuroendocrine tumor model.

Science.gov (United States)

Liu, Fei; Zhu, Hua; Yu, Jiangyuan; Han, Xuedi; Xie, Qinghua; Liu, Teli; Xia, Chuanqin; Li, Nan; Yang, Zhi

2017-06-01

Somatostatin receptors are overexpressed in neuroendocrine tumors, whose endogenous ligands are somatostatin. DOTA-TATE is an analogue of somatostatin, which shows high binding affinity to somatostatin receptors. We aim to evaluate the 68 Ga/ 177 Lu-labeling DOTA-TATE kit in neuroendocrine tumor model for molecular imaging and to try human-positron emission tomography/computed tomography imaging of 68 Ga-DOTA-TATE in neuroendocrine tumor patients. DOTA-TATE kits were formulated and radiolabeled with 68 Ga/ 177 Lu for 68 Ga/ 177 Lu-DOTA-TATE (M-DOTA-TATE). In vitro and in vivo stability of 177 Lu-DOTA-TATE were performed. Nude mice bearing human tumors were injected with 68 Ga-DOTA-TATE or 177 Lu-DOTA-TATE for micro-positron emission tomography and micro-single-photon emission computed tomography/computed tomography imaging separately, and clinical positron emission tomography/computed tomography images of 68 Ga-DOTA-TATE were obtained at 1 h post-intravenous injection from patients with neuroendocrine tumors. Micro-positron emission tomography and micro-single-photon emission computed tomography/computed tomography imaging of 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE both showed clear tumor uptake which could be blocked by excess DOTA-TATE. In addition, 68 Ga-DOTA-TATE-positron emission tomography/computed tomography imaging in neuroendocrine tumor patients could show primary and metastatic lesions. 68 Ga-DOTA-TATE and 177 Lu-DOTA-TATE could accumulate in tumors in animal models, paving the way for better clinical peptide receptor radionuclide therapy for neuroendocrine tumor patients in Asian population.

Treatment of pains from bone metastases with 90Y

International Nuclear Information System (INIS)

Kutzner, J.; Daehnert, W.; Schreyer, T.; Grimm, W.; Brod, K.H.; Becker, M.

1981-01-01

For palliation of pain caused by bone metastases beta radiation isotope therapy was successful. As shown in experimental work on animals bone uptake of 90 Y with its shorter half-life is high when it is administered as a citrate complex. 90 Y can be eluted with high purity from a 90 Sr cow. The retention in man was found by whole-body counting to be higher than 80%. In preliminary trials on 16 patients the analgetic effect was the same as that of 89 Sr. The properties of 90 Y therapy are discussed. (orig.) [de

Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers.

Science.gov (United States)

Villard, Linda; Romer, Anna; Marincek, Nicolas; Brunner, Philippe; Koller, Michael T; Schindler, Christian; Ng, Quinn K T; Mäcke, Helmut R; Müller-Brand, Jan; Rochlitz, Christoph; Briel, Matthias; Walter, Martin A

2012-04-01

Radiopeptide therapy is commonly performed with a single radioisotope. We aimed to compare the effectiveness of somatostatin-based radiopeptide therapy with a single versus a combination of radioisotopes. In a cohort study, patients with metastasized neuroendocrine cancer were treated with repeated cycles of (90)yttrium-labeled tetraazacyclododecane-tetraacetic acid modified Tyr-octreotide ([(90)Y-DOTA]-TOC) or with cycles alternating between [(90)Y-DOTA]-TOC and (177)lutetium-labeled DOTA-TOC ([(177)Lu-DOTA]-TOC) until tumor progression or permanent toxicity. Multivariable Cox regression and competing risk regression were used to study predictors of survival and renal toxicity in patients completing three or more treatment cycles. A total of 486 patients completed three or more treatment cycles; 237 patients received [(90)Y-DOTA]-TOC and 249 patients received [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC. Patients receiving [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC had a significantly longer survival than patients receiving [(90)Y-DOTA]-TOC alone (5.51 v 3.96 years; hazard ratio, 0.64; 95% CI, 0.47 to 0.88; P = .006). The rates of severe hematologic toxicities (6.3% v 4.4%; P = .25) and severe renal toxicity (8.9% v 11.2%; P = .47) were comparable in both groups. [(90)Y-DOTA]-TOC + [(177)Lu-DOTA]-TOC was associated with improved overall survival compared with [(90)Y-DOTA]-TOC alone in patients completing three or more cycles of treatment. Contrary to the current practice in radiopeptide therapy, our results suggest an advantage of using a combination of radioisotopes.

The challenges of treating paraganglioma patients with 177Lu-DOTATATE PRRT: Catecholamine crises, tumor lysis syndrome and the need for modification of treatment protocols

International Nuclear Information System (INIS)

Makis, William; Mccann, Karey; Mcewan, Alexander J. B.

2015-01-01

A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with 177 Lu-[DOTA0,Tyr3]octreotate (DOTATATE) radioisotope therapy using established protocols. Three paraganglioma patients were treated with 4–5 cycles of 177 Lu-DOTATATE and were evaluated for side effects and response to therapy. Two of the three patients developed severe adverse reactions following their first 177 Lu-DOTATATE treatment. One patient developed a catecholamine crisis and tumor lysis syndrome within hours of treatment, requiring intensive care unit (ICU) support, and another developed a catecholamine crisis 3 days after treatment, requiring hospitalization. The treatment protocols at our institution were subsequently modified by increasing the radioisotope infusion time from 15 to 30 min, as recommended in the literature, to 2–4 h and by reducing the administered dose of 177 Lu-DOTATATE. Subsequent 177 Lu-DOTATATE treatments utilizing the modified protocols were well tolerated, and response to therapy was achieved in all three patients, resulting in significantly improved quality of life. 177 Lu-DOTATATE is an exciting new therapeutic option in the management of paragangliomas; however, current treatment protocols described in the literature may need to be modified by lengthening the infusion time and/or lowering the initial treatment dose to prevent or reduce the severity of adverse reactions

Evaluation and comparison of Ga-68 DOTA-TATE and Ga-68 DOTA-NOC PET/CT imaging in well-differentiated thyroid cancer.

Science.gov (United States)

Ocak, Meltem; Demirci, Emre; Kabasakal, Levent; Aygun, Aslan; Tutar, Rumeysa O; Araman, Ahmet; Kanmaz, Bedii

2013-11-01

Somatostatin receptor (Sstr) scintigraphy with radiolabelled somatostatin analogues has been used extensively for the diagnosis and therapy of Sstr-expressing tumours. It has been shown that well-differentiated thyroid cancer (WDTC) cells have a high expression of Sstr2, Sstr3 and Sstr5. Hence, WDTC cells could be an ideal target for the evaluation of lesion uptake of Ga-68 DOTA-1-NaI3-octreotide (DOTA-NOC), which has a high affinity not only to Sstr2 but also to Sstr3 and Sstr5. The aim of the present study was to evaluate the value of Ga-68 DOTA-NOC as a target for Sstr2-expressing, Sstr3-expressing and Sstr5-expressing tumours in WDTC patients and to compare the results with those of Ga-68 DOTA-TATE in the same patient population. Thirteen patients with WDTC were included in our study: nine with papillary thyroid cancer, three with Hurthle cell carcinoma and one with follicular thyroid carcinoma. All patients had elevated serum thyroglobulin levels and negative post-therapeutic I-131 whole-body scans, which were obtained after the last radioiodine treatment. All patients had undergone two consecutive PET imaging studies with Ga-68 DOTA-D-Phe1-Tyr3-octreotate (DOTA-TATE) and Ga-68 DOTA-NOC, respectively. All images were evaluated visually, and maximum standardized uptake values were calculated. Both Ga-68 DOTA-TATE and Ga-68 DOTA-NOC PET images gave comparable results. Among the 13 patients, imaging with both Ga-68 DOTA-TATE and Ga-68 DOTA-NOC gave negative results in five (38%) patients and positive results in eight (62%) patients. A total of 45 lesions were identified on Ga-68 DOTA-TATE images and 42 on Ga-68 DOTA-NOC images; three lesions were missed. Lesion uptake was significantly higher on Ga-68 DOTA-TATE images. Maximum standardized uptake values of Ga-68 DOTA-TATE and Ga-68 DOTA-NOC were 12.9±9.1 and 6.3±4.1 (n=54, PDOTA-TATE has a higher lesion uptake even in WDTC patients and may have potential advantage over Ga-68 DOTA-NOC.

Adsorption of 90Sr and 90Y by bottom-set beds in the Atlantic ocean

International Nuclear Information System (INIS)

Gromov, V.V.; Shakhova, N.F.; Emel'yanov, E.M.

1978-01-01

The behaviour of 90 Sr and 90 Y has been studied in an adsorption system of sea water-bottom-set beds of the Atlantic ocean (red clay; pelitic silt). It has been shown that strontium is present in the sea water in one form, viz, Sr 2+ . Adsorption of 90 Sr with bottom-set beds follows the ion-exchange mechanism. Yttrium is present in the sea water at least three forms (two absorbable and one non-absorbable). Yttrium-90 adsorption is an irreversible process and only about 10% 90 Y is desorbed by the sea water from red clay and silt

Solid tumors after chemotherapy or surgery for testicular nonseminoma: a population-based study.

Science.gov (United States)

Fung, Chunkit; Fossa, Sophie D; Milano, Michael T; Oldenburg, Jan; Travis, Lois B

2013-10-20

Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminoma patients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility.

Radioembolization and the dynamic role of 90Y PET/CT

Directory of Open Access Journals (Sweden)

Alexander S Pasciak

2014-02-01

Full Text Available Before the advent of tomographic imaging, it was postulated that decay of 90Y to the 0+ excited state of 90Zr may result in emission of a positron-electron pair. While the branching ratio for pair production is small (~32x10-6, PET has been successfully used to image 90Y in numerous recent patient and phantom studies. 90Y PET imaging has been performed on a variety of PET/CT systems, with and without time-of-flight (TOF and/or resolution recovery capabilities as well as on both BGO and L(YSO based scanners. On all systems, resolution and contrast superior to bremsstrahlung SPECT has been reported. The intrinsic radioactivity present in L(YSO-based PET scanners is a potential limitation associated with accurate quantification of 90Y. However, intrinsic radioactivity has been shown to have a negligible effect at the high activity concentrations common in 90Y radioembolization. Accurate quantification is possible on a variety of PET scanner models, with or without TOF, although TOF improves accuracy at lower activity concentrations. Quantitative 90Y PET images can be transformed into 3D maps of absorbed dose based on the premise that the 90Y activity distribution does not change after infusion. This transformation has been accomplished primarily with the use of 3D dose point-kernel convolution. From a clinical standpoint, 90Y PET provides a superior post-infusion evaluation of treatment technical success owing to its improved resolution. Absorbed dose maps generated from quantitative PET data can be used to predict treatment efficacy and manage patient follow-up. For patients who receive multiple treatments, this information can also be used to provide patient-specific treatment planning for successive therapies, potentially improving response. The broad utilization of 90Y PET has the potential to provide a wealth of dose-response information, which may lead to development of improved radioembolization treatment-planning models in the future.

A retrospective review of Y90 synovectomy in Auckland

International Nuclear Information System (INIS)

Stamp, L.

2000-01-01

Full text: A retrospective review of Yttrium 90 synovectomies carried out from June 1997 to February 1999 in Auckland Hospital to determine outcome from the procedure. Methods: Patients were sent a questionnaire for each treated knee The principal outcome measures assessed in the month prior and the 6 months after the Y90 were pain, swelling, walking distance and overall disability score. Referring doctors were sent a questionnaire to provide information on duration of synovitis and treatment. Outcomes measured were presence of effusion 6 months after the Y90, requirement for intra-articular steroid in the 12 months prior to and after the yttrium and change of therapy due lo ongoing symptoms in the treated knee. Results: 29 patients and 40 knees had Y90 during the study period 86% patients with 87.5% knees responded. Referring doctors for 86% patients accounting for 87.5% knees responded. The procedure was well tolerated with the majority of patients reporting nil-mild discomfort during and in the 24 hours after Y90. 86% knees treated reported improvement with a reduction in pain and swelling Patient global assessment reduced from 3.8 to 2.0 while physician global assessment reduced from 3.9 to 3.0. There was an improvement in walking distance 6 months after Y90 with the number of knees able to walk >1km increasing from 2 to 17 14 of 25 patients required a change in treatment because of ongoing problems in the treated knee and one patient has undergone knee joint replacement One further patient is waiting knee joint replacement The need for intra-articular steroid was reduced with 83%, knees having an average of 2.4 steroid injections in the 12 months prior to Y90 compared to 38% knees having an average of 0.7 steroid injections in the 12 months after Y90. Of the 30 knees reporting Improvement 24 knees are at least 12 months post Y90. Of these 50% were Improved at 12 months. As a result of this audit we continue to offer this procedure in the Auckland area, and

Preparation & in vitro evaluation of 90Y-DOTA-rituximab

Science.gov (United States)

Kameswaran, Mythili; Pandey, Usha; Dash, Ashutosh; Samuel, Grace; Venkatesh, Meera

2016-01-01

Background & objectives: Radioimmunotherapy is extensively being used for the treatment of non-Hodgkin's lymphoma (NHL). Use of rituximab, a chimeric anti-CD20 antibody directed against the CD20 antigen in combination with suitable beta emitters is expected to result in good treatment response by its cross-fire and bystander effects. The present work involves the conjugation of p-isothiocyanatobenzyl DOTA (p-SCN-Bn-DOTA) to rituximab, its radiolabelling with 90Y and in vitro and in vivo evaluation to determine its potential as a radioimmunotherapeutic agent. Methods: Rituximab was conjugated with p-SCN-Bn-DOTA at 1:1 antibody: DOTA molar ratio. The number of DOTA molecules linked to one molecule of rituximab was determined by radioassay and spectroscopic assay. Radiolabelling of rituximab with 90Y was carried out and its in vitro stability was evaluated. In vitro cell binding studies were carried out in Raji cells expressing CD20 antigen. Biodistribution studies were carried out in normal Swiss mice. Results: Using both radioassay and spectroscopic method, it was determined that about five molecules of DOTA were linked to rituximab. Radiolabelling of the rituximab conjugate with 90Y and subsequent purification on PD-10 column gave a product with radiochemical purity (RCP) > 98 per cent which was retained at > 90 per cent up to 72 h when stored at 37°C. In vitro cell binding experiments of 90Y-DOTA-rituximab with Raji cells exhibited specific binding of 20.7 ± 0.1 per cent with 90Y-DOTA-rituximab which reduced to 15.5 ± 0.2 per cent when incubated with cold rituximab. The equilibrium constant Kd for 90Y-DOTA-Rituximab was determined to be 3.38 nM. Radiolabelled antibody showed clearance via hepatobiliary and renal routes and activity in tibia was found to be quite low indicating in vivo stability of 90Y-DOTA-rituximab. Interpretation & conclusions: p-SCN-Bn-DOTA was conjugated with rituximab and radiolabelling with 90Y was carried out. In vitro studies carried

Work Environment in the Operating Room during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy : Factors Influencing Choice of Protective Equipment

OpenAIRE

Näslund Andréasson, Sara

2011-01-01

Peritoneal carcinomatosis (PC) is a common metastatic manifestation of both gastrointestinal and gynecological malignancies. Curative modes of treatment are cytoreductive surgery (CRS) combined with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). Surgeons and operating room (OR) staff attending these procedures are exposed to chemotherapy and electrocautery smoke. Heated chemotherapy (HIPEC) may vaporize and become inhaled by those administering it and, moreover, large quant...

Radioimmunotherapy of indolent non-Hodgkin's lymphoma with Yttrium-90 labeled anti-CD20 monoclonal antibody therapy does not preclude subsequent chemotherapy or autologous hematologic stem cell transplantation therapy in most patients

International Nuclear Information System (INIS)

Wiseman, G.A.; Witzig, T.E.; Ansell, S.M.; Ristow, K.M.

2002-01-01

Introduction: Yttrium-90 (Y-90) labeled anti-CD20 monoclonal antibody (ibritumomab tiuxetan or Zevalin TM ) is a novel therapy for patients with relapsed CD20+ B-cell non-Hodgkin's lymphoma (NHL). Patients treated with Zevalin radioimmunotherapy (RIT) are limited from higher doses due to transient and reversible platelet and neutrophil suppression. Patients with indolent NHL who relapse or are refractory to chemotherapy have a 70-80% overall response rate and a 20-30% complete response rate when treated with Zevalin RIT. Therefore additional treatment is required in a minority of patients shortly after Zevalin therapy and in many others at relapse. Relapsed patients are generally treated with chemotherapy alone or high dose chemotherapy followed by autologous transplantation. We wanted to evaluate the ability of patients to tolerate subsequent therapy given at relapse following Zevalin RIT. Methods: We had 58 patients who relapsed after receiving Zevalin RIT and later received additional therapy. The clinical records and lab results were reviewed and compared with a matched control group of patients treated prior to Zevalin availability who received chemotherapy without prior Zevalin RIT. Results: The toxicity in 58 patients treated with Zevalin RIT and subsequent therapy was not significantly different from the control group who did not receive Zevalin RIT. Patients had a median of two subsequent therapies (range, 1-7) after Zevalin. Twenty eight percent required blood cell growth factor support with subsequent chemotherapy and 2 patients required reductions from the standard chemotherapy doses due to prolonged myelosuppression. Eight patients subsequently had successful autologous hematologic stem cell transplant with cells collected after Zevalin. Thirteen of the 58 patients (28%) treated with standard dose chemotherapy were hospitalized for neutropenic fever or thrombocytopenia. Conclusions: Chemotherapy or high dose chemotherapy with autologous transplantation

The challenges of treating paraganglioma patients with {sup 177}Lu-DOTATATE PRRT: Catecholamine crises, tumor lysis syndrome and the need for modification of treatment protocols

Energy Technology Data Exchange (ETDEWEB)

Makis, William; Mccann, Karey; Mcewan, Alexander J. B. [Dept. of Diagnostic Imaging, Cross Cancer Institute, Alberta (China)

2015-09-15

A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with {sup 177}Lu-[DOTA0,Tyr3]octreotate (DOTATATE) radioisotope therapy using established protocols. Three paraganglioma patients were treated with 4–5 cycles of {sup 177}Lu-DOTATATE and were evaluated for side effects and response to therapy. Two of the three patients developed severe adverse reactions following their first {sup 177}Lu-DOTATATE treatment. One patient developed a catecholamine crisis and tumor lysis syndrome within hours of treatment, requiring intensive care unit (ICU) support, and another developed a catecholamine crisis 3 days after treatment, requiring hospitalization. The treatment protocols at our institution were subsequently modified by increasing the radioisotope infusion time from 15 to 30 min, as recommended in the literature, to 2–4 h and by reducing the administered dose of {sup 177}Lu-DOTATATE. Subsequent {sup 177}Lu-DOTATATE treatments utilizing the modified protocols were well tolerated, and response to therapy was achieved in all three patients, resulting in significantly improved quality of life. {sup 177}Lu-DOTATATE is an exciting new therapeutic option in the management of paragangliomas; however, current treatment protocols described in the literature may need to be modified by lengthening the infusion time and/or lowering the initial treatment dose to prevent or reduce the severity of adverse reactions.

New modalities (setting, fractionation) of radioimmunotherapy by 90Y-ibritumomab tiuxetan (90Y zevalin) in first line treatment of follicular type non Hodgkin malignant lymphomas: efficiency, toxicity and personalized dosimetry approach

International Nuclear Information System (INIS)

Morschhauser, F.

2008-12-01

Rationale: radioimmunotherapy (R.I.T.) with 90 Y-ibritumomab tiuxetan ([ 90 Y] Zevalin ) is a new treatment option for patients with relapsed/refractory non Hodgkin follicular lymphoma (F.L.). Efficacy increases when Zevalin is used earlier in the disease course. Currently, Zevalin dosage is based on weight and not dosimetry. This most likely results in a wide range of absorbed dose to critical organs and tumor, which in turn translates in unpredictable efficacy and toxicity. Optimizing R.I.T. with [ 90 Y] Zevalin will require its use as part of first-line therapy and implementation of patient-specific dosimetry methods in clinical trials. Objectives and methods: we have consecutively studied 2 new modalities of using Zevalin in first line therapy of F.L.. First, we conducted an international, randomized, phase 3 trial to evaluate the efficacy and safety of consolidation with Zevalin(15 MBq/Kg) in patients with advanced-stage F.L. achieving at least a partial response after induction immuno chemotherapy. A second approach consisted of evaluating a fractionated schedule with 2 doses of Zevalin (11.1 MBq/kg each), 9 to 13 weeks apart, as front line therapy in F.L. patients with high tumor burden. As part of this second approach, we designed a refined imaging-based (planar and 3-dimensional) dosimetry protocol to improve prediction of dose efficacy and toxicity after each dose of zevalin. Data acquisition was performed in 3 centers (Lille, Nantes and Manchester) while data treatment and specific dose calculations for major organ, tumor masses and bone marrow were centralized. Conclusion: Consolidation of first remission with 90 Y-ibritumomab tiuxetan in advanced-stage follicular lymphoma is highly effective with no unexpected toxicities, prolonging P.F.S. by 2 years and resulting in high P.R.-to-C.R. conversion rates regardless of type of first-line induction treatment. Preliminary data show the feasibility of front line fractionated R.I.T. with Zevalin in patient

Therapeutic result of radioactive nuclide 90Sr/90Y treatment in patients with benign prostatic hypertrophy (BPH)

International Nuclear Information System (INIS)

Chen Hanchao; Li Yuying

2008-01-01

Objective: To study the effect of radioactive nuclide 90 Sr/ 90 Y treatment in patients with benign prostatic hypertrophy (BPH). Methods: Sixty patients with BPH were treated with a course of transurethral radioactive nuclide 90 Sr/ 90 Y therapy. Results: The severity of BPH was assessed with four parameters: maximal flow rate (MFR), volume of residual urine (VRU), international prostatic symptom score (IPSS) and volume (size) of prostate. In this series, the total effective rate was 93.33% with no treatment- related mortality. Favorable changes of the parameters after a course of radioactive nuclide therapy were significant. Conclusion: Radioactive nuclide 90 Sr/ 90 Y therapy for patients with BPH was safe, easily performed and quite effective. This procedure is worth popularizing in appropriate patients. (authors)

Comparison of {sup 68}Ga-DOTATATE and {sup 68}Ga-DOTANOC PET/CT imaging in the same patient group with neuroendocrine tumours

Energy Technology Data Exchange (ETDEWEB)

Kabasakal, Levent [Istanbul University, Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul (Turkey); Cerrahpasa Tip Fakultesi, Nukleer Tip Anabilim Dali, Aksaray, Istanbul (Turkey); Demirci, Emre; Uslu, Ilhami; Kanmaz, Bedii [Istanbul University, Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul (Turkey); Ocak, Meltem; Araman, Ahmet; Ozsoy, Yildiz [Istanbul University, Department of Pharmaceutical Technology, Pharmacy Faculty, Istanbul (Turkey); Decristoforo, Clemens [Medical University of Innsbruck, Clinical Department of Nuclear Medicine, Innsbruck (Austria)

2012-08-15

Recent studies have suggested that positron emission tomography (PET) imaging with {sup 68}Ga-labelled DOTA-somatostatin analogues (SST) like octreotide and octreotate is useful in diagnosing neuroendocrine tumours (NETs) and has superior value over both CT and planar and single photon emission computed tomography (SPECT) somatostatin receptor scintigraphy (SRS). The aim of the present study was to evaluate the role of {sup 68}Ga-DOTA-1-NaI{sup 3}-octreotide ({sup 68}Ga-DOTANOC) in patients with SST receptor-expressing tumours and to compare the results of {sup 68}Ga-DOTA-D-Phe{sup 1}-Tyr{sup 3}-octreotate ({sup 68}Ga-DOTATATE) in the same patient population. Twenty SRS were included in the study. Patients' age (n = 20) ranged from 25 to 75 years (mean 55.4 {+-} 12.7 years). There were eight patients with well-differentiated neuroendocrine tumour (WDNET) grade1, eight patients with WDNET grade 2, one patient with poorly differentiated neuroendocrine carcinoma (PDNEC) grade 3 and one patient with mixed adenoneuroendocrine tumour (MANEC). All patients had two consecutive PET studies with {sup 68}Ga-DOTATATE and {sup 68}Ga-DOTANOC. All images were evaluated visually and maximum standardized uptake values (SUV{sub max}) were also calculated for quantitative evaluation. On visual evaluation both tracers produced equally excellent image quality and similar body distribution. The physiological uptake sites of pituitary and salivary glands showed higher uptake in {sup 68}Ga-DOTATATE images. Liver and spleen uptake values were evaluated as equal. Both {sup 68}Ga-DOTATATE and {sup 68}Ga-DOTANOC were negative in 6 (30 %) patients and positive in 14 (70 %) patients. In {sup 68}Ga-DOTANOC images only 116 of 130 (89 %) lesions could be defined and 14 lesions were missed because of lack of any uptake. SUV{sub max} values of lesions were significantly higher on {sup 68}Ga-DOTATATE images. Our study demonstrated that the images obtained by {sup 68}Ga-DOTATATE and {sup 68}Ga

Prospective comparison of {sup 68}Ga-DOTATATE and {sup 18}F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Energy Technology Data Exchange (ETDEWEB)

Archier, Aurelien; Taieb, David [Aix-Marseille University, Department of Nuclear Medicine, La Timone and North University Hospital, Marseille (France); Aix-Marseille University, European Center for Research in Medical Imaging, Marseille (France); Inserm UMR1068 Marseille Cancerology Research Center, Institut Paoli-Calmettes, Marseille (France); Varoquaux, Arthur; Beschmout, Eva [Aix-Marseille University, Department of Medical Imaging, Conception Hospital, Marseille (France); Garrigue, Philippe; Guillet, Benjamin [Aix-Marseille University, Department of Nuclear Medicine, La Timone and North University Hospital, Marseille (France); Aix-Marseille University, Department of Radiopharmacy, La Timone and North University Hospital, Marseille (France); Montava, Marion; Fakhry, Nicolas [Aix-Marseille University, Department of Otorhinolaryngology-Head and Neck Surgery, Conception Hospital, Marseille (France); Guerin, Carole; Sebag, Frederic [Aix-Marseille University, Department of Endocrine Surgery, Conception Hospital, Marseille (France); Gabriel, Sophie [Aix-Marseille University, Department of Nuclear Medicine, La Timone and North University Hospital, Marseille (France); Aix-Marseille University, European Center for Research in Medical Imaging, Marseille (France); Morange, Isabelle; Castinetti, Frederic [Aix-Marseille University, Department of Endocrinology, Conception Hospital, Marseille (France); Barlier, Anne [Aix-Marseille, University, Laboratory of Biochemistry and Molecular Biology, Conception Hospital, Marseille (France); Loundou, Anderson [Aix-Marseille University, Department of Public Health, Marseille (France); Pacak, Karel [National Institutes of Health, Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD (United States)

2016-07-15

Pheochromocytomas/paragangliomas (PHEOs/PGLs) overexpress somatostatin receptors and recent studies have already shown excellent results in the localization of these tumors using {sup 68}Ga-labeled somatostatin analogs ({sup 68}Ga-DOTA-SSA), especially in patients with germline succinate dehydrogenase subunit B gene (SDHB) mutations and head and neck PGLs (HNPGLs). The value of {sup 68}Ga-DOTA-SSA has to be established in sporadic cases, including PHEOs. Thus, the aim of this study was to compare {sup 68}Ga-DOTATATE PET/CT, {sup 18}F-FDOPA PET/CT, and conventional imaging in patients with various PHEOs/PGLs with a special emphasis on sporadic cases, including those located in the adrenal gland. {sup 68}Ga-DOTATATE, {sup 18}F-FDOPA PET/CT, and conventional imaging (contrast-enhanced CT and MRI with MR angiography sequences) were prospectively performed in 30 patients (8 with SDHD mutations, 1 with a MAX mutation and 21 sporadic cases) with PHEO/PGL at initial diagnosis or relapse. The patient-based sensitivities were 93 % (28/30), 97 % (29/30), and 93 % (28/30) for {sup 68}Ga-DOTATATE PET/CT, {sup 18}F-FDOPA PET/CT, and conventional imaging, respectively. The lesion-based sensitivities were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for {sup 68}Ga-DOTATATE PET/CT, {sup 18}F-FDOPA PET/CT, and conventional imaging respectively (p = 0.042). {sup 68}Ga-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) than {sup 18}F-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging (24/30; p = 0.024). {sup 68}Ga-DOTATATE PET/CT missed two PHEOs of a few millimeters in size and a large recurrent PHEO. One lesion was considered false-positive on {sup 68}Ga-DOTATATE PET/CT and corresponded to a typical focal lesion of fibrous dysplasia on MRI. Among the 11 lesions missed by conventional imaging, 7 were detected by conventional imaging with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent PHEO). {sup 68}Ga-DOTATATE PET/CT is the most sensitive tool in the

The effects of multidisciplinary therapies, surgery plus gemcitabine, cisplatin and paclitaxel (GCP) chemotherapy, against advanced urothelial carcinoma

International Nuclear Information System (INIS)

Tanimoto, Ryuta; Saika, Takashi; Fujio, Kei

2008-01-01

Combination chemotherapy with Gemcitabine, Cisplatin and Paclitaxel (GCP) is an active and well-tolerated combination for the treatment of advanced urothelial carcinoma. There is no evidence that multidisciplinary therapy, surgery plus GCP chemotherapy, can improve survival for patients with advanced urothelial carcinoma. We retrospectively analyzed the tolerability and efficacy of multidisciplinary therapy, surgery plus GCP chemotherapy, against advanced urothelial carcinoma. In this institution, patients (pts) with histologically verified advanced urothelial carcinoma received 2-4 cycles of gemcitabine 1,200 mg/m 2 on days 1 and 8, cisplatin 70 mg/m 2 on day 1, and paclitaxel 80 mg/m 2 on days 1 and 8 prior or subsequent to surgery. Radiologic response was evaluated with computed tomography and magnetic resonance imaging. Between May 2003 and Oct 2007, 19 pts (8 pts as neoadjuvant therapy (group A) and 11 as adjuvant therapy (group B)) were analyzed. Median age was 57 years. All pts had Performance Status 0 or 1. Initial tumor, nodes and metastasis (TNM) stage was T3-4 N0 M0 in 5, T any N1-2 M0 in 9 and T any N any M1 in 5 pts. The chemotherapy was well tolerated with infrequent grade III/IV toxicity (neutropenia in 6 and anemia in 2, thrombocytopenia in 4 patients). Median follow-up was 18 months (4-47). By Oct 2007, 18 pts had undergone radical surgery (9 pts radical cystectomy, 8 pts nephroureterectomy, and 1 pt retroperitoneal lymph node dissection). In group A, the radiologic response rate was documented in 6 out of 8 accessible pts (75%), including 1 complete response (CR) and 1 pathological CR. Two out of 8 pts (25%) relapsed and died. In group B, 6 pts out 11 (55%) relapsed and 2 (18%) died of the cancer. Median estimated progression-free survival and median overall survival were 15.4 months and 19.9 months respectively. Multidisciplinary therapy, surgery plus GCP chemotherapy, is effective and tolerable even in cases of metastatic urothelial carcinoma. A

30-Day, 90-day and 1-year mortality after emergency colonic surgery

DEFF Research Database (Denmark)

Pedersen, T; Watt, S K; Tolstrup, M-B

2017-01-01

PURPOSE: Emergency surgery is an independent risk factor in colonic surgery resulting in high 30-day mortality. The primary aim of this study was to report 30-day, 90-day and 1-year mortality rates after emergency colonic surgery, and to report factors associated with 30-day, 90-day and 1-year...... mortality. Second, the aim was to report 30-day postoperative complications and their relation to in-hospital mortality. METHODS: All patients undergoing acute colonic surgery in the period from May 2009 to April 2013 at Copenhagen University Hospital Herlev, Denmark, were identified. Perioperative data...... postoperative deaths. CONCLUSION: Mortality and complication rates after emergency colonic surgery are high and associated with patient related risk factors that cannot be modified, but also treatment related outcomes that are modifiable. An increased focus on medical and other preventive measures should...

Chemotherapy for carcinoma of stomach

International Nuclear Information System (INIS)

Salek, T.

2011-01-01

Of all patients with gastric cancer 80 % to 90 % are either diagnosed at an advanced stage when the tumour is inoperable, or develop a recurrence within five years after surgery. Chemotherapy clearly improves survival in comparison to best supportive care only. No chemotherapy regimen showed a survival benefit better than 5-fluorouracil alone in a phase III trial for advanced gastric cancer in 1990s, and several new cytotoxic agents became available in late 1990s. Thereafter, a couple of phase III trials supported the substitution of infusional 5-fluorouracil by orally administered agents and the replacement of cisplatin by oxaliplatin in early 2000s. Trastuzumab has succeeded in showing a survival benefit for patients with Her-2 positive gastric cancer which accounts for about 10 - 20 % of the cancer. This means that the door is opened to the new era of chemotherapy with molecular target agents and with individualization for advanced gastric cancer. (author)

Study of plasma binding of receptor-specific peptides

OpenAIRE

Gregor, David

2008-01-01

The binding ability of two receptor specific peptides namely 90Y-DOTA-TATE and 111In-DOTA-TATE was studied in therm of interspecies comparison by the method of equilibrium dialysis. This plasma protein binding was different for the chosen animal species (human, rat, rabbit, bovine eventually pork) whereas binding of 90Y-DOTA- TATE was higher than binding of 111In-DOTA-TATE. KEYWORDS: Protein binding, radiofarmaceuticals, equilibrium dialysis, 90Y-DOTA-TATE, 111In- DOTA-TATE

The effect of 90Sr/90Y β-rays on benign prostatic hyperplasia

International Nuclear Information System (INIS)

Kong Xiangbo; Ma Qingjie; Gu Xinquan

2004-01-01

Objective: To investigate the effect of 90Sr/90Y β-rays on Benign prostatic hyperplasia (BPH). Methods: In order to carry out β intracavitary irradiation, the active area of the applicator was located into prostate gland section of urethra in 37 patients. The dose was controlled 30∼50Gy in each patient and the patients were observed for 3 months. Results: After two weeks 26 cases were remarkably improved, 7 cases were improved and 4 cases were ineffective. There was significant difference on MFR, PVR, I-PSS and volume of prostate gland before and after treatment (P<0.01=. Conclusion: Clinical tests indicate that the 90Sr/90Y prostatic hyperplasia applicators provide a safe, effective ,non-invasive and economical therapeutic method for BPH. It is especially applicable for old and high-risk patients. (authors)

Long Distance Endovascular Growth of Jugulotympanic Paraganglioma Evident in 68Ga-DOTATATE PET but Concealed on CT.

Science.gov (United States)

Avramovic, Nemanja; Weckesser, Matthias; Velasco, Aglaé; Stenner, Markus; Noto, Benjamin

2017-02-01

A 60-year-old woman was referred to contrast-enhanced CT for evaluation of jugular vein thrombosis incidentally detected by ultrasound. Contrast-enhanced CT showed an enhanced tumor of the right skull base highly suspicious of jugulotympanic paraganglioma. However, the jugular veins showed a nearly symmetric contrast enhancement without clear evidence of thrombosis. Consecutive Ga-DOTATATE PET/CT depicted high tumor uptake, which comprised the entire internal jugular vein. Endovascular growth of paraganglioma might be missed on contrast-enhanced CT because of high vascularization of the lesion. Ga-DOTATATE PET is suited for accurate determination of tumor extent.

Half-life evaluations for 3H, 90Sr, and 90Y

International Nuclear Information System (INIS)

MacMahon, Desmond

2006-01-01

A recent paper has reviewed methods for the evaluation of discrepant sets of data and demonstrated the results of applying these methods to the published half-life data of 90 Sr and 137 Cs [MacMahon, T.D., Pearce, A., Harris, P., 2004. Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281]. The half-life data for 3 H has been subject to a comprehensive review and critical evaluation by Lucas and Unterweger [2000. Comprehensive review and critical evaluation of the half-life of tritium. J. Res. Natl. Inst. Stand. Technol. 105, 541-549]. The current paper reports the results of applying the various evaluation procedures of MacMahon et al. Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281] to the data of Lucas and Unterweger [Comprehensive review and critical evaluation of the half-life of tritium. J. Res. Natl. Inst. Stand. Technol. 105, 541-549], resulting in a recommended half-life of 4497(4) days. MacMahon et al. [Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281] highlighted problems in the evaluation of the discrepant half-life data of 90 Sr, in particular the worrying upward trend in the data, where the weighted mean of all the measurements increases, on average, by 35 days each time a new measurement result is added. The current paper reports on further analyses of these data. New measurements of the half-life of 90 Y have been reported by Kossert and Schrader [2004. Standardization by liquid scintillation counting and half-life measurements of 90 Y. Appl. Radiat. Isot. 60, 741]. This has prompted a new evaluation of all available published 90 Y half-life data. The data are fairly consistent, and a value of 64.063(16) h is recommended

Determination of 90Sr in milk by solvent extraction of 90Y

International Nuclear Information System (INIS)

Mitsuhashi, Toshihiko; Sakanoue, Masanobu.

1977-01-01

In order to replace the conventional method using violent fuming nitric acid, a new method for the determination of 90 Sr in milk has been developed by using the solvent extraction with bis (2-ethylhexyl) phosphoric acid (HDEHP). The daughter nuclide 90 Y in a radiochemical equilibrium with its parent 90 Sr was extracted with 2:1 HDEHP-toluene from the acid solution (1M HCl) of milk ash sample prepared by dry-ashing. After stripping with 8M HCl, 90 Y, together with stable yttrium added as carrier, was precipitated as oxalate to prepare β-counting source. The radiochemical purity was confirmed by decay curve. The decontamination of strontium was checked by applying non-dispersive fluorescence x-ray analysis using 133 Ba as irradiating source. Bone samples of cow were also analyzed by the same method and the results were compared with those obtained by other methods. The duplicate crosschecking analyses of finely ground bone samples were carried out to examine the effectiveness of this method. This simple new method was found to be very effective for the routine analysis of 90 Sr in these samples. (auth.)

Validation of Extraction Paper Chromatography as a Quality Control Technique for Analysis of Sr-90 in Y-90 Product

International Nuclear Information System (INIS)

Nipavan, Poramatikul; Jatupol, Sangsuriyan; Wiranee, Sriweing

2009-07-01

Full text: Yttrium-90 (Y-90) is a daughter product of strontium-90 (Sr-90). It is specified that there should be less than 2 micro-curie of Sr-90 in Y-90 radiopharmaceuticals. Since both nuclides are beta emitting and there is always a contamination of Y-90 in Sr-90 sample, validation of the analytical method is necessary. In this study, commercial Y-90 and Sr-85 (a gamma emitting isotope of strontium) were used as daughter and mother nuclides, respectively. Extraction paper chromatography technique and its efficient validation method were investigated. Bis-(2-ethylhexyl) diphosphonate was dropped at the origin of chromatography paper and air dried prior to sample drops. Validation of the separation was done by radio-chromatography scanning of the chromatography paper. Their energy spectra were identified in the spectra mode of Packard Cobra II automatic gamma counter, which can differentiate a pure gamma, a pure beta and a mixture of beta and gamma nuclides. Results showed that yttrium acetate remained fixed at the origin of the chromatography paper while strontium acetate moved to the solvent front when developed in saline. In conclusion, the extraction paper chromatography technique can effectively separate Sr-90 from Y-90

[68Ga]DOTATATE PET/MRI and [18F]FDG PET/CT are complementary and superior to diffusion-weighted MR imaging for radioactive-iodine-refractory differentiated thyroid cancer

International Nuclear Information System (INIS)

Vrachimis, Alexis; Stegger, Lars; Wenning, Christian; Noto, Benjamin; Konnert, Julia Renate; Riemann, Burkhard; Weckesser, Matthias; Burg, Matthias Christian; Allkemper, Thomas; Heindel, Walter; Schaefers, Michael

2016-01-01

The purpose of this study was to determine whether [ 68 Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [ 18 F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC). The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [ 18 F]FDG PET/CT and [ 68 Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference. Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [ 68 Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [ 18 F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [ 18 F]FDG PET/CT, [ 68 Ga]DOTATATE PET/MRI and DWI, respectively. [ 18 F]FDG PET(/CT) was superior to [ 68 Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [ 68 Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [ 18 F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [ 18 F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases. [ 18 F]FDG PET/CT was more sensitive than [ 68 Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [ 68 Ga]DOTATATE PET(/MRI) was more sensitive and [ 18 F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [ 18 F]FDG PET for postoperative monitoring of patients with

Development of a dosimetric system for 90Sr + 90Y betatherapy applicators

International Nuclear Information System (INIS)

Coelho, Talita Salles

2010-01-01

The 90 Sr+ 90 Y applicators, used in betatherapy for prevention of keloids and pterigium, are imported and many times their dosimetric features are shown only in an illustrated form by the manufacturers. The exhaustive routine of the medical physicists in the clinic do not make possible the accomplishment of procedures for the confirmation of these parameters. This work presents the development of a methodology for the dosimetry of 90 Sr+ 90 Y betatherapy applicators. The Monte Carlo code MCNP5 was used for the simulation of the percentage depth dose curves and dose distribution profiles produced by these applicators. The experimental measurements of the radial and axial radiation attenuation, have been done with a mini-extrapolation chamber, thermoluminescent dosimeters and radiographic films. The experimental results have been compared with the simulated values. Both percentage depth dose curves and the radial dose profiles, the theoretical and the experimental ones, have presented good agreement, which may validate the use of the MCNP5 for these simulations, confirming the viability of the usage of this method in procedures of beta emitter sources dosimetry. (author)

Gallium-68 DOTA-TATE Positron Emission Tomography/Computed Tomography: Scintigraphic Changes of Adrenal Glands Following Management of Ectopic Cushing's Syndrome by Steroidogenesis Inhibitors

International Nuclear Information System (INIS)

Huang, Yu-Ting; Aziz, Shaikh Irfan; Kumar, Aravind S. Ravi

2014-01-01

In the era of emerging functional imaging techniques, an understanding of the effects of hormonal therapies on the scintigraphic appearance of endocrine organs is desirable to minimize the erroneous scan interpretation. The mechanisms by which changes in the scintigraphic appearance of endocrine organs occur however sometimes remain ambiguous. This case demonstrates the gallium-68 (Ga-68) DOTA-TATE positron emission tomography/computed tomography (CT) appearance of adrenal glands following management with steroidogenesis inhibitors. The potential mechanisms underlying this change are discussed. A 17-year-old boy with adrenocorticotropic hormone (ACTH) dependent Cushing's syndrome secondary to ectopic ACTH secretion underwent pre- and post-metyrapone and dexamethasone treatment Ga-68 DOTA-TATE scans 4 months apart. Pretreatment, both adrenals demonstrated normal symmetrical prominent Ga-68 DOTA-TATE uptake and normal CT appearance. The posttherapy scan revealed marked symmetrical suppression of Ga-68 DOTA-TATE uptake, but with bilateral adrenal hypertrophy on CT

Optimizing labelling conditions of 213Bi-DOTATATE for preclinical applications of peptide receptor targeted alpha therapy.

Science.gov (United States)

Chan, Ho Sze; de Blois, Erik; Konijnenberg, Mark W; Morgenstern, Alfred; Bruchertseifer, Frank; Norenberg, Jeffrey P; Verzijlbergen, Fred J; de Jong, Marion; Breeman, Wouter A P

2017-01-01

213 Bismuth ( 213 Bi, T 1/2 = 45.6 min) is one of the most frequently used α-emitters in cancer research. High specific activity radioligands are required for peptide receptor radionuclide therapy. The use of generators containing less than 222 MBq 225 Ac (actinium), due to limited availability and the high cost to produce large-scale 225 Ac/ 213 Bi generators, might complicate in vitro and in vivo applications though.Here we present optimized labelling conditions of a DOTA-peptide with an 225 Ac/ 213 Bi generator (< 222 MBq) for preclinical applications using DOTA-Tyr 3 -octreotate (DOTATATE), a somatostatin analogue. The following labelling conditions of DOTATATE with 213 Bi were investigated; peptide mass was varied from 1.7 to 7.0 nmol, concentration of TRIS buffer from 0.15 mol.L -1 to 0.34 mol.L -1 , and ascorbic acid from 0 to 71 mmol.L -1 in 800 μL. All reactions were performed at 95 °C for 5 min. After incubation, DTPA (50 nmol) was added to stop the labelling reaction. Besides optimizing the labelling conditions, incorporation yield was determined by ITLC-SG and radiochemical purity (RCP) was monitored by RP-HPLC up to 120 min after labelling. Dosimetry studies in the reaction vial were performed using Monte Carlo and in vitro clonogenic assay was performed with a rat pancreatic tumour cell line, CA20948. At least 3.5 nmol DOTATATE was required to obtain incorporation ≥ 99 % with 100 MBq 213 Bi (at optimized pH conditions, pH 8.3 with 0.15 mol.L -1 TRIS) in a reaction volume of 800 μL. The cumulative absorbed dose in the reaction vial was 230 Gy/100 MBq in 30 min. A minimal final concentration of 0.9 mmol.L -1 ascorbic acid was required for ~100 MBq (t = 0) to minimize radiation damage of DOTATATE. The osmolarity was decreased to 0.45 Osmol/L.Under optimized labelling conditions, 213 Bi-DOTATATE remained stable up to 2 h after labelling, RCP was ≥ 85 %. In vitro showed a negative correlation between ascorbic acid

Bulky mesonephric adenocarcinoma of the uterine cervix treated with neoadjuvant chemotherapy and radical surgery: report of the first case.

Science.gov (United States)

Ditto, Antonino; Martinelli, Fabio; Bogani, Giorgio; Gasparri, Maria L; Donato, Violante Di; Paolini, Biagio; Carcangiu, Maria L; Lorusso, Domenica; Raspagliesi, Francesco

2016-11-11

Malignant mesonephric adenocarcinoma of the uterine cervix is a rare occurrence with few cases described in the literature. Although surgery seems to be effective in the treatment of early-stage tumor, no cases describing outcomes of locally advanced stage are available. We report the first case of a patient with International Federation of Obstetrics and Gynecologists stage IIB mesonephric adenocarcinoma undergoing neoadjuvant chemotherapy and radical surgery. Despite the inherent limitation of a single description of a case, our experience supports the utilization of neoadjuvant chemotherapy in patients with malignant mesonephric adenocarcinoma of the uterine cervix. Further prospective multi-institutional studies are needed.

Effect of integrated surgery + radiotherapy + chemotherapy treatment on survival status and serum indexes in patients with gallbladder carcinoma

Directory of Open Access Journals (Sweden)

Zhi-Li Wei

2016-12-01

Full Text Available Objective: To study the effect of integrated surgery + radiotherapy + chemotherapy treatment on the survival status and serum indexes in patients with gallbladder carcinoma. Methods: A total of 68 patients with gallbladder carcinoma were divided into observation group (received integrated surgery + radiotherapy + chemotherapy treatment and control group (received surgery + radiotherapy according to different treatments. Differences in the content of tumor markers, growth factors and adhesion molecules in serum as well as the median survival time and survival rate in 5 years of follow-up were compared between the two groups 1 month after treatment. Results: Tumor markers β2-MG, CA19-9, CA242, CA125, CA724, CEA and AFP content in serum of observation group after treatment were significantly lower than those of control group; growth factors VEGF, FGF, EGFR and HER2 content in serum were significantly lower than those of control group while IGFBP-2 and IGFBP-3 content were significantly higher than those of control group; adhesion molecules E-selectin, ICAM-1, VCAM-1 and sE-Cd content in serum were significantly lower than those of control group; the median survival time of 5-year follow-up as well as 1-, 3- and 5-year survival rate were significantly greater than those of control group. Conclusions: Integrated treatment of surgery + radiotherapy + chemotherapy can optimize the short-term and long-term curative effect in patients with gallbladder carcinoma.

Evaluation of quantitative planar 90Y bremsstrahlung whole-body imaging

International Nuclear Information System (INIS)

Minarik, D; Ljungberg, M; Gleisner, K Sjoegreen; Segars, P

2009-01-01

With high-dose administration of 90 Y labeled antibodies, it is possible to image 90 Y without an admixture of 111 In. We have earlier shown that it is possible to perform quantitative 90 Y bremsstrahlung SPECT for dosimetry purposes with reasonable accuracy. However, whole-body (WB) activity quantification with the conjugate view method is not as time consuming as SPECT and has been the method of choice for dosimetry. We have investigated the possibility of using a conjugate view method where scatter-, backscatter- and septal-penetration compensations are performed by inverse filtering and attenuation correction is performed with a WB x-ray image, for total-body and organ activity quantification of 90 Y. The method was evaluated using both Monte Carlo simulated scintillation camera images using realistic source distributions, and by an experimental phantom study. The method was evaluated in terms of image quality and accuracy of the activity quantification. The experimental phantom study was performed using the RSD torso phantom with 90 Y activity uniformly distributed in the liver insert. A GE Discovery VH/Hawkeye system was used to acquire the image. The simulation study was performed for a realistic activity distribution in the NCAT anthropomorphic phantom where 90 Y bremsstrahlung images were generated using the SIMIND MC program. Two different phantom configurations and two activity distributions were simulated. To mimic the RSD phantom experiment one simulation study was also made with 90 Y activity located only in the liver. The SIMIND program was configured to resemble a GE Discovery VH/Hawkeye system. An x-ray projector program was used to generate whole-body x-ray images from the NCAT phantom for attenuation correction in the conjugate view method. Organ activities were calculated from ROIs that exactly covered the organs. Corrections for background activity, overlapping activity and source extension in the depth direction were applied on the ROI data

Diffuse nesidioblastosis diagnosed on a Ga-68 DOTATATE positron emission tomography/computerized tomography

International Nuclear Information System (INIS)

Arun, Sasikumar; Mittal, Bhagwant Rai; Shukla, Jaya; Bhattacharya, Anish; Kumar, Praveen

2013-01-01

The authors describe a 50 days old pre-term infant with persistent hyperinsulinemic hypoglycemia of infancy in whom 68 Ga DOTATATE positron emission tomography/computerized tomography scan showed diffusely increased tracer uptake in the entire pancreas with no abnormal tracer uptake anywhere else in the body, suggestive of a diffuse variant of nesidioblastosis. (author)

Adjuvant chemotherapy compliance is not superior after thoracoscopic lobectomy

DEFF Research Database (Denmark)

Licht, Peter B; Schytte, Tine; Jakobsen, Erik

2014-01-01

BACKGROUND: It is generally assumed that patient compliance with adjuvant chemotherapy is superior after video-assisted thoracoscopic surgery compared with open lobectomy for non-small cell lung cancer (NSCLC). The level of evidence for this assumption, however, is limited to single-institution, ......BACKGROUND: It is generally assumed that patient compliance with adjuvant chemotherapy is superior after video-assisted thoracoscopic surgery compared with open lobectomy for non-small cell lung cancer (NSCLC). The level of evidence for this assumption, however, is limited to single...... adjuvant chemotherapy and 121 (38.7%) completed all four cycles. Ordinal logistic regression revealed that chemotherapy compliance (none, partial, and full chemotherapy) was significantly reduced by the patient's age (p....02). No significant difference between video-assisted thoracoscopic surgery and thoracotomy was seen regarding chemotherapy compliance (p=0.17), number of chemotherapy cycles (p=0.60), or time from surgery to chemotherapy (p = 0.41). CONCLUSIONS: Complete national data do not support the widespread assumption...

Systemic Chemotherapy using FLOT - Regimen Combined with Cytoreductive Surgery plus HIPEC for Treatment of Peritoneal Metastasized Gastric Cancer. .

Science.gov (United States)

Müller, H; Hotopp, Th; Tofeili, A; Wutke, K

2014-05-01

The aim was to evaluate the feasibility and the effectiveness of neoadjuvant systemic chemotherapy using FLOT - protocol followed by cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC) followed by systemic chemotherapyand in patients with peritoneal carciriomatosis (PC) from gastric cancer. Twenty six (median age 53 years, range 39 - 71) were scheduled for three cycles of neoadjuvant systemic chemotherapy using bi-weekly FLOT - protocol followed by CRS + HIPEC. Thereafter 3 additional cycles of FLOT were given. During HIPEC in Colliseum technique Oxaliplatin was given in a dosage of 200 mg/m2 and Docetaxel in a dosage of 80 mg/m2. All patients underwent cytoreductive surgery plus HIPEC. Peritoneal Cancer index was > 15 in 3 cases only. Complete resection could be carried out in all cases (CC-O 18, CC-18). Postoperative complication rate was 23% with no mortality within 30 days. Anastomotic leakage rate was 3.2%. Overall survival was 19.0 months with a 2-year survival rate 38%. Regression analysis demonstrated a Peritoneal Cancer Index PCI > 12 as negative factor for survival. Neoadju- vant chemotherapy using FLOT - protocol followed by CRS + HIPEC seems to be associated with prolonged OS in patients with peritoneal carcinomatosis from gastric cancer. This treatment is not recommended for patients with extensive peritoneal involvement and PCI > 12.

Determination of /sup 90/Sr in milk by solvent extraction of /sup 90/Y

Energy Technology Data Exchange (ETDEWEB)

Mitsuhashi, T [National Inst. of Animal Industry, Chiba (Japan); Sakanoue, M

1977-10-01

In order to replace the conventional method using violent fuming nitric acid, a new method for the determination of /sup 90/Sr in milk has been developed by using the solvent extraction with bis (2-ethylhexyl) phosphoric acid (HDEHP). The daughter nuclide /sup 90/Y in a radiochemical equilibrium with its parent /sup 90/Sr was extracted with 2:1 HDEHP-toluene from the acid solution (1M HCl) of milk ash sample prepared by dry-ashing. After stripping with 8M HCl, /sup 90/Y, together with stable yttrium added as carrier, was precipitated as oxalate to prepare ..beta..-counting source. The radiochemical purity was confirmed by decay curve. The decontamination of strontium was checked by applying non-dispersive fluorescence x-ray analysis using /sup 133/Ba as irradiating source. Bone samples of cow were also analyzed by the same method and the results were compared with those obtained by other methods. The duplicate crosschecking analyses of finely ground bone samples were carried out to examine the effectiveness of this method. This simple new method was found to be very effective for the routine analysis of /sup 90/Sr in these samples.

Is adjuvant chemotherapy necessary for patients with microinvasive breast cancer after surgery?

Institute of Scientific and Technical Information of China (English)

Hai-Fei Niu; Li-Juan Wei; Jin-Pu Yu; Zhen Lian; Jing Zhao; Zi-Zheng Wu; Jun-Tian Liu

2016-01-01

.105). Conclusions:Patients with MIBC who overexpress Ki-67 and with negative hormonal receptors have relatively substantial risk of relapse within the first five years after surgery. However, adjuvant chemotherapy can only improve the outcomes of ER(-)/PR(-) patients, but not those who overexpress Ki-67. Further studies with prolonged follow-up of large cohorts are recommended to assess the prognostic significance and treatment of this lesion.

Development of a dosimetric system for {sup 90}Sr + {sup 90}Y betatherapy applicators; Desenvolvimento de um sistema de dosimetria para aplicadores de betaterapia de {sup 90}Sr + {sup 90}Y

Energy Technology Data Exchange (ETDEWEB)

Coelho, Talita Salles

2010-07-01

The {sup 90}Sr+{sup 90}Y applicators, used in betatherapy for prevention of keloids and pterigium, are imported and many times their dosimetric features are shown only in an illustrated form by the manufacturers. The exhaustive routine of the medical physicists in the clinic do not make possible the accomplishment of procedures for the confirmation of these parameters. This work presents the development of a methodology for the dosimetry of {sup 90}Sr+{sup 90}Y betatherapy applicators. The Monte Carlo code MCNP5 was used for the simulation of the percentage depth dose curves and dose distribution profiles produced by these applicators. The experimental measurements of the radial and axial radiation attenuation, have been done with a mini-extrapolation chamber, thermoluminescent dosimeters and radiographic films. The experimental results have been compared with the simulated values. Both percentage depth dose curves and the radial dose profiles, the theoretical and the experimental ones, have presented good agreement, which may validate the use of the MCNP5 for these simulations, confirming the viability of the usage of this method in procedures of beta emitter sources dosimetry. (author)

Separation of 90Y from 90Sr by solvent extraction with ionizable crown ethers

International Nuclear Information System (INIS)

Wood, D.J.; Elshani, S.; Du, H.S.; Natale, N.R.; Wai, C.M.

1993-01-01

Sym-Dibenzo-16-crown-5-oxyacetic acid and its analogues are selective for the extraction of Y 3+ over Sr 2+ from aqueous solutions into chloroform. The selectivity and the pH range of extraction are influenced by the structure of the ligand. The size of the macrocyclic cavity, the tether length of the lariat, the attachment of alkyl functional groups to the lariat, and the identity of the ionizable group can affect selectivity and extraction efficiency. When the carboxylic acid at the terminal end of the lariat is replaced by a hydroxamic acid, the selectivity for Y 3+ over Sr 2+ is significantly increased. Using these ionizable crown ethers as extractants, 90 Y fractions of greater than 99.9% purity can be obtained in a single solvent extraction step from solutions of 90 Sr. 11 refs., 5 figs., 2 tabs

Gallium‐68 DOTATATE Production with Automated PET Radiopharmaceutical Synthesis System: A Three Year Experience

Directory of Open Access Journals (Sweden)

Alireza Aslani

2014-10-01

Full Text Available Objective(s: Gallium‐68 (Ga‐68 is an ideal research and hospital‐based PET radioisotope. Currently, the main form of Ga‐68 radiopharmaceutical that is being synthesised in‐house is Ga‐68 conjugated with DOTA based derivatives. The development of automated synthesis systems has increased the reliability, reproducibility and safety of radiopharmaceutical productions. Here we report on our three year, 500 syntheses experience with an automated system for Ga‐68 DOTATATE. Methods: The automated synthesis system we use is divided into three parts of a servomotor modules, b single use sterile synthesis cassettes and, c a computerized system that runs the modules. An audit trail is produced by the system as a requirement for GMP production. The required reagents and chemicals are made in‐. The Germanium breakthrough is determined on a weekly basis. Production yields for each synthesis are calculated to monitor the performance and efficiency of the synthesis. The quality of the final product is assessed after each synthesis by ITLC‐SG and HPLC methods. Results: A total of 500 Ga‐68 DOTATATE syntheses (>800 patient doses were performed between March 2011 and February 2014. The average generator yield was 81.3±0.2% for 2011, 76.7±0.4% for 2012 and 75.0±0.3% for 2013. Ga‐68 DOTATATE yields for 2011, 2012, and 2013 were 81.8±0.4%, 82.2±0.4% and 87.9±0.4%, respectively. These exceed the manufacturer’s expected value of approximately 70%. Germanium breakthrough averaged 8.6×10‐6% of total activity which is well below the recommended level of 0.001%. The average ITLC‐measured radiochemical purity was above 98.5% and the average HPLC‐measured radiochemical purity was above 99.5%. Although there were some system failures during synthesis, there were only eight occasions where the patient scans needed to be rescheduled. Conclusion: In our experience the automated synthesis system performs reliably with a relatively low incident

Outcomes of surgery in patients aged ≥90 years in the general surgical setting.

Science.gov (United States)

Sudlow, A; Tuffaha, H; Stearns, A T; Shaikh, I A

2018-03-01

Introduction An increasing proportion of the population is living into their nineties and beyond. These high risk patients are now presenting more frequently to both elective and emergency surgical services. There is limited research looking at outcomes of general surgical procedures in nonagenarians and centenarians to guide surgeons assessing these cases. Methods A retrospective analysis was conducted of all patients aged ≥90 years undergoing elective and emergency general surgical procedures at a tertiary care facility between 2009 and 2015. Vascular, breast and endocrine procedures were excluded. Patient demographics and characteristics were collated. Primary outcomes were 30-day and 90-day mortality rates. The impact of ASA (American Society of Anesthesiologists) grade, operation severity and emergency presentation was assessed using multivariate analysis. Results Overall, 161 patients (58 elective, 103 emergency) were identified for inclusion in the study. The mean patient age was 92.8 years (range: 90-106 years). The 90-day mortality rates were 5.2% and 19.4% for elective and emergency procedures respectively (p=0.013). The median survival was 29 and 19 months respectively (p=0.001). Emergency and major gastrointestinal operations were associated with a significant increase in mortality. Patients undergoing emergency major colonic or upper gastrointestinal surgery had a 90-day mortality rate of 53.8%. Conclusions The risk for patients aged over 90 years having an elective procedure differs significantly in the short term from those having emergency surgery. In selected cases, elective surgery carries an acceptable mortality risk. Emergency surgery is associated with a significantly increased risk of death, particularly after major gastrointestinal resections.

Assessing residual cancer cells using MRI and US after preoperative chemotherapy in primary breast cancer to omit surgery.

Science.gov (United States)

Iwase, Madoka; Sawaki, Masataka; Hattori, Masaya; Yoshimura, Akiyo; Ishiguro, Junko; Kotani, Haruru; Gondo, Naomi; Adachi, Yayoi; Kataoka, Ayumi; Onishi, Sakura; Sugino, Kayoko; Iwata, Hiroji

2018-04-04

Enhanced magnetic resonance imaging (MRI) and ultrasonography (US) are used to assess residual lesions after preoperative chemotherapy before surgery. However, residual lesion assessments based on preoperative imaging often differ from postoperative pathologic diagnoses. We retrospectively reviewed the accuracy of preoperative residual lesion assessments, including ductal carcinoma in situ (DCIS) cases to find criteria for cases in which surgery can be omitted. We reviewed 201 patients who received preoperative chemotherapy and surgery in our hospital from January 2013 to November 2016. Presurgical evaluations regarding the possible existence of residual lesions, and clinical Complete Response (cCR) or non-cCR, were compared with postoperative pathological diagnoses. Of the 201 patients, 52 were diagnosed with cCR, and 39 with pathological complete response (pCR). Predictions for residual lesions were 86.4% sensitive, 76.9% specific, and 84.6% accurate. When patients were divided into 4 groups by estrogen receptor (ER) and HER2 status, sensitivity in each group was ER + /HER2 - : 91.4%; ER - /HER2 - : 94.1%; ER + /HER2 + : 78.6%; and ER - /HER2 + : 78.5%. Of the 22 patients preoperatively assessed with cCR, but diagnosed with non-pCR, the median invasive residual tumor size was 2 mm (range 0-46 mm); 5 patients (22.7%) had only DCIS. Predicting residual lesions after preoperative chemotherapy by using MRI and US is a reasonable strategy. However, current methods are inadequate for identifying patients who can omit surgery; therefore, a new strategy for detecting small tumors in these patients is needed.

Therapeutic challenge in brain metastases: chemotherapy, surgery or radiotherapy

International Nuclear Information System (INIS)

Mena, Ivan; Contreras, Manuel; Ceballos Francisco

1998-01-01

Metastases to the brain occur in 25 to 35% of patients with systemic cancer. Cerebral metastatic is the most common intracranial tumor in adults and occur up to 10 times more frequently than primary tumors in the central nervous system. Significant advances have occurred in the diagnosis and treatment of metastases to the brain, and the therapeutic nihilism of the past is now no longer warranted for most patients. With the currently available treatments, most patients do not die of their brain metastases and usually experience effective palliation of neurologic symptoms and meaning full extension of life. As a trial to limit the cerebral metastatic disease, many and diverse therapy options have been developed such as: chemotherapy, surgery plus whole-brain radiotherapy, only radiation therapy, therapy with neutron, intersticial brachytherapy and stereotactic radiosurgery. In selected cases, surgery plus whole-brain radiotherapy is the conventional treatment for single metastases. However, recurrence usually limits the quality of life and greatly decrease the patients time life, and the therapy options are scarce. This piece of writing also includes a review of the available therapy forms to manage this kind of lesions. (The author)

90Y and 90Sr separation from hydrochloric acid solutions using TODGA as the extractant by solvent extraction and SLM methods

International Nuclear Information System (INIS)

Dutta, S.; Raut, D.R.; Mohapatra, P.K.; Manchanda, V.K.

2010-01-01

Yttrium-90 is an important radionuclide known for its therapeutic application in nuclear medicine. It is a pure β-emitter with no associated gamma rays and decays to stable daughter 90 Zr. Suitability of this isotope is because of its short half-life (t 1/2 = 64.2 hrs) and high β emissions (E max = 2.28 MeV. An important source of 90 Y is through the decay of 90 Sr, which produces carrier free isotope. 90 Sr (t 1/2 28 yrs) attains secular equilibrium with 90 Y in a short period and can serve as a long term source for the latter isotope because of relatively long half-life of the parent isotope. Solvent extraction studies with N,N,N',N'-tetra-octyldiglycolamide (TODGA) has shown that Y(III) is well extracted in 6 M HCI while at the same time, extraction of Sr(II) is very low leading to a separation factor (D Y /D Sr = 60,000). This property of TODGA can be exploited for the separation of Y from Sr. In the present work, Supported Liquid Membrane (SLM) based separation of Y and Sr has been explored using TODGA as the carrier

The Bad Berka dose protocol: comparative results of dosimetry in peptide receptor radionuclide therapy using (177)Lu-DOTATATE, (177)Lu-DOTANOC, and (177)Lu-DOTATOC.

Science.gov (United States)

Schuchardt, Christiane; Kulkarni, Harshad R; Prasad, Vikas; Zachert, Carolin; Müller, Dirk; Baum, Richard P

2013-01-01

The objective of this study is to analyze the in vivo behavior of the (177)Lu-labeled peptides DOTATATE, DOTANOC, and DOTATOC used for peptide receptor radionuclide therapy (PRRNT) of neuroendocrine tumors (NETs), by measuring organ and tumor kinetics and by performing dosimetric calculations. Two hundred fifty-three patients (group 1) with metastasized NET who underwent PRRNT were examined. Out of these, 185 patients received (177)Lu-DOTATATE, 9 were treated with (177)Lu-DOTANOC, and 59 with (177)Lu-DOTATOC. Additionally, 25 patients receiving, in consecutive PRRNT cycles, DOTATATE followed by DOTATOC (group 2) and 3 patients receiving DOTATATE and DOTANOC (group 3) were analyzed. Dosimetric calculations (according to MIRD scheme) were performed using OLINDA software. In group 1, DOTATOC exhibited the lowest and DOTANOC the highest uptake and therefore mean absorbed dose in normal organs (whole body, kidney, and spleen). In group 2, there was a significant difference between DOTATATE and DOTATOC concerning kinetics and normal organ doses. (177)Lu-DOTATOC had the lowest uptake/dose delivered to normal organs and highest tumor-to-kidney ratio. There were no significant differences between the three peptides concerning tumor kinetics and mean absorbed tumor dose. The study demonstrates a correlation between high affinity of DOTANOC in vitro and high uptake in normal organs/whole body in vivo, resulting in a higher whole-body dose. DOTATOC exhibited the lowest uptake and dose delivered to normal tissues and the best tumor-to-kidney ratio. Due to large interpatient variability, individual dosimetry should be performed for each therapy cycle.

Practical reconstruction protocol for quantitative 90Y bremsstrahlung SPECT/CT

International Nuclear Information System (INIS)

Siman, W.; Mikell, J. K.; Kappadath, S. C.

2016-01-01

Purpose: To develop a practical background compensation (BC) technique to improve quantitative 90 Y-bremsstrahlung single-photon emission computed tomography (SPECT)/computed tomography (CT) using a commercially available imaging system. Methods: All images were acquired using medium-energy collimation in six energy windows (EWs), ranging from 70 to 410 keV. The EWs were determined based on the signal-to-background ratio in planar images of an acrylic phantom of different thicknesses (2–16 cm) positioned below a 90 Y source and set at different distances (15–35 cm) from a gamma camera. The authors adapted the widely used EW-based scatter-correction technique by modeling the BC as scaled images. The BC EW was determined empirically in SPECT/CT studies using an IEC phantom based on the sphere activity recovery and residual activity in the cold lung insert. The scaling factor was calculated from 20 clinical planar 90 Y images. Reconstruction parameters were optimized in the same SPECT images for improved image quantification and contrast. A count-to-activity calibration factor was calculated from 30 clinical 90 Y images. Results: The authors found that the most appropriate imaging EW range was 90–125 keV. BC was modeled as 0.53× images in the EW of 310–410 keV. The background-compensated clinical images had higher image contrast than uncompensated images. The maximum deviation of their SPECT calibration in clinical studies was lowest (<10%) for SPECT with attenuation correction (AC) and SPECT with AC + BC. Using the proposed SPECT-with-AC + BC reconstruction protocol, the authors found that the recovery coefficient of a 37-mm sphere (in a 10-mm volume of interest) increased from 39% to 90% and that the residual activity in the lung insert decreased from 44% to 14% over that of SPECT images with AC alone. Conclusions: The proposed EW-based BC model was developed for 90 Y bremsstrahlung imaging. SPECT with AC + BC gave improved lesion detectability and activity

Clinical outcomes of Y90 radioembolization for recurrent hepatocellular carcinoma following curative resection

Energy Technology Data Exchange (ETDEWEB)

Ali, Rehan; Riaz, Ahsun; Gabr, Ahmed; Abouchaleh, Nadine; Mora, Ronald; Al Asadi, Ali [Northwestern University, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Caicedo, Juan Carlos; Abecassis, Michael; Katariya, Nitin [Northwestern University, Department of Surgery, Division of Transplant Surgery, Chicago, IL (United States); Maddur, Haripriya; Kulik, Laura [Northwestern University, Department of Medicine, Division of Hepatology, Chicago, IL (United States); Lewandowski, Robert J. [Northwestern University, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Chicago, IL (United States); Salem, Riad [Northwestern University, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Northwestern University, Department of Surgery, Division of Transplant Surgery, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Chicago, IL (United States)

2017-12-15

To assess safety/efficacy of yttrium-90 radioembolization (Y90) in patients with recurrent hepatocellular carcinoma (HCC) following curative surgical resection. With IRB approval, we searched our prospectively acquired database for patients that were treated with Y90 for recurrent disease following resection. Baseline characteristics and bilirubin toxicities following Y90 were evaluated. Intention-to-treat overall survival (OS) and time-to-progression (TTP) from Y90 were assessed. Forty-one patients met study inclusion criteria. Twenty-six (63%) patients had undergone minor (≤3 hepatic segments) resection while 15 (37%) patients underwent major (>3 hepatic segments) resections. Two patients (5%) had biliary-enteric anastomoses created during surgical resection. The median time from HCC resection to the first radioembolization was 17 months (95% CI: 13-37). The median number of Y90 treatment sessions was 1 (range: 1-5). Ten patients received (entire remnant) lobar Y90 treatment while 31 patients received selective (≤2 hepatic segments) treatment. Grades 1/2/3/4 bilirubin toxicity were seen in nine (22%), four (10%), four (10%), and zero (0%) patients following Y90. No differences in bilirubin toxicities were identified when comparing lobar with selective approaches (P = 0.20). No post-Y90 infectious complications were identified. Median TTP and OS were 11.3 (CI: 6.5-15.5) and 22.1 months (CI: 10.3-31.3), respectively. Radioembolization is a safe and effective method for treating recurrent HCC following surgical resection, with prolonged TTP and promising survival outcomes. (orig.)

Intraoperative avidination for radionuclide treatment as a radiotherapy boost in breast cancer: results of a phase II study with 90Y-labeled biotin

International Nuclear Information System (INIS)

Paganelli, Giovanni; De Cicco, Concetta; Carbone, Giuseppe; Pacifici, Monica; Ferrari, Mahila E.; Cremonesi, Marta; Di Dia, Amalia; Pagani, Gianmatteo; Galimberti, Viviana; Luini, Alberto; Leonardi, Maria Cristina; Ferrari, Annamaria; Orecchia, Roberto; De Santis, Rita; Zurrida, Stefano; Veronesi, Umberto

2010-01-01

External beam radiotherapy (EBRT) after conservative surgery for early breast cancer requires 5-7 weeks. For elderly patients and those distant from an RT center, attending for EBRT may be difficult or impossible. We investigated local toxicity, cosmetic outcomes, and quality of life in a new breast irradiation technique - intraoperative avidination for radionuclide therapy (IART) - in which avidin is administered to the tumor bed and 90 Y-labelled biotin later administered intravenously to bind the avidin and provide irradiation. Reduced duration EBRT (40 Gy) is given subsequently. After surgery, 50 (ten patients), 100 (15 patients) or 150 mg (ten patients) of avidin was injected into the tumor bed. After 12-24 h, 3.7 GBq 90 Y-biotin (beta source for therapeutic effect) plus 185 MBq 111 In-biotin (gamma source for imaging and dosimetry) was infused slowly. Whole-body scintigraphy and SPECT/CT images were taken for up to 30 h. Shortened EBRT started 4 weeks later. Local toxicity was assessed by RTOG scale; quality of life was assessed by EORTC QOL-30. Of 35 patients recruited (mean age 63 years; range 42-74) 32 received IART plus EBRT. 100 mg avidin provided 19.5 ± 4.0 Gy to the tumor bed and was considered the optimum dose. No side-effects of avidin or 90 Y-biotin occurred, with no hematological or local toxicity. Local G3 toxicity occurred in 3/32 patients during EBRT. IART plus EBRT was well accepted, with good cosmetic outcomes and maintained quality of life. IART plus reduced EBRT can accelerate irradiation after conservative breast surgery. (orig.)

Parametric Net Influx Rate Images of 68Ga-DOTATOC and 68Ga-DOTATATE: Quantitative Accuracy and Improved Image Contrast.

Science.gov (United States)

Ilan, Ezgi; Sandström, Mattias; Velikyan, Irina; Sundin, Anders; Eriksson, Barbro; Lubberink, Mark

2017-05-01

68 Ga-DOTATOC and 68 Ga-DOTATATE are radiolabeled somatostatin analogs used for the diagnosis of somatostatin receptor-expressing neuroendocrine tumors (NETs), and SUV measurements are suggested for treatment monitoring. However, changes in net influx rate ( K i ) may better reflect treatment effects than those of the SUV, and accordingly there is a need to compute parametric images showing K i at the voxel level. The aim of this study was to evaluate parametric methods for computation of parametric K i images by comparison to volume of interest (VOI)-based methods and to assess image contrast in terms of tumor-to-liver ratio. Methods: Ten patients with metastatic NETs underwent a 45-min dynamic PET examination followed by whole-body PET/CT at 1 h after injection of 68 Ga-DOTATOC and 68 Ga-DOTATATE on consecutive days. Parametric K i images were computed using a basis function method (BFM) implementation of the 2-tissue-irreversible-compartment model and the Patlak method using a descending aorta image-derived input function, and mean tumor K i values were determined for 50% isocontour VOIs and compared with K i values based on nonlinear regression (NLR) of the whole-VOI time-activity curve. A subsample of healthy liver was delineated in the whole-body and K i images, and tumor-to-liver ratios were calculated to evaluate image contrast. Correlation ( R 2 ) and agreement between VOI-based and parametric K i values were assessed using regression and Bland-Altman analysis. Results: The R 2 between NLR-based and parametric image-based (BFM) tumor K i values was 0.98 (slope, 0.81) and 0.97 (slope, 0.88) for 68 Ga-DOTATOC and 68 Ga-DOTATATE, respectively. For Patlak analysis, the R 2 between NLR-based and parametric-based (Patlak) tumor K i was 0.95 (slope, 0.71) and 0.92 (slope, 0.74) for 68 Ga-DOTATOC and 68 Ga-DOTATATE, respectively. There was no bias between NLR and parametric-based K i values. Tumor-to-liver contrast was 1.6 and 2.0 times higher in the parametric

Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumors: First comparative results using the somatostatin analogues Lu-177 DOTA-NOC and Lu-177 DOTA-TATE

International Nuclear Information System (INIS)

Wehrmann, C.; Senftleben, S.; Baum, R.P.

2005-01-01

Peptide receptor radionuclide therapy (PRRT) is used in our department since 5 years (approx. 400 applications) for the treatment of patients with metastatic neuroendocrine tumors. Of all known peptides, the somatostatin analogue DOTA-NOC shows in vitro the highest affinity to somatostatin receptors (sstr) 3 and 5 and a very high affinity to sstr 2. We studied the in vivo behaviour of the two peptides DOTA-NOC and DOTA-TATE (highest affinity to sstr 2) by the use of different parameters like tumor and organ uptake, effective half-lifes (kinetics) and mean absorbed organ and tumor doses. We studied 27 patients with metastatic neuroendocrine tumors with high somatostatin expression, as verified prior to treatment by Ga-68 DOTA-NOC receptor PET/CT or somatostatin receptor scintigraphy (Tc-99m EDDA-Hynic TOC or In-111 OctreoScan, planar and SPECT). 22 patients (8M and 14F; aged 619 years) were treated with 2500 6790 MBq Lu-177 DOTA-TATE. Another 5 patients (1M and 4F, aged 6310 years) were treated with 4000 7400 MBq Lu-177 DOTA-NOC. Labelling efficiency and radiochemical purity using Lutetium-177 chloride (obtained from PerkinElmer Life Sciences, USA) were constantly over 99.5%. Whole-body scans (anterior/posterior) were performed at 0.5h, 3h, 24h, 48h, 72h and 96h p.i. ROIs were drawn over the whole-body, organs, and different metastases (mainly in the liver). Blood samples were obtained in 12 patients after therapy with Lu-177 DOTA-TATE over 5 days for calculating the kinetics in blood. The ROI results were used to determine the uptake and effective half-life in different organs (kidney, spleen, liver, bone etc.) and the tumor residence times. By means of geometric mean, and after background correction, the ROI results were also used to calculate the estimated absorbed organ and tumor doses using the OLINDA software. Compared to Lu-177 DOTA-TATE (=100%), the uptake of Lu-177 DOTA-NOC was higher for the whole-body (45%) and for normal tissues (28%), and also in the

Accumulation of Sr90-Y90 by the developing spawn and larvae of Coregonus lavaretus L

International Nuclear Information System (INIS)

Kulikov, N.V.; Ozhegov, L.N.

1976-01-01

The results are given of laboratory experiments aimed at studying accumulation of Sr-90 and its daughter product Y-90 in the spawn and larvae of whitefish, a representative of autumn spawning fish species. The results are of interest for predicting possible consequences of radioactive contamination of water bodies and introduction of limits for permissible concentration of radioactive substances in aqueous medium. The accumulation coefficient of Sr-90 in the spawn reaches its maximum after the first twenty four hours of the experiment. Subsequently throughout the incubation period the accumulation coefficient (AC) of radionuclide does not undergo any changes being about 3. Besides it has been established that the equilibrium distribution of Sr-90 in whitefish spawn and the surrounding solution occurs during the first two hours. Unlike Sr-90 the accumulation of Y-90 occurs during the whole incubation period and results in the AC value of 80 by the end of the spawn incubation. The experiments aimed at determining the strength of radionuclide fixation by whitefish spawn and larvae revealed that both radionuclides in the spawn are rather mobile. Strontium separates fully from it during the first twenty four hours and yttrium marked by higher fixation strength transfers completely from the spawn into surrounding aqueous medium by the end of the experiment. In larvae the radionuclides are fixed stroger than in the spawn. The approximate radiation doses of embryos by the time of their hatching have been estimated. The estimates indicate that the total radiation dose of the spawn developing in aqueous solution of Sr-90 - Y-90 with 1.1 curie/0 -5 concentration is about 500 radl

Radiolabeling, characterization and preliminary studies of 90Y-octreotate

International Nuclear Information System (INIS)

Klementyeva, O.E.; Bruskin, A.B.; Larenkov, A.A.; Kodina, G.E.; Korsunsky, V.N.

2015-01-01

Full text of publication follows. Introduction: Overexpression of the somatostatin receptors in neuroendocrine tumors has become the molecular basis for the use of somatostatin analogues in diagnosis and therapy for these neoplasms. The high energy (maximum 2.2 MeV) and penetration range (R 95 5.7 mm) of β-particles from 90 Y are advantageous, with a direct killing of somatostatin receptor positive cells and a crossfire effect which hits nearby receptor-negative tumour cells [Ref. 1]. Aim: the investigation of the reaction conditions for the preparation of 90 Y-Octreotate and its in vitro characterization. Materials and methods: DOTA-Octreotate (Farm-Syntez Ltd.) and 88 YCl 3 (V/O Isotop) were used without purification. 88 Y-Octreotate was prepared in acetate buffer solution and its radiochemical purity was controlled by ITLC. In-vitro experiments were carried out with melanoma B16. Studies of internalization were performed as described in [Ref. 2]. Results: the maximal accumulation in the cells was observed after 90 min from the beginning of incubation and was about 3.9%. In our experiments, we found high level of internalization of the surface-bound 88 Y-Octreotate into B16 cells. Maximal internalization level was 80% after 60 min of incubation. Conclusion: the optimal conditions for effective labeling (> 95%) of DOTA-Octreotate were found. The results obtained using the gamma-emitting 88 Y, provide a basis for in vivo research 90 Y octreotate as radiotherapeutic agent. References: [Ref. 1] Bodei, L.; Pepe, G.; Paganelli, G.; Peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumors with somatostatin analogues. Eur. Rev. Med. Pharmacol. Sci., 2010; v. 14: 347-351. [Ref. 2] Garcia Garayoa E., Allemann-Tannahill L., et al. In vitro and in vivo evaluation of new radiolabeled neurotensin (8-13) analogs with high affinity for NT1 receptors. Nucl. Med. Biol. 2001; 28: 75-84. (authors)

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial and recurrent ovarian carcinoma: a single center experience.

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Pavlov, Maja J; Ceranic, Miljan S; Latincic, Stojan M; Sabljak, Predrag V; Kecmanovic, Dragutin M; Sugarbaker, Paul H

2017-09-07

With standard treatment of epithelial ovarian cancer (EOC), prognosis is very poor. The aim of this study is to show early and late results in patients who underwent cytoreductive surgery and intraperitoneal chemotherapy. This was a retrospective single centre study. All patients with advanced and recurrent ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) or modified early postoperative intraperitoneal chemotherapy (EPIC) were included in the study. In the period 1995-2014, 116 patients were treated, 55 with primary EOC and 61 with recurrent EOC. The mean age was 59 years (26-74). Statistically, median survival time was significantly longer in the group with primary advanced cancer of the ovary (41.3 months) compared to relapsed ovarian cancer (27.3 months). Survival for the primary EOC was 65 and 24% at 3 and 5 years, respectively. Survival for recurrent EOC was 33 and 16% at 3 and 5 years, respectively. Mortality was 1/116 (0.8%). Morbidity was 11/116 (9.5%). Peritoneal cancer index (PCI) was ≤20 in 59 (51%) patients and statistically, their average survival was significantly longer than in the group of 57 (49%) patients with PCI >20 (p = 0.014). In advanced or recurrent EOC, a curative therapeutic approach was pursued that combined optimal cytoreductive surgery and intraperitoneal chemotherapy. PCI and timing of the intervention (primary or recurrent) were the strongest independent prognostic factors.

Diaphragm and lung-preserving surgery with hyperthermic chemotherapy for malignant pleural mesothelioma: A 10-year experience.

Science.gov (United States)

Ambrogi, Marcello Carlo; Bertoglio, Pietro; Aprile, Vittorio; Chella, Antonio; Korasidis, Stylianos; Fontanini, Gabriella; Fanucchi, Olivia; Lucchi, Marco; Mussi, Alfredo

2018-04-01

The best surgical treatment for malignant pleural mesothelioma is still under a debate, but recent evidence points toward a less-invasive approach to reduce morbidity and mortality. We reported our 10-year experience of a limited surgical approach associated with hyperthermic intrathoracic chemotherapy (HITHOC). Between 2005 and 2014, patients with epithelioid or biphasic malignant pleural mesothelioma were treated with lung-diaphragm-pericardium-sparing pleurectomy associated with double-drug HITHOC; at least 3 cycles of adjuvant chemotherapy were then administered. The primary outcome examined was the feasibility of the procedure, whereas secondary outcomes were overall survival and disease-free interval. Among 49 patients, 41 were male. Median age was 68 years (35-76 years). Histology was epithelioid in 43 cases. Pathologic stage I, II, III, and IV occurred in 12, 14, 20, and 3 cases, respectively. No intraoperative complications or postoperative mortality occurred, whereas morbidity rate was 46.9%. Median hospital stay was 8 days (5-45 days). Actuarial median overall survival was 22 months and a 1-, 2-, and 5-year survival accounted for 79.6%, 45.7%, and 9.9%, respectively. Disease-free survival after surgery was 62%, 37.5%, and 18.5% at 1, 2, and 5 years, respectively. Risk factors analysis for overall survival confirmed a significant role for early stages, epithelioid histology, and fibrinogen serum levels. Cytoreductive surgery associated with HITHOC and adjuvant chemotherapy appears feasible and safe, with no mortality and low morbidity. Preserving lung and diaphragmatic function might warrant an acceptable long-term outcome. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Manual on the proper use of lutetium-177-labeled somatostatin analogue (Lu-177-DOTA-TATE) injectable in radionuclide therapy (2nd ed.).

Science.gov (United States)

Hosono, Makoto; Ikebuchi, Hideharu; Nakamura, Yoshihide; Nakamura, Nobutaka; Yamada, Takahiro; Yanagida, Sachiko; Kitaoka, Asami; Kojima, Kiyotaka; Sugano, Hiroyasu; Kinuya, Seigo; Inoue, Tomio; Hatazawa, Jun

2018-04-01

Here we present the guideline for the treatment of neuroendocrine tumors using Lu-177-DOTA-TATE on the basis of radiation safety aspects in Japan. This guideline was prepared by a study supported by Ministry of Health, Labour, and Welfare, and approved by Japanese Society of Nuclear Medicine. Lu-177-DOTA-TATE treatment in Japan should be carried out according to this guideline. Although this guideline is applied in Japan, the issues for radiation protection shown in this guideline are considered internationally useful as well. Only the original Japanese version is the formal document.

Comparison of Ga-68 DOTA-TATE and Ga-68 DOTA-LAN PET/CT imaging in the same patient group with neuroendocrine tumours: preliminary results.

Science.gov (United States)

Demirci, Emre; Ocak, Meltem; Kabasakal, Levent; Araman, Ahmet; Ozsoy, Yildiz; Kanmaz, Bedii

2013-08-01

Recent studies have suggested that PET imaging with Ga-68-labelled DOTA-somatostatin analogues such as octreotide and octreotate is useful in diagnosing neuroendocrine tumours (NETs) and has superior value over both computed tomography and planar and SPECT somatostatin receptor scintigraphy. The aim of the present study was to evaluate the role of Ga-68 DOTA-lanreotide (Ga-68-DOTA-LAN) in patients with somatostatin receptor (sst)-expressing tumours and to compare the results of Ga-68 DOTA-D-Phe1-Tyr3-octreotate (Ga-68-DOTA-TATE) in the same patient population. Twelve patients with NETs who were referred to our department for somatostatin receptor scintigraphy were included in the study. There were four patients with well-differentiated neuroendocrine tumour (WDNET) grade 1, two patients with WDNET grade 2, and three patients with poorly differentiated neuroendocrine carcinoma (PDNEC) grade 3. There was also one patient with medullary thyroid cancer, one patient with meningioma and one patient with MEN-1. All patients underwent two consecutive PET imaging studies with Ga-68-DOTA-TATE and Ga-68 DOTA-LAN. All images were evaluated visually, and maximum standardized uptake value was calculated for quantitative evaluation. On visual examination of maximum intensity projection images, GA-68 DOTA-LAN was seen to have high background activity and high bone marrow uptake. Both tracers defined 67 lesions. Ga-68 DOTA-TATE images revealed 63 (94%) clearly defined lesions, missing four lesions. In contrast, Ga-68 DOTA-LAN images defined only 23 (44%) lesions, missing 44 (56%) lesions. Thirty-two bone lesions were detected on Ga-68-DOTA-TATE images. Among them, only 11 (34%) were positive on Ga-68 DOTA-LAN images, whereas 21 (66%) were negative. When we evaluated liver, mediastinum and gastrointestinal tract lesions, Ga-68 DOTA-LAN was seen to be positive for 12 (34%) lesions and negative for 23 (66%) lesions. Although the results are preliminary, the image quality obtained by

Peritoneal metastases of colorectal origin - cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The financial aspect.

Science.gov (United States)

Jastrzębski, Tomasz; Bębenek, Marek

2017-12-30

The incidence of peritoneal carcinomatosis of colorectal cancer amounts to 5%-15% for synchronous metastases and as much as 40% in cases of local recurrence. Best results are obtained for cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment offers much better outcomes, leading to 5-year survival rates of as much as 30%-50%. The procedures require significant experience in abdominal surgery, are time-consuming (mean duration of the procedure ranging from 6 to 8 hours) and are burdened by complications that are due not only to the procedure itself but also to the intraperitoneal administration of the cytostatic drug at elevated temperature (41.5 °C). After the procedure, patients are required to be admitted to intensive care units due to potential complications associated with the extent and duration of the procedure as well as chemotherapy administered in hyperthermia. Postoperative management of these patients requires appropriate experience of the entire medical and nursing team. Cytoreductive surgeries combined with HIPEC as highly specialized medical procedures should be assessed for their potential long-term benefits and their costs should be appropriately calculated with consideration to realistic reimbursement rates. Realistic valuation and reimbursement covering the overall average cost of the procedure is recommended by the National Consultant in Surgical Oncology as well as the ESMO consensus guidelines.

Chemotherapy preceding surgery or irradiation in carcinoma of the ovaries

International Nuclear Information System (INIS)

Einhorn, N.; Nilsson, B.; Sjovall, K.

1985-01-01

At the Gynaecological Department of Radiumhemmet a noninvasive procedure in the diagnosis of ovarian masses has been developed during the 1950's. A fine-needle aspiration biopsy instrument developed and evaluated has been extensively utilized during the last 20 years for the diagnosis of ovarian masses. Fine-needle aspiration biopsy gave the opportunity to apply the philosophy of Hans-Ludvig Kottmeier who already declared in 1961 that aggressive and extensive surgery is valid for mucinous cancer but not for serous and endometrioid neoplasms fixed to surrounding tissues. This was the rational behind the Radiumhemmet policy where preoperative fine-needle aspiration biopsy diagnosis made it possible to use pre-operative chemotherapy and radiotherapy in patients with loco-regional disease

Benefit of Adjuvant Chemotherapy After Curative Resection of Lung Metastasis in Colorectal Cancer.

Science.gov (United States)

Park, Hyung Soon; Jung, Minkyu; Shin, Sang Joon; Heo, Su Jin; Kim, Chang Gon; Lee, Min Goo; Beom, Seung Hoon; Lee, Chang Young; Lee, Jin Gu; Kim, Dae Joon; Ahn, Joong Bae

2016-03-01

The survival benefit of adjuvant chemotherapy after colorectal cancer (CRC) lung metastasectomy is uncertain. We enrolled 221 CRC patients who underwent pulmonary metastasectomy between October 2002 and July 2013, including those with previous liver metastasis that had been curatively resected. Disease-free survival (DFS) and overall survival (OS) were calculated from the day of lung metastasectomy. Among all patients, 176 (79.6%) received adjuvant chemotherapy after lung metastasectomy. Median follow-up was 34.7 months from the time of lung metastasectomy [95% confidence interval (95% CI), 7.4-90.9 months]. Patients treated with adjuvant chemotherapy had longer DFS compared with surgery alone (median 32.7 vs 11.2 months respectively, P = 0.076). Multivariate analysis revealed previous liver metastasis, preoperative carcinoembryonic antigen ≥5 ng/mL, disease-free interval chemotherapy as independent risk factors for recurrence. Low-risk patients who had 0-1 risk factors received a significant survival benefit from adjuvant chemotherapy [hazard ratio (HR) 0.54; 95% CI 0.32-0.91, P = 0.020]; however, high-risk patients with ≥2 risk factors did not (HR 1.02; 95% CI 0.48-2.14, P = 0.964). Patients treated with adjuvant chemotherapy showed no OS benefit compared with patients who received surgery alone (median 89.6 vs 86.8 months respectively, P = 0.833). CRC patients received lung metastasectomy could have a DFS benefit from adjuvant chemotherapy, especially in low-risk patients. Larger, prospective studies are needed to evaluate the role of adjuvant chemotherapy after CRC lung metastasectomy.

Radiolabeling oligo nuclieotide with 90Y and its radiolysis

International Nuclear Information System (INIS)

Liu Changbin; Tian Jiahe; Zhang Jinming; Yin Dayi; Guo Zhe

2005-01-01

Objective: To evaluate labeling Morpholinos (MORF), a DNA analogue, with 90 Y using p-isothiocyanatobenzyl-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) as chelater and assess its stability and hybridization in vitro. Methods: A 25 mer MORF with a primary amine on the 3' equivalent end attached via a 10 member linker was conjugated with an isothiocyanate backbone derivative of DOTA. The conjugated product was labeled in various buffers over a different range of concentrations (0.5-2 mol/L) and pH(3-8.5). The labeled MORF was investigated for stability and hybridization in vitro. Results: By size exclusion high performance liquid chromatogram (HPLC) and instant thin layer chromatography (ITLC) analysis, the DOTA conjugated MORF was successfully radiolabeled, the labeling efficiency was (50 ± 12)%, the specific radioactivity was 5.05 x 10 6 MBq/mmol, radiochemistry purity >95%. The labeled MORF showed one sharp peak by HPLC that shifted completely to earlier retention times following addition of a polymer conjugated with the complementary MORF. In saline at room temperature and in serum at 37 degree C, the radioactivity profile of 90 Y showed a pronounced lower molecular weight peak which did not shifted and was shown due to 90 Y-DOTA resulting from radiolysis. Conclusion: MORF can be successfully labeled with 90 Y via DOTA as chelater, but care it must be taken to avoid the effect of radiolysis. (authors)

DOTA-TATE peptides labelling with Lutetium 177: Preliminary study

International Nuclear Information System (INIS)

Aliaga, Eleazar; Robles, Anita; Ramos, Bertha; Martinez, Flor

2014-01-01

he peptide DOTA-TATE was labeled with lutetium 177 according to the methodology provided under the regional project RLA/6/074, sponsored by the IAEA. The labeling was done in 0.26 M gentisic acid solution in 0.8 M sodium acetate buffer, pH 5, at 100 °C for 30 minutes in a dry heating block. The radiochemical purity was assessed by thin layer chromatography, using ITLC SG strips and a mixture of 0.15 M ammonium acetate - methanol (1:1) as solvent. The radiolabeled peptide 177 Lu-DOTA-TATE reached a radiochemical purity of 98 % with a specific activity of 2,8 mCi/µg of peptide. (authors).

Radio chemotherapy for uterine cervix carcinoma

International Nuclear Information System (INIS)

Resbeut, M.; Alzieu, C.; Gonzague-Casabianca, L.; Haie-Meder, C.

2000-01-01

Low-stage uterine cervix carcinoma can be treated by either surgery, radiation therapy or combined treatments with high cure rates ranging from 90 to 95 % for stage IB1 tumors. However, the standard treatment, combining external beam plus intracavitary radiation, fails to control the progression of the disease in 35 to 90 % of patients with locally advanced cervical cancer. No substantial improvements have been made in the treatment of these tumors in the past two decades. The addition of concurrent 5-FU in a phase III study failed to improve the results in the overall patient population, but the five-year DFS was significantly better in a subset of patients (tumor > 5 cm and IB/IIA or medial parametrial IIB disease). Concurrent chemo-radiation and adjuvant chemotherapy with epirubicin showed, in a phase III study, a significant longer DFS in patients treated with chemotherapy despite the same long-term local tumor control. After many phase II studies, five phase III studies have recently demonstrated a 40 to 60 % reduction in the relative risk of recurrence with cisplatin containing chemo-radiation. Across these studies, the risk of death was reduced by 30 to 50 %. The benefit was less clear in patients with stages III-IV tumors than in patients with lower stages associated with poor prognostic factors. Hematologic and gastrointestinal toxicity of chemo-radiation was greater than that of radiotherapy alone. However, late side effects were similar in the different treatment groups. These results must be confirmed with a longer follow-up. The importance of concurrent chemotherapy during the brachytherapy procedure should be analyzed. It has yet to be determined which chemotherapy regimen achieves the most favorable therapeutic ratio. (authors)

(99m)Tc-EDDA/HYNIC-octreotate - a new radiotracer for detection and staging of NET: a case of metastatic duodenal carcinoid.

Science.gov (United States)

Hubalewska-Dydejczyk, Alicja; Szybiński, Piotr; Fröss-Baron, Katarzyna; Mikolajczak, Renata; Huszno, Bohdan; Sowa-Staszczak, Anna

2005-01-01

Somatostatin receptor scintigraphy (SRS) has become a routine imaging method for the diagnostics of neuroendocrine tumours (NET). (99m)Tc-EDDA/HYNIC-octreotate (Polatom, Poland) is a new radiotracer with high affinity for SSTR2 and similar physiological biodistribution to (111)In-Octreoscan. We present a case of a 47-year-old man with disseminated duodenal carcinoid. The patient had been operated due to the tumour mass detected in pancreatic head area. Histopathology revealed carcinoid of the duodenal wall with local lymph node and liver metastases. The patient was qualified for chemotherapy stopped due to severe leucopenia. (99m)Tc EDDA/HYNIC-octreotate scintigraphy was performed for staging and to determine SSTR status of the tumour before planned 90Y-DOTATATE therapy. The multiple metastatic lesions were detected all over the body. The high quality images with high target/non target ratio were obtained. (99m)Tc-MDP scintigraphy confirmed multiple bone metastases. On the basis of SRS result the patient was qualified for 90Y-DOTA-TATE therapy. In conclusion, (99m)Tc EDDA/HYNIC-octreotate can be regarded as a promising tracer for staging and to determine SSTR status of NET.

A gate evaluation of the sources of error in quantitative90 Y PET.

Science.gov (United States)

Strydhorst, Jared; Carlier, Thomas; Dieudonné, Arnaud; Conti, Maurizio; Buvat, Irène

2016-10-01

Accurate reconstruction of the dose delivered by 90 Y microspheres using a postembolization PET scan would permit the establishment of more accurate dose-response relationships for treatment of hepatocellular carcinoma with 90 Y. However, the quality of the PET data obtained is compromised by several factors, including poor count statistics and a very high random fraction. This work uses Monte Carlo simulations to investigate what impact factors other than low count statistics have on the quantification of 90 Y PET. PET acquisitions of two phantoms-a NEMA PET phantom and the NEMA IEC PET body phantom-containing either 90 Y or 18 F were simulated using gate. Simulated projections were created with subsets of the simulation data allowing the contributions of random, scatter, and LSO background to be independently evaluated. The simulated projections were reconstructed using the commercial software for the simulated scanner, and the quantitative accuracy of the reconstruction and the contrast recovery of the reconstructed images were evaluated. The quantitative accuracy of the 90 Y reconstructions were not strongly influenced by the high random fraction present in the projection data, and the activity concentration was recovered to within 5% of the known value. The contrast recovery measured for simulated 90 Y data was slightly poorer than that for simulated 18 F data with similar count statistics. However, the degradation was not strongly linked to any particular factor. Using a more restricted energy range to reduce the random fraction in the projections had no significant effect. Simulations of 90 Y PET confirm that quantitative 90 Y is achievable with the same approach as that used for 18 F, and that there is likely very little margin for improvement by attempting to model aspects unique to 90 Y, such as the much higher random fraction or the presence of bremsstrahlung in the singles data. © 2016 American Association of Physicists in Medicine.

Y-90 microsphere therapy: prevention of adverse events.

Science.gov (United States)

Schultz, Cheryl C; Campbell, Janice; Bakalyar, Donovan; Beauvais, Michele; Feng, Wenzheng; Savin, Michael

2009-08-01

Thirty-three (33) events that were inconsistent with intended treatment for 471 Y-90 microsphere deliveries were analyzed from 2001 to 2007. Each occurrence was categorized, based on root-cause analysis, as a device/product defect and/or operator error event. Events were further categorized, if there was an adverse outcome, as spill/leak, termination, recatheterization, dose deviation, and/or a regulatory medical event. Of 264 Y-90 Therasphere (MDS Nordion, Ottawa, Ontario, Canada) treatments, 15 events were reported (5.7%). Of 207 Y-90 SIR-Spheres (Sirtex, Wilmington, MA) treatments, 18 events were reported (8.7%). Twenty-five (25) of 33 events (76%) were device/product defects: 73% for Therasphere (11 of 15) and 78% for SIR-Spheres (14 of 18). There were 31 adverse outcomes associated with 33 events: 15 were leaks and/or spills, 9 resulted in termination of the dose administration, 3 resulted in recatheterization for dose compensation, 2 were dose deviations (doses differing from the prescribed between 10% and 20%), and 2 were reported as regulatory medical events. Fifty-five (55) corrective actions were taken: 39 (71%) were related to the manufacturer and 16 (29%) were hospital based. This process of analyzing each event and measuring our outcomes has been effective at minimizing adverse events and improving patient safety.

Phase II/III multicentre randomised controlled trial evaluating a strategy of primary surgery and adjuvant chemotherapy versus peri-operative chemotherapy for resectable gastric signet ring cell adenocarcinomas – PRODIGE 19 – FFCD1103 – ADCI002

International Nuclear Information System (INIS)

Piessen, Guillaume; Mariette, Christophe; Messager, Mathieu; Le Malicot, Karine; Robb, William B; Di Fiore, Frédéric; Guilbert, Marie; Moreau, Marie; Christophe, Véronique; Adenis, Antoine

2013-01-01

A dramatic increase in the incidence of the diffuse form of gastric adenocarcinomas and particularly signet ring cell carcinomas has been observed in Western countries. Evidence is accruing that signet ring cell carcinomas may have inherent chemo resistance leaving many clinicians unsure of the benefits of delaying surgery to pursue a neoadjuvant approach. PRODIGE-19-FFCD1103-ADCI002 is a prospective multicentre controlled randomised phase II/III trial comparing current standard of care of perioperative chemotherapy (2x3 cycles of Epirubicin, cisplatin, 5-fluorouracil) with a strategy of primary surgery followed by adjuvant chemotherapy (6 cycles of Epirubicin, cisplatin, 5-fluorouracil) in patients with a stage IB-III gastric signet ring cell tumour. The principal objective of the phase II study (84 patients) is to determine if the experimental arm (primary surgery followed by adjuvant chemotherapy) has sufficient interest in terms of percentage of living patients at 24 months to be evaluated in a phase III trial. If 7 or less patients in the experimental arm are alive at 24 months, phase III will not be initiated. The primary objective of phase III (230 additional patients) is to demonstrate superiority of the experimental arm in terms of overall survival. Secondary endpoints include overall survival at 36 months, disease free survival at 24 and 36 months, R0 resection rates, treatment tolerance, postoperative mortality and morbidity evaluated by Clavien-Dindo severity index, the prognostic impact of positive peritoneal cytology and the assessment of quality of life. An ancillary study will assess the emotional and cognitive impact of surgery and perioperative chemotherapy for both the patient and their partner. As inherent chemo resistance of signet ring cell tumours and delay in definitive surgery may favour tumour progression we hypothesise that a policy of primary surgery followed by adjuvant chemotherapy will improve overall survival compared to a standard

Country report: India. Development of Radiopharmaceuticals Based on 188Re and 90Y for Radionuclide Therapy

International Nuclear Information System (INIS)

Venkatesh, M.; Pandey, U.; Dhami, P.S.; Chakravarty, R.; Kameswaran, M.; Subramanian, S.; Dash, A.; Samuel, G.

2010-01-01

During the past decade, our group has focused attention on the development of therapeutic radiopharmaceuticals incorporating radioisotopes such as 90 Y, 188 Re etc. As the primary source of the radioisotopes 90 Y and 188 Re are the 90 Sr/ 90 Y generators and 188 W/ 188 Re generators respectively, the local availability of these generator systems is very important for the successful development of radiopharmaceuticals incorporating these radioisotopes. In this context, 90 Sr/ 90 Y generators based on Supported Liquid Membrane (SLM) [1-3] and electrochemical techniques [4] could be designed and deployed in our laboratories for the elution of 90 Y to be used for preparation of 90 Y labeled products. This work formed a part of the IAEA co-ordinated CRP on “Development of Generator Technologies for Therapeutic Radionuclides: 90 Y and 188 Re”. In this report, work on the development of 90 Y radiopharmaceuticals for treatment of liver cancer and non-Hodgkin’s lymphoma (NHL) is reported. In addition, comparison of the Extraction Paper Chromatography technique (EPC) developed for determination of 90 Sr contamination in 90 Y samples with the US Pharmacopeia recommended method as well as the validation of the EPC technique is presented

Radiation Safety in Production of Y-90 from an electrochemical generator. CENTIS experience

International Nuclear Information System (INIS)

Ayra Pardo, Fernando Enrique

2016-01-01

From a project with the International Atomic Energy Agency, Isotope Center installation and commissioning began operating an electrochemical generator of Sr-90 / Y-90 inside a glove box shielded. The aim was to ensure the production of Y-90 needed in the research carried out in Cuba with this radionuclide for the medical industry. Associate at the beginning of this practice, compliance with all regulatory requirements approved in the country from the radiological point of view that demonstrated the safety of this for both operators and the general public became necessary. Using the MCNPX code generator installation was simulated and the equivalent dose Hp (10) were obtained for the operator: 6.27 mSv / y Hp (0.07): 17 mSv / a for a source of 10 Ci of 90 Sr- 90 Y . Also the use of TLD dosimeters similar to those used for gamma emitting radionuclides for controlling beta exposures was evaluated. high sensitivity lithium fluoride tablets couple energy beta particles of Y-90 which ensures its use for measuring the magnitude Hp (007) was demonstrated. two possible solutions for the recovery of liquid waste 90 Sr one another by distillation and ion exchange are evaluated. To transport the Y-90 may be used the package currently used in marketing the rest of the CENTIS radiopharmaceuticals. As a final result, the practice was approved and included in the Operating License Center Isotopes. (author)

Monte Carlo simulation of PET and SPECT imaging of {sup 90}Y

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Akihiko, E-mail: takahsr@hs.med.kyushu-u.ac.jp; Sasaki, Masayuki [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Himuro, Kazuhiko; Yamashita, Yasuo; Komiya, Isao [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Baba, Shingo [Department of Clinical Radiology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

2015-04-15

Purpose: Yittrium-90 ({sup 90}Y) is traditionally thought of as a pure beta emitter, and is used in targeted radionuclide therapy, with imaging performed using bremsstrahlung single-photon emission computed tomography (SPECT). However, because {sup 90}Y also emits positrons through internal pair production with a very small branching ratio, positron emission tomography (PET) imaging is also available. Because of the insufficient image quality of {sup 90}Y bremsstrahlung SPECT, PET imaging has been suggested as an alternative. In this paper, the authors present the Monte Carlo-based simulation–reconstruction framework for {sup 90}Y to comprehensively analyze the PET and SPECT imaging techniques and to quantitatively consider the disadvantages associated with them. Methods: Our PET and SPECT simulation modules were developed using Monte Carlo simulation of Electrons and Photons (MCEP), developed by Dr. S. Uehara. PET code (MCEP-PET) generates a sinogram, and reconstructs the tomography image using a time-of-flight ordered subset expectation maximization (TOF-OSEM) algorithm with attenuation compensation. To evaluate MCEP-PET, simulated results of {sup 18}F PET imaging were compared with the experimental results. The results confirmed that MCEP-PET can simulate the experimental results very well. The SPECT code (MCEP-SPECT) models the collimator and NaI detector system, and generates the projection images and projection data. To save the computational time, the authors adopt the prerecorded {sup 90}Y bremsstrahlung photon data calculated by MCEP. The projection data are also reconstructed using the OSEM algorithm. The authors simulated PET and SPECT images of a water phantom containing six hot spheres filled with different concentrations of {sup 90}Y without background activity. The amount of activity was 163 MBq, with an acquisition time of 40 min. Results: The simulated {sup 90}Y-PET image accurately simulated the experimental results. PET image is visually

Dosimetry characterization of the commercial CaF2 for beta radiation of 90Sr + 90Y

International Nuclear Information System (INIS)

Oliveira, Mercia L.; Caldas, Linda V.E.

2003-01-01

This work studies the dosimetric characteristics of the CaF 2 commercial dosimetry for detection of 90 Sr + 90 Y beta radiation for using in the calibration of flat and concave appliers. Were determined the repetitiousness and linearity of answers of the samples, and their calibration curves

Concurrent chemotherapy, accelerated hyperfractionated split course radiation therapy and surgery for esophageal cancer

International Nuclear Information System (INIS)

Becker, M.; Adelstein, D.J.; Rice, T.W.; Kirk, M.A. van; Kirby, T.J.; Koka, A.; Tefft, M.; Zuccaro, G.

1996-01-01

Purpose/Objectives: A prospective single arm trial was undertaken to determine the toxicity, the clinical and pathologic response rates and survival for patients with esophageal cancer treated with concurrent chemotherapy(CC) and accelerated hyperfractionated split course radiotherapy(AHFSCRT) followed by surgical resection. Materials and Methods: A prospective single arm trial was conducted between 1991 and 1995 for patients with T1-4, N0-1, M1(celiac or supraclavicular) adenocarcinoma or squamous cell carcinoma of the esophagus. A total of 74 patients entered onto the protocol, and 72 are eligible and evaluable. Neoadjuvant chemotherapy consisting of two cycles of Cisplatin(20mg/m2/day) and 5-fluorouracil (1000mg/m2/day) given concurrently with AHSCRT 1.5Gy BID (at least 6 hour between fractions) to 2400cGy and 2100cGy, with cycles 1 and 2 of chemotherapy respectively. Patients were staged/restaged with barium esophagram(BS), computerized tomograph of the chest(CAT), upper endoscopy(EGD) with ultrasound (EUS) and evaluated for surgical resection. A single adjuvant course of concurrent chemotherapy and AHSCRT was delivered for those patients who were pathologic partial responders(pPR). Results: Initial clinical staging revealed one patient stage I, 24 patients' stage IIA, 2 patients' with stage IIB, 34 patients' with stage III and 6 patients' with stage IV disease. Five patients could not be staged adequately. The toxicity to neoadjuvant therapy included nausea in 85% (grade 3 in 1%), esophagitis 90% (grade 3 in 18%), neutropenia grade 3 of 43% (with fever 17%), thrombocytopenia grade 4 in 10% and nephrotoxicity in 8%. There was one death due to neoadjuvant therapy. Of the 72 evaluable patients, 67 underwent surgery, and 65(90%) had a complete resection. Twenty-seven percent were pathologic complete responders, including 22% with adenocarcinoma and 36% with squamous cell carcinoma. Complete pathologic response after neoadjuvant therapy was accurately predicted by

Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer.

Science.gov (United States)

Supaadirek, Chunsri; Pesee, Montien; Thamronganantasakul, Komsan; Thalangsri, Pimsiree; Krusun, Srichai; Supakalin, Narudom

2016-01-01

To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMTRT) without surgery. A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January 1st, 2003 and December 31st, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMTRT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5fluorouracil short infusion plus leucovorin and/or capecitabine or 5fluorouracil infusion alone. All patients received pelvic irradiation. There were 5 patients (10.4%) with a complete pathological response. The 3 yearoverall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (prectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.

Practical reconstruction protocol for quantitative {sup 90}Y bremsstrahlung SPECT/CT

Energy Technology Data Exchange (ETDEWEB)

Siman, W.; Mikell, J. K.; Kappadath, S. C., E-mail: skappadath@mdanderson.org [Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030 (United States)

2016-09-15

Purpose: To develop a practical background compensation (BC) technique to improve quantitative {sup 90}Y-bremsstrahlung single-photon emission computed tomography (SPECT)/computed tomography (CT) using a commercially available imaging system. Methods: All images were acquired using medium-energy collimation in six energy windows (EWs), ranging from 70 to 410 keV. The EWs were determined based on the signal-to-background ratio in planar images of an acrylic phantom of different thicknesses (2–16 cm) positioned below a {sup 90}Y source and set at different distances (15–35 cm) from a gamma camera. The authors adapted the widely used EW-based scatter-correction technique by modeling the BC as scaled images. The BC EW was determined empirically in SPECT/CT studies using an IEC phantom based on the sphere activity recovery and residual activity in the cold lung insert. The scaling factor was calculated from 20 clinical planar {sup 90}Y images. Reconstruction parameters were optimized in the same SPECT images for improved image quantification and contrast. A count-to-activity calibration factor was calculated from 30 clinical {sup 90}Y images. Results: The authors found that the most appropriate imaging EW range was 90–125 keV. BC was modeled as 0.53× images in the EW of 310–410 keV. The background-compensated clinical images had higher image contrast than uncompensated images. The maximum deviation of their SPECT calibration in clinical studies was lowest (<10%) for SPECT with attenuation correction (AC) and SPECT with AC + BC. Using the proposed SPECT-with-AC + BC reconstruction protocol, the authors found that the recovery coefficient of a 37-mm sphere (in a 10-mm volume of interest) increased from 39% to 90% and that the residual activity in the lung insert decreased from 44% to 14% over that of SPECT images with AC alone. Conclusions: The proposed EW-based BC model was developed for {sup 90}Y bremsstrahlung imaging. SPECT with AC + BC gave improved lesion

Thermoluminescent dosimetry of beta radiations of 90 Sr/ 90 Y using ZrO2: Eu

International Nuclear Information System (INIS)

Olvera T, L.; Azorin N, J.; Barrera S, M.; Soto E, A.M.; Rivera M, T.

2005-01-01

In this work the results of studying the thermoluminescent properties (TL) of the doped zirconium oxide with europium (ZrO 2 : Eu 3+ ) before beta radiations of 90 Sr/ 90 Y are presented. The powders of ZrO 2 : Eu 3+ were obtained by means of the sol-gel technique and they were characterized by means of thermal analysis and by X-ray diffraction. The powders of ZrO 2 : Eu 3+ , previously irradiated with beta particles of 90 Sr/ 90 Y, presented a thermoluminescent curve with two peaks at 204 and 292 C respectively. The TL response of the ZrO 2 : Eu 3+ as function of the absorbed dose was lineal from 2 Gy up to 90 Gy. The fading of the information of the ZrO 2 : Eu 3+ was of 10% the first 2 hours remaining almost constant the information by the following 30 days. The ZrO 2 doped with the (Eu 3+ ) ion it was found more sensitive to the beta radiation that the one of zirconium oxide without doping (ZrO 2 ) obtained by the same method. Those studied characteristics allow to propose to the doped zirconium oxide with europium like thermoluminescent dosemeter for the detection of the beta radiation. (Author)

Depth dose curves from 90Sr+90Y clinical applicators using the thermoluminescent technique

International Nuclear Information System (INIS)

Antonio, Patricia L.; Caldas, Linda V.E.; Oliveira, Mercia L.

2009-01-01

The 90 Sr+ 90 Y beta-ray sources widely used in brachytherapy applications were developed in the 1950's. Many of these sources, called clinical applicators, are still routinely used in several Brazilian radiotherapy clinics for the treatment of superficial lesions in the skin and eyes, although they are not commercialized anymore. These applicators have to be periodically calibrated, according to international recommendations, because these sources have to be very well specified in order to reach the traceability of calibration standards. In the case of beta-ray sources, the recommended quantity is the absorbed dose rate in water at a reference distance from the source. Moreover, there are other important quantities, as the depth dose curves and the source uniformity for beta-ray plaque sources. In this work, depth dose curves were obtained and studied of five dermatological applicators, using thin thermoluminescent dosimeters of CaSO 4 :Dy and phantoms of PMMA with different thicknesses (between 1.0 mm and 5.0 mm) positioned between each applicator and the TL pellets. The depth dose curves obtained presented the expected attenuation response in PMMA, and the results were compared with data obtained for a 90 Sr+ 90 Y standard source reported by the IAEA, and they were considered satisfactory. (author)

Quality of life after cytoreductive surgery plus early intraperitoneal postoperative chemotherapy for pseudomyxoma peritonei: A prospective study

DEFF Research Database (Denmark)

Jess, Per; Iversen, Lene Hjerrild; Nielsen, Mette B

2008-01-01

PURPOSE: The modern treatment of pseudomyxoma peritonei is cytoreductive surgery plus intraperitoneal chemotherapy resulting in a survival of up to 70 percent after 20 years. The goal of this study was to investigate the impact on quality of life of this very aggressive treatment, which has not b...

Decreased Cardiovascular Risk after Roux-en-Y Gastric Bypass Surgery in Chinese Diabetic Patients with Obesity.

Science.gov (United States)

Zhao, Xue; Duan, Wenyan; Sun, Chenglin; Li, Zhuo; Liu, Yujia; Xiao, Xianchao; Wang, Gang; Gang, Xiaokun; Wang, Guixia

2017-01-01

The influence of bariatric surgery on cardiovascular risks in Chinese diabetic patients remains unclear. Here, we aimed to explore the impact of Roux-en-Y gastric bypass surgery (RYGB) on cardiovascular risks in Chinese diabetic patients with obesity. Twenty Chinese patients with T2DM and obesity undergoing RYGB surgery were included in this study. Cardiovascular risk factors were measured before and 18 months after surgery. A 10-year cardiovascular risk was calculated by the UKPDS risk engine. Linear regression analysis was performed on CHD risk, stroke risk, and baseline metabolic parameters. The complete remission rate of diabetes was 90% after RYGB surgery, with significant improvements in blood pressure, BMI, glucose, and lipid metabolism ( P women,  5 years, using noninsulin therapy presented more obvious improvements in the 10-year cardiovascular risk after RYGB surgery. WHR, age, LDL-C, and HbA1c were the most important factors influencing CHD or stroke risk after RYGB surgery ( P treatment to reduce cardiovascular risk in Chinese diabetic patients with obesity.

SU-G-201-12: Investigation of Beta-Emitter 90Sr-90Y Dose Distribution Using Gafchromic EBT3 Film for Application On Conformal Skin Brachytherapy Device

International Nuclear Information System (INIS)

Ferreira, C; Johnson, D; Ahmad, S; Rasmussen, K; Jung, J

2016-01-01

Purpose: To investigate 90 Sr- 90 Y as a high dose rate (HDR) source for application in a conformal skin brachytherapy (CSBT) device. The CSBT device has been previously developed to provide patient specific treatment for small inoperable lesions and irregular surfaces. Methods: A popular beta emitter, 90 Sr- 90 Y was tested for feasibility in a CSBT device. A 1 cm diameter plaque was used to deliver dose to a solid water phantom containing EBT3 Gafchromic films arranged at the surface and perpendicular to it. Additionally, a 1 cm diameter 6 MeV electron beam was used to irradiate EBT3 film at 100 cm SSD with a 0.5 cm bolus. Films were digitized with an Epson Expression 10000 XL scanner and calibrated with a 6 MeV electron specific dose curve. Normalized percent depth doses (PDD) and dose profiles for both techniques were analyzed using ImageJ. Results: Dose distributions achieved with the 90 Sr- 90 Y sources were compared with those of external electron beam radiation therapy (EBRT). Penumbra (20%- 80%) for EBRT and 90Sr-90Y were 4.3 mm and 1.6 mm, respectively. PDD values of 50% (normalized to 2 mm) were 10.1 mm and 2.8 mm for electron and 90 Sr- 90 Y, respectively. Flatness (80% of the central beam profile) was 14.1% at a 5 mm depth for EBRT and 4.0% at surface for the 90 Sr- 90 Y. Conclusion: As expected, the PDDs of 90 Sr- 90 Y in water are shallower than that of external electron beams for the same field size. 90 Sr- 90 Y can be used in CSBT to provide patient specific treatment where shallower depth doses than that provided by electron external beams may be required: e.g. eyelids, nose, lips, ears, etc. The customizability of EBRT could be replicated by using multiple adjacent 90 Sr- 90 Y plaque placements.

SU-G-201-12: Investigation of Beta-Emitter 90Sr-90Y Dose Distribution Using Gafchromic EBT3 Film for Application On Conformal Skin Brachytherapy Device

Energy Technology Data Exchange (ETDEWEB)

Ferreira, C; Johnson, D; Ahmad, S [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States); Rasmussen, K [University of Texas HSC SA, San Antonio, TX (United States); Jung, J [East Carolina University Greenville, NC (United States)

2016-06-15

Purpose: To investigate {sup 90}Sr-{sup 90}Y as a high dose rate (HDR) source for application in a conformal skin brachytherapy (CSBT) device. The CSBT device has been previously developed to provide patient specific treatment for small inoperable lesions and irregular surfaces. Methods: A popular beta emitter, {sup 90}Sr-{sup 90}Y was tested for feasibility in a CSBT device. A 1 cm diameter plaque was used to deliver dose to a solid water phantom containing EBT3 Gafchromic films arranged at the surface and perpendicular to it. Additionally, a 1 cm diameter 6 MeV electron beam was used to irradiate EBT3 film at 100 cm SSD with a 0.5 cm bolus. Films were digitized with an Epson Expression 10000 XL scanner and calibrated with a 6 MeV electron specific dose curve. Normalized percent depth doses (PDD) and dose profiles for both techniques were analyzed using ImageJ. Results: Dose distributions achieved with the {sup 90}Sr-{sup 90}Y sources were compared with those of external electron beam radiation therapy (EBRT). Penumbra (20%- 80%) for EBRT and 90Sr-90Y were 4.3 mm and 1.6 mm, respectively. PDD values of 50% (normalized to 2 mm) were 10.1 mm and 2.8 mm for electron and {sup 90}Sr-{sup 90}Y, respectively. Flatness (80% of the central beam profile) was 14.1% at a 5 mm depth for EBRT and 4.0% at surface for the {sup 90}Sr-{sup 90}Y. Conclusion: As expected, the PDDs of {sup 90}Sr-{sup 90}Y in water are shallower than that of external electron beams for the same field size. {sup 90}Sr-{sup 90}Y can be used in CSBT to provide patient specific treatment where shallower depth doses than that provided by electron external beams may be required: e.g. eyelids, nose, lips, ears, etc. The customizability of EBRT could be replicated by using multiple adjacent {sup 90}Sr-{sup 90}Y plaque placements.

90Y production of high purity by electrochemical separation

International Nuclear Information System (INIS)

Alberti Ramírez, Alejandro; Serra Águila, Rolando; Morín Zorrilla, José Antonio; Pino Peraza, Madián; Soler Iglesias, Joel; Cruz Morales, Amed

2016-01-01

In this paper 90 Y is obtained without added carrier, by electrolytic separation from a solution in secular equilibrium Sr-Y and further purification in three cycles electrolytic automated, at constant current. The process productivity was 60-80 mCi (2220-2960 MBq). The long half-life of 90 Sr to be used by virtually indefinitely ensuring the stability of the raw material for generator operation, which helps sustainability and production stability. In 18 productions to date could be found to both content of 90 Sr equal to 0.110 ± 0.004 (k = 2) kBq / g by various methods, for their ability combination with DTPA, bifunctional chelate appropriate range of concentrations and even in the presence of trace metals, resulting in excellent characteristics for use as precursor in the preparation of therapeutic radiopharmaceuticals including radioimmunotherapy. The latter being a pure beta emitter with physical half-life, comparable to the time of capture and residence of many antibodies in tumors. The influence of Fe (III) was studied by the method of addition and concluded that only affects the performance of DTPA 90 Y marking if their presence is above a concentration of 0.018 mol / L. We show that the presence of other metals such as Pb (II), Zn (II) and Cu (II) also affects performance complexation

Treatment of neuroendocrine tumors (NETs) expressing SMT 90Y and 177Lu

International Nuclear Information System (INIS)

Oliva González, Juan P.; Baum, Richard

2016-01-01

Neuroendocrine tumors (NETs) are a relatively rare and extremely heterogeneous group, essentially characterized by a different metabolism and endocrine histologically pattern. NETs are a challenge for physicians not only for diagnosis but also for early treatment. In addition to this, QT or RT treatments that require a high rate of cell proliferation to be effective, they are not in these tumors as slow growth. The primary treatment of NETs is surgery, either with a curative intent or tumor shrinkage. Peptide Receptors Radiotherapy (RTPR) consists of the administration for therapeutic purposes of Radiolabeled Synthetic Peptides that bind specifically and with high affinity to receptors of tumor cells. The RTPR of TNE with SMT analogues is effective for handling or metastizados inoperable patients. The Conference gives an accurate picture of the treatment of these tumors both 90 Y as 177 Lu. (author)

Dosimetry characterization of the commercial CaF{sub 2} for beta radiation of {sup 90}Sr + {sup 90}Y; Caracterizacao dosimetrica de CaF{sub 2} comercial para radiacao beta de {sup 90}Sr + {sup 90}Y

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Mercia L.; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: mlolivei@ipen.br, e-mail: lcaldas@ipen.br

2003-07-01

This work studies the dosimetric characteristics of the CaF{sub 2} commercial dosimetry for detection of {sup 90}Sr + {sup 90}Y beta radiation for using in the calibration of flat and concave appliers. Were determined the repetitiousness and linearity of answers of the samples, and their calibration curves.

An Overview of the Production, Quality Control and Feasibility of Using 90Y as a Therapeutic Radionuclide

International Nuclear Information System (INIS)

Venkatesh, M.

2009-01-01

90 Y is increasingly accepted world wide as a radionuclide for in-vivo therapy owing to attractive decay features (T1/2 2.67 d; Eβ max 2.28 MeV) and viable production feasibility in high specific activities. 90 Y is most often recommended for treatment of large tumour lesions as the hard β rays are effective in delivering therapeutic dose to large volume. However, possibility of high radiation dose to the critical organs such as bone marrow and kidneys is an important concern that is given due weightage while designing therapy using 90 Y. The best route to avail 90 Y for therapy applications is from 90 Sr, though neutron actiation of natural 89 Y(100% abundance) is feasible. The absorption cross section σ is barely 1.38 b, resulting in low specific activity 90 Y which is useful for limited applications. The possibility of obtaining 90Y through a radionuclide generator as the daughter of a long lived parent 90 Sr (T1/2 28.9 y) is a major advantage that enables access to high specific activity 90 Y. Transporting the 90Y activity to a user institution from a centralized production facility is reasonably feasible and this facilitates its wide spread use. Several generator designs have been developed and reported to access 90 Y. Solvent extraction using a chelating molecule in an organic solvent (0.3M HDEHP/n-dodecane), column chromatography using ion exchange resins (cationic as well as anionic; Dowex-50x8; AG 50x16; Aminex-A5) or inorganic exchanger, membrane based separation using chelating ligand impregnated membranes (CMPO in electrochemical separation are some of the methods reported. Limitations such as elution of 90 Y after initial elution of 90 Sr, availability of 90 Y as a chelated complex which then has to be treated to enable labeling the molecule of interest, possibility of obtaining small quantities of 90 Y owing to radiolytic damages to the separation system components, paucity of special automation gadgets for handling the high activities remotely

Radiation protection in radionuclide therapies with (90)Y-conjugates: risks and safety.

Science.gov (United States)

Cremonesi, Marta; Ferrari, Mahila; Paganelli, Giovanni; Rossi, Annalisa; Chinol, Marco; Bartolomei, Mirco; Prisco, Gennaro; Tosi, Giampiero

2006-11-01

The widespread interest in (90)Y internal radionuclide treatments has drawn attention to the issue of radiation protection for staff. Our aim in this study was to identify personnel at risk and to validate the protection devices used. (90)Y-MoAb (Zevalin, 15 cases, 1.1 GBq/patient) and (90)Y-peptide ((90)Y-DOTATOC) systemic (i.v., 50 cases, 3.0 GBq/patient) and locoregional (l.r., 50 cases, 0.4 GBq/patient) treatments were considered. Radiolabelling was carried out in a dedicated hot cell. Tele-tongs, shielded (PMMA: polymethylmethacrylate) syringes/vials and an automatic dose fractionating system were used. Operators wore anti-X-ray and anti-contamination gloves, with TLD dosimeters placed over the fingertips. For i.v. administration, activity was administered by a dedicated system; for l.r. administration, during activity infusion in the brain cavity, tongs were used and TLDs were placed over the fingertips. The air kerma-rate was measured around the patients. The use of devices provided a 75% dose reduction, with mean fingertip doses of 2.9 mGy (i.v. MoAbs), 0.6 mGy (i.v. peptides)/radiolabelling procedure and 0.5 mGy/l.r. administration. The mean effective dose to personnel was 5 microSv/patient. The air kerma-rate around the patients administered i.v. (90)Y-peptides were 3.5 (1 h) and 1.0 (48 h) microGy/h at 1 m. Patient hospitalisation of 6 h (l.r.)/48 h (i.v.) guaranteed that the recommended limits of 3 mSv/year to family members and 0.3 mSv/year to the general population (Council Directive 97/43/Euratom) were respected. When specific procedures are adopted, a substantial improvement in (90)Y manipulation is attainable, reducing doses and increasing safety. For the widespread clinical use of (90)Y-conjugates, a completely automatic labelling procedure is desirable.

Clinical feasibility of {sup 90}Y digital PET/CT for imaging microsphere biodistribution following radioembolization

Energy Technology Data Exchange (ETDEWEB)

Wright, Chadwick L.; Binzel, Katherine; Zhang, Jun; Knopp, Michael V. [The Ohio State University Wexner Medical Center, Wright Center of Innovation in Biomedical Imaging, Department of Radiology, Columbus, OH (United States); Wuthrick, Evan J. [The Ohio State University Wexner Medical Center, Department of Radiation Oncology, Columbus, OH (United States)

2017-07-15

The purpose of this study was to evaluate the clinical feasibility of next generation solid-state digital photon counting PET/CT (dPET/CT) technology and imaging findings in patients following {sup 90}Y microsphere radioembolization in comparison with standard of care (SOC) bremsstrahlung SPECT/CT (bSPECT/CT). Five patients underwent SOC {sup 90}Y bremsstrahlung imaging immediately following routine radioembolization with 3.5 ± 1.7 GBq of {sup 90}Y-labeled glass microspheres. All patients also underwent dPET/CT imaging at 29 ± 11 h following radioembolization. Matched pairs comparison was used to compare image quality, image contrast and {sup 90}Y biodistribution between dPET/CT and bSPECT/CT images. Volumetric assessments of {sup 90}Y activity using different isocontour thresholds on dPET/CT and bSPECT/CT images were also compared. Digital PET/CT consistently provided better visual image quality and {sup 90}Y-to-background image contrast while depicting {sup 90}Y biodistribution than bSPECT/CT. Isocontour volumetric assessment using a 1% threshold precisely outlined {sup 90}Y activity and the treatment volume on dPET/CT images, whereas a more restrictive 20% threshold on bSPECT/CT images was needed to obtain comparable treatment volumes. The use of a less restrictive 10% threshold isocontour on bSPECT/CT images grossly overestimated the treatment volume when compared with the 1% threshold on dPET/CT images. Digital PET/CT is clinically feasible for the assessment of {sup 90}Y microsphere biodistribution following radioembolization, and provides better visual image quality and image contrast than routine bSPECT/CT with comparable acquisition times. With further optimization and clinical validation, dPET technology may allow faster and more accurate imaging-based assessment of {sup 90}Y microsphere biodistribution. (orig.)

Clinical efficacy of breast-conserving surgery combined with neoadjuvant chemotherapy for locally advanced breast cancer: a report of 81 cases

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Zhi-yu CAO

2015-07-01

Full Text Available Objective　To investigate the clinical efficacy of neoadjuvant chemotherapy combined with breast-conserving surgery for locally advanced breast cancer. Methods　Eighty-one patients with locally advanced breast cancer were selected from those who were admitted into 309 Hospital of PLA from January 2009 to October 2013, consisting of 65 patients in stage Ⅲa and 16 in stage Ⅲb, and they were treated with neoadjuvant chemotherapy combined with breast-conserving surgery. The clinical efficacy [complete response (CR, partial response (PR, stable disease (SD and progress disease (PD] was observed during follow-up. Results　All the patients were followed-up for 12-60 months with a median of 34 months. There were 12 CR patients (14.8%, including 4 with pathological complete response (4.9%, and 52 PR patients (64.2%, 17 SD patients (21.0%. No PD was observed. The overall response rate(ORR was 79.0%(64/81. After follow-up for 12-60 months (median 34 months, distant metastasis to the lung, liver, meninges and bone occurred in 3 patients (3.7%, 3/81 and 1 of them died. Forty-eight patients received breastconserving surgery. The local recurrence rate was 6.3% (3/48. Assessment of cosmetic result was carried out in 48 patients who received breast-conserving surgery and comprehensive treatment for one year, and excellent results were obtained in 14.6% (7/48, good in 43.8% (21/48, and poor in 41.7% (20/48. Conclusions　The therapeutic efficacy of locally advanced breast cancer is satisfactory by neoadjuvant chemotherapy and breast-conserving surgery. Standardization of excision and postoperative radiotherapy, systemic comprehensive treatment is the key to the success of the treatment. DOI: 10.11855/j.issn.0577-7402.2015.06.14

Same-day {sup 90}Y radioembolization: implementing a new treatment paradigm

Energy Technology Data Exchange (ETDEWEB)

Gabr, Ahmed; Kallini, Joseph Ralph; Gates, Vanessa L.; Hickey, Ryan; Desai, Kush; Thornburg, Bartley; Marshall, Karen; Salzig, Krystina; Williams, Melissa; Del Castillo, Carlene; Hohlastos, Elias; Lewandowski, Robert J. [Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Kulik, Laura; Ganger, Daniel [Northwestern University, Department of Medicine, Division of Hepatology, Chicago, IL (United States); Baker, Talia [Northwestern University, Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Chicago, IL (United States); Salem, Riad [Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Chicago, IL (United States); Northwestern University, Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Chicago, IL (United States); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Department of Medicine, Division of Hematology and Oncology, Chicago, IL (United States)

2016-12-15

To assess the feasibility of conducting pretreatment mesenteric angiography, coil embolization, {sup 99m}Tc macroaggregated albumin ({sup 99m}Tc-MAA) scintigraphy, and {sup 90}Y radioembolization treatment in a single, same-day, combined outpatient encounter. This was a retrospective study of 78 patients treated during the period 2008 - 2015 who were managed in a single outpatient encounter under the guidance of the Interventional Radiology Department and The Nuclear Medicine Department. Pretreatment planning was performed by reviewing baseline imaging and estimated perfused liver volume bearing the tumor. The region of interest was estimated using 3-D software; this value was used for dosimetry planning. Maximum lung shunting fractions of 10 % for hepatocellular carcinoma and 5 % for liver metastases were assumed. Subsequently, hepatic angiography and {sup 99m}Tc-MAA scintigraphy were performed followed by {sup 90}Y treatment in one outpatient encounter. Total in-room procedure time was recorded. All patients underwent same-day angiography, {sup 99m}Tc-MAA scintigraphy and {sup 90}Y radioembolization. Of the 78 patients, 16 received multiple segmental treatments to both lobes, 44 received treatment to the right lobe, and 18 received treatment to the left lobe. The median dose was 106 Gy. The median number of {sup 90}Y vials needed was two (range one to six). The median in-room time was 160 min (75 - 250 min). The residential status of the patients was as follows, 18 % (14/78) were local residents, 55 % (43/78) traveled from outside the city limits, 18 % (14/78) were from out-of-state, and 9 % (7/78) were resident abroad. Of the 78 patients, 61 (77 %) had hepatocellular carcinoma, and 17 (22 %) had liver metastases. The median lung dose was 3.5 Gy. This study demonstrated the feasibility of same-day {sup 90}Y evaluation and treatment while maintaining the principles of safe and effective {sup 90}Y infusion including tumoricidal dosimetry (lobar, segmentectomy

Comparison of positron emission tomography/CT and bremsstrahlung imaging following Y-90 radiation synovectomy

International Nuclear Information System (INIS)

Barber, Thomas W.; Yap, Kenneth S.K.; Cherk, Martin H.; Kalff, Victor; Powell, Anne

2013-01-01

The aim of this study is to compare the results of positron emission tomography (PET)/CT with bremsstrahlung imaging following Y-90 radiation synovectomy. All patients referred to our institution for Y-90 radiation synovectomy between July 2011 and February 2012 underwent both PET/CT and bremsstrahlung planar (±single photon emission computed tomography (SPECT) or SPECT/CT) imaging at 4 or 24 h following administration of Y-90 silicate colloid. PET image acquisition was performed for between 15 and 20min. In patients who underwent SPECT, side-by-side comparison with PET was performed and image quality/resolution scored using a five-point scale. The distribution pattern of Y-90 on PET and bremsstrahlung imaging was compared with the intra- or extra-articular location of Y-90 activity on fused PET/CT. Thirteen joints (11 knees and two ankles) were imaged with both PET/CT and planar bremsstrahlung imaging with 12 joints also imaged with bremsstrahlung SPECT. Of the 12 joints imaged with SPECT, PET image quality/resolution was superior in 11 and inferior in one. PET demonstrated a concordant distribution pattern compared with bremsstrahlung imaging in all scans, with the pattern classified as diffuse in 12 and predominantly focal in one. In all 12 diffuse scans, PET/CT confirmed the Y-90 activity to be located intra-articularly. In the one predominantly focal scan, the fused PET/CT images localised the Y-90 activity to mostly lie in the extra-articular space of the knee. PET/CT can provide superior image quality compared with bremsstrahlung imaging and may enable reliable detection of extra-articular Y-90 activity when there are focal patterns on planar bremsstrahlung imaging.

PET/CT comparing 68Ga-DOTATATE and other radiopharmaceuticals and in comparison with CT/MRI for the localization of sporadic metastatic pheochromocytoma and paraganglioma

International Nuclear Information System (INIS)

Janssen, Ingo; Chen, Clara C.; Millo, Corina M.; Herscovitch, Peter; Ling, Alexander; Taieb, David; Lin, Frank I.; Adams, Karen T.; Wolf, Katherine I.; Pacak, Karel; Fojo, Antonio T.; Buchmann, Inga; Kebebew, Electron

2016-01-01

Pheochromocytomas/paragangliomas (PPGLs) and their metastases are tumors that predominantly express somatostatin receptor 2 (SSR2). 68 Ga-DOTA(0)-Tyr(3)-octreotate ( 68 Ga-DOTATATE) is a PET radiopharmaceutical with both high and selective affinity for SSRs. The purpose of this study was to evaluate the utility of 68 Ga-DOTATATE in comparison with other specific and nonspecific radiopharmaceuticals recommended in the current guidelines for the localization of metastatic sporadic PPGL by PET/CT. This prospective study included 22 patients (15 men, 7 women; aged 50.0 ± 13.9 years) with confirmed metastatic PPGL, a negative family history for PPGL, and negative genetic testing, who underwent 68 Ga-DOTATATE, 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET/CT, and CT/MRI. Only 12 patients underwent an additional 18 F-fluorodihydroxyphenylalanine ( 18 F-FDOPA) PET/CT scan and only 11 patients underwent an additional 18 F-fluorodopamine ( 18 F-FDA) PET/CT scan. The rates of detection of metastatic lesions were compared among all the imaging studies. A composite of all functional and anatomical imaging studies served as the imaging comparator. 68 Ga-DOTATATE PET/CT showed a lesion-based detection rate of 97.6 % (95 % confidence interval, CI, 95.8 - 98.7 %). 18 F-FDG PET/CT, 18 F-FDOPA PET/CT, 18 F-FDA PET/CT, and CT/MRI showed detection rates of 49.2 % (CI 44.5 - 53.6 %; p < 0.01), 74.8 % (CI 69.0 - 79.9 %; p < 0.01), 77.7 % (CI 71.5 - 82.8 %; p < 0.01), and 81.6 % (CI 77.8 - 84.8 %; p < 0.01), respectively. The results of this study demonstrate the superiority of 68 Ga-DOTATATE PET/CT in the localization of sporadic metastatic PPGLs compared to all other functional and anatomical imaging modalities, and suggest modification of future guidelines towards this new imaging modality. (orig.)

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non-small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience.

Science.gov (United States)

Savic, Milan; Kontic, Milica; Ercegovac, Maja; Stojsic, Jelena; Bascarevic, Slavisa; Moskovljevic, Dejan; Kostic, Marko; Vesovic, Radomir; Popevic, Spasoje; Laban, Marija; Markovic, Jelena; Jovanovic, Dragana

2017-09-01

In spite of the progress made in neoadjuvant therapy for operable non small-cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA. Retrospective data of 163 patients diagnosed with stage IIIA NSCLC after surgery was analyzed. The patients were divided into two groups: a preoperative chemotherapy group including 59 patients who received platinum-etoposide doublet treatment before surgery, and an upfront surgery group including 104 patients for whom surgical resection was the first treatment step. Adjuvant chemotherapy or/and radiotherapy was administered to 139 patients (85.3%), while 24 patients (14.7%) were followed-up only. The rate of N2 disease was significantly higher in the upfront surgery group ( P   0.05). There was significant difference in preoperative chemotherapy group regarding relapse rate and treatment outcomes related to the lymph node status comparing to the upfront surgery group. Neoadjuvant/adjuvant chemo-therapy is a part of treatment for patients with stage IIIA NSCLC, but further investigation is required to determine optimal treatment. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

The exploration of nursing care for patients with benign prostatic hyperplasia treated using 90Sr-90Y

International Nuclear Information System (INIS)

Xiao Lizhen; Bai Xuemei; Zhang Bihui; Yang Xiaoling

2004-01-01

An exploration of nursing care for patients with benign prostatic hyperplasia (BPH) treated using 90 Sr- 90 Y through the rectum was carried out . The treatment result and nursing experience in 90 cases were reported in this paper. Before the therapy nurses explained the method and principle of this treatment to the patients for the sake of increasing their confidence and to help them complete the treatment course successfully. During the radiotherapy, nurses practiced strictly radiation protection principles and operating instructions. They assisted the patients to have a healthy life style and good diet . The result of treatment indicated that the total effectiveness rate was 96.7%. The symptoms of lower urinary obstruction were improved evidently and the life quality of the patients elevated. Observation of clinical system confirmed that 90 Sr- 90 Y may be a new treatment method of BPH with benefits of safe irradiation dos, easy operation, non-traumatization, painlessness, and remarkable curative effects. However, it should be stressed that nursing care plays a pivotal role in the treatment result. (authors)

A GATE evaluation of the sources of error in quantitative {sup 90}Y PET

Energy Technology Data Exchange (ETDEWEB)

Strydhorst, Jared, E-mail: jared.strydhorst@gmail.com; Buvat, Irène [IMIV, U1023 Inserm/CEA/Université Paris-Sud and ERL 9218 CNRS, Université Paris-Saclay, CEA/SHFJ, Orsay 91401 (France); Carlier, Thomas [Department of Nuclear Medicine, Centre Hospitalier Universitaire de Nantes and CRCNA, Inserm U892, Nantes 44000 (France); Dieudonné, Arnaud [Department of Nuclear Medicine, Hôpital Beaujon, HUPNVS, APHP and Inserm U1149, Clichy 92110 (France); Conti, Maurizio [Siemens Healthcare Molecular Imaging, Knoxville, Tennessee, 37932 (United States)

2016-10-15

Purpose: Accurate reconstruction of the dose delivered by {sup 90}Y microspheres using a postembolization PET scan would permit the establishment of more accurate dose–response relationships for treatment of hepatocellular carcinoma with {sup 90}Y. However, the quality of the PET data obtained is compromised by several factors, including poor count statistics and a very high random fraction. This work uses Monte Carlo simulations to investigate what impact factors other than low count statistics have on the quantification of {sup 90}Y PET. Methods: PET acquisitions of two phantoms—a NEMA PET phantom and the NEMA IEC PET body phantom-containing either {sup 90}Y or {sup 18}F were simulated using GATE. Simulated projections were created with subsets of the simulation data allowing the contributions of random, scatter, and LSO background to be independently evaluated. The simulated projections were reconstructed using the commercial software for the simulated scanner, and the quantitative accuracy of the reconstruction and the contrast recovery of the reconstructed images were evaluated. Results: The quantitative accuracy of the {sup 90}Y reconstructions were not strongly influenced by the high random fraction present in the projection data, and the activity concentration was recovered to within 5% of the known value. The contrast recovery measured for simulated {sup 90}Y data was slightly poorer than that for simulated {sup 18}F data with similar count statistics. However, the degradation was not strongly linked to any particular factor. Using a more restricted energy range to reduce the random fraction in the projections had no significant effect. Conclusions: Simulations of {sup 90}Y PET confirm that quantitative {sup 90}Y is achievable with the same approach as that used for {sup 18}F, and that there is likely very little margin for improvement by attempting to model aspects unique to {sup 90}Y, such as the much higher random fraction or the presence of

Evaluation of Effective Parameters on Labeling of Hydroxyapatite Compound with 90Y and Introducing the Best Method to Produce 90Y-HAp Radiopharmaceutical for Radio synovectomy

International Nuclear Information System (INIS)

Davarpanah, M. R.; Khoshhosn, H. A.; Attar Nosrati, S.; Harati, S. M.; Aghamiri, S. M.; Ghannadi Maragheh, M.

2012-01-01

Radio synovectomy is a local intra-articular injection of radionuclides in colloidal form for treatment of articular inflammatory in rheumatoid arthritis, hemophilia or orthopedic troubles. β-emitting radionuclides can be used for various joints based on radiation energy. 90 Y is a pure β-emitter with a half-life of 64.1 hours that is used for treatment of the knee joint. β-radiation of this radionuclide possesses maximum energy of 2.281 MeV (99.98%), mean pathway of 3.6 mm in the soft tissue and maximum 11 mm. In this project, hydroxyapatite (HAp) is applied as a colloid maker agent that interacts with 90 Y 3+ ions via ion-dipole bonds and produces 90 Y-HAp. The colloidal pharmaceutical is produced by adding an acidic solution of 90 YCl 3 to an HAp suspension in saline. Effective parameters within which the colloid is applied, such as the volume of diluent, HAp particle size and sonication effect were evaluated and tested. First, these determinative parameters were optimized in the simulated conditions and then examined in the active phase. Finally, the best procedure was determined for the production of the radiopharmaceutical. Radionuclide purity of the radiopharmaceutical according to the primary 90 YCl 3 solution was over 99.9%. Labeling yield and radiochemical purity were obtained over 99% using TLC method in saline solvent up to three days after production of radiopharmaceutical. Radiochemical purity of 90 Y-HAp colloid was also evaluated in human serum albumin solution for three days at room temperature. The amount of released activity was between 0.3 to 2%.

Radioactive impurities in radiopharmaceuticals with Y-90. Consequences for waste disposal; Radioaktive Verunreinigungen in Radiopharmazeutika mit Y-90. Konsequenzen fuer die Entsorgung von Reststoffen

Energy Technology Data Exchange (ETDEWEB)

Wanke, C.; Solle, A.; Geworski, L. [Medizinische Hochschule Hannover (Germany). Stabsstelle Strahlenschutz und Abt. Medizinische Physik

2016-07-01

Y-90 plays an important role in nuclear medicine and is of particular interest in radiation synovectomy (RSO) and in Selective internal radiation therapy (SIRT). Longer-lived impurities were investigated in a pharmaceutical used in RSO and in glass microspheres applied for SIRT. For this, measurements were carried out to identify gamma-emitting impurities. Especially in the late measurements, after decay of Y-90, impurities such as Y-88 and Y-91, Zn-65, Eu-152, Gd-153, Tb-160 und Yb-169 were identified, which accounted for less than 0,01 % of the total radioactivity at the calibration date, so that all pharmaceutical requirements were met. The impurities, however, have to be taken into account in waste management and clearance. Assuming typical masses, waste from RSO can undergo unrestricted clearance based on the clearance values tabulated in the German Radiation Protection Ordinance, provided sufficient decay storage. For waste from SIRT with glass microspheres, however, other clearance or disposal options have to be found.

Metabolic Changes After Roux-N-Y Bariatric Surgery In Hispanics.

Science.gov (United States)

Hernández-Gil de Lamadrid, José; Nieves-Rivera, Juan J; Mora, Laura; Corretjer, Lisa; Altieri, Pablo I; Suárez, Albert; Banchs, Héctor L; Muñiz, Jesús; Soto, Marie Ivelisse; Escobales, Nelson; Crespo, María

2015-01-01

The objective was to describe the metabolic outcomes 12 months after bariatric surgery (Roux-N-Y) in morbidly obese Hispanic patients, and evaluate the correlation between weight loss and the observed changes. Medical records from a hundred-and-two Hispanic obese patients who underwent bariatric surgery were identified at the University of Puerto Rico (UPR) Hospital. The following variables were obtained before and 12 months after surgery: Body Mass Index (BMI), body weight, total cholesterol (TC), triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), and fasting blood sugar (FBS). Ninety-seven percent of patients underwent Roux-N-Y surgery; 79.4% were females and 44% were diabetics. We observed statistically significant reductions (p N-Y significantly improves the lipid profile and FBS levels in obese Hispanic patients. The poor correlation factor between weight loss and these variables suggests that other mechanisms, independent from weight loss, are responsible for these changes.

Therapy with {sup 90}Y microspheres: radiation protection in new medical therapies; Terapia con microesferas de {sup 90}Y: proteccion radiologica en nuevas terapias medicas

Energy Technology Data Exchange (ETDEWEB)

Rojo, Ana; Puerta, Nancy, E-mail: arojo@arn.gob.ar [Autoridad Regulatoria Nuclear (ARN), Buenos Aires (Argentina)

2013-07-01

Primary liver cancer is one of the most frequent in the world and with a low cure rate. Radioembolization using 90y spheres is a promising treatment of this pathology and involves the percutaneous vascular application of radioisotope-labeled the order of Micron size particles. The advantages of this technique include the permit administered high doses of radiation to small volumes with low relative toxicity, offer the possibility of treating all the liver including microscopic tumors, and finally, the feasibility of combined with other therapies. Radiation protection in new medical therapies requires justification and optimization, as requirements for their implementation. The application of the principle of optimization in the context of the protection of the patient must be the minimum that it can be reasonably reached compatible with the required doses of treatment dose to healthy tissue. With {sup 90}Y microspheres therapy this optimization applies to the activity of 90y which is administered to the patient, and estimation methods are postulated. in this work are analyzed comparatively these methods, described the early physicists, equations and the limitations of each. Finally, it is concluded that the optimal method to be implemented for the evaluation of the activity of {sup 90}Y manage must be based in a voxel dosimetric model specific for each patient, however, the partitional method may be a good alternative if you don't have the tools to apply the method.

Radiochemical schemes of obtaining 89Sr and 90Y radionuclides

International Nuclear Information System (INIS)

Usarov, Z. O.

2010-03-01

Key words: strontium-89, yttrium-90, extraction and extraction-chromatographic purification of radionuclides, radiopharmaceuticals. Subjects of research: strontium-89 and yttrium-90 radionuclides and their chloride forms. Purpose of work is developing of radiochemical technologies on obtaining of 89 Sr and 90 Y on the WWR-SM reactor with high radionuclide purity. Methods of research: extraction and extraction-chromatographic methods of radionuclides separation, beta- and gamma-spectrometric methods of activity measuring. The results obtained and their novelty: Were determined the conformity to laws of Y and Sr distribution in two-phase systems TBP-HNO 3 , TBP-NH 4 NO 3 , TBP-HCI, HDEHP-NO 3 , HDEHP-NH 4 NO 3 and HDEHP-HCI. Were determined the conformity to laws of Y and Sr distribution in systems with craun ethers DB-18K-6 and DTBDB-18K-6 from water solutions of HNO 3 . Radiochemical technologies on obtaining of 89 Sr and 90 Y radionuclides including radiochemical process of yttrium target with using the systems TBP-HNO 3 and HDEHP/Teflone were developed. Practical value: the radiochemical technology of obtaining 89 Sr with high radionuclide purity was developed. The method of preparation a chloride compound of 89 SrCl 2 which is used as a drug form for preparation of 89 Sr- 'Metastron' was developed. The relatively simple method of on the way obtaining 90 Y in the reactor with high radionuclidic purity that is useful for follow using in medical practice was offered. Degree of embed and economic effectivity: the developed technologies have approbation in manufacturing conditions in Radiopreparat Enterprise of INP AS RU and were offered for receiving of domestic preparations against of import foreign analogues. The statement about using the invention by obtained patent is attached to dissertation. Field of application: the received results will be introduced in manufacture at Radiopreparat Enterprise of INP AS RU for receiving of domestic preparations

Thermoluminescent dosimetry of beta radiations of 90 Sr/ 90 Y using amorphous ZrO2

International Nuclear Information System (INIS)

Rivera M, T.; Olvera T, L.; Azorin N, J.; Barrera R, M.; Soto E, A.M.

2005-01-01

In this work the results of studying the thermoluminescent properties (Tl) of the zirconium oxide in its amorphous state (ZrO 2 -a) before beta radiations of 90 Sr/ 90 Y are presented. The amorphous powders of the zirconium oxide were synthesized by means of the sol-gel technique. The sol-gel process using alkoxides like precursors, is an efficient method to prepare a matrix of zirconium oxide by hydrolysis - condensation of the precursor to form chains of Zr-H 3 and Zr-O 2 . One of the advantages of this technique is the obtention of gels at low temperatures with very high purity and homogeneity. The powders were characterized by means of thermal analysis and by X-ray diffraction. The powders of ZrO 2 -a, previously irradiated with beta particles of 90 Sr/ 90 Y, presented a thermoluminescent curve with two peaks at 150 and 257 C. The dissipation of the information of the one ZrO 2 -a was of 40% the first 2 hours remaining constant the information for the following 30 days. The reproducibility of the information was of ± 2.5% in standard deviation. The studied characteristics allow to propose to the amorphous zirconium oxide as thermoluminescent dosemeter for the detection of beta radiation. (Author)

Collimator and energy window optimization for 90Y bremsstrahlung SPECT imaging: A SIMIND Monte Carlo study

International Nuclear Information System (INIS)

Roshan, Hoda Rezaei; Mahmoudian, Babak; Gharepapagh, Esmaeil; Azarm, Ahmadreza; Pirayesh Islamian, Jalil

2016-01-01

Treatment efficacy of radioembolization using Yttrium-90 ( 90 Y) microspheres is assessed by the 90 Y bremsstrahlung single photon emission computed tomography (SPECT) imaging following radioembolization. The radioisotopic image has the potential of providing reliable activity map of 90 Y microspheres distribution. One of the main reasons of the poor image quality in 90 Y bremsstrahlung SPECT imaging is the continuous and broad energy spectrum of the related bremsstrahlung photons. Furthermore, collimator geometry plays an impressive role in the spatial resolution, sensitivity and image contrast. Due to the relatively poor quality of the 90 Y bremsstrahlung SPECT images, we intend to optimize the medium-energy (ME) parallel-hole collimator and energy window. The Siemens e.cam gamma camera equipped with a ME collimator and a voxelized phantom was simulated by the SImulating Medical Imaging Nuclear Detectors (SIMIND) program. We used the SIMIND Monte Carlo program to generate the 90 Y bremsstrahlung SPECT projection of the digital Jaszczak phantom. The phantom consist of the six hot spheres ranging from 9.5 to 31.8 mm in diameter, which are used to evaluate the image contrast. In order to assess the effect of the energy window on the image contrast, three energy windows ranging from 60 to 160 KeV, 160 to 400 KeV, and 60 to 400 KeV were set on a 90 Y bremsstrahlung spectrum. As well, the effect of the hole diameter of a ME collimator on the image contrast and bremsstrahlung spectrum were investigated. For the fixed collimator and septa thickness values (3.28 cm and 1.14 mm, respectively), a hole diameter range (2.35–3.3 mm) was chosen based on the appropriate balance between the spatial resolution and sensitivity. The optimal energy window for 90 Y bremsstrahlung SPECT imaging was extended energy window from 60 to 400 KeV. Besides, The optimal value of the hole diameter of ME collimator was obtained 3.3 mm. Geometry of the ME parallel-hole collimator and energy

Thoracoscopic surgery for pulmonary metastases after chemotherapy using a tailor-made virtual lung

International Nuclear Information System (INIS)

Akiba, Tadashi; Marushima, Hideki; Kinoshita, Satoki; Kamiya, Noriteru; Odaka, Makoto; Takeyama, Hiroshi; Morikawa, Toshiaki

2011-01-01

Details with regard to the standard criteria for a therapeutic metastasectomy and the use of video-assisted thoracic surgery (VATS) remain elusive. To evaluate the feasibility of VATS using a tailor-made virtual lung for patients with pulmonary metastases after chemotherapy, we reviewed the following cases. Clinical data from October 2006 to April 2010 were obtained from patients who received chemotherapy before a pulmonary metastasectomy (lobectomy or segmentectomy). VATS was the primarily selected surgical approach except for treating hilar lesions. A lobectomy was performed when the metastasis was greater than 3.0 cm in diameter or located deeply in the lobe. Tailor-made virtual lungs were created using three-dimensional multidetector computed tomography before lobectomy on a routine basis. The virtual lung consisted of three-dimensional pulmonary vessels, a tracheobronchial tree, pulmonary parenchyma, and tumors. Twelve operations, consisting of 1 segmentectomy, 10 lobectomies, and 1 wedge bronchoplasty upper lobectomy, were performed on 11 patients during the study period. VATS was completed in 10 of these 12 operations. The mean operative time for the lobectomies was 257 min, and the mean operative bleeding volume was 215 ml. Two cases experienced postoperative transient atrial fibrillation, and no mortalities associated with these operations were reported. VATS was performed safely in instances of metastasectomy after chemotherapy, and the tailor-made virtual lung assisted in lung orientation during the operation. (author)

Chemoprevention, chemotherapy, and chemoresistance in colorectal cancer.

Science.gov (United States)

Marin, Jose J G; Sanchez de Medina, Fermin; Castaño, Beatriz; Bujanda, Luis; Romero, Marta R; Martinez-Augustin, Olga; Moral-Avila, Rosario Del; Briz, Oscar

2012-05-01

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in industrialized countries. Chemoprevention is a promising approach, but studies demonstrating their usefulness in large populations are still needed. Among several compounds with chemopreventive ability, cyclooxygenase inhibitors have received particular attention. However, these agents are not without side effects, which must be weighed against their beneficial actions. Early diagnosis is critical in the management of CRC patients, because, in early stages, surgery is curative in >90% of cases. If diagnosis occurs at stages II and III, which is often the case, neoadjuvant chemotherapy and radiotherapy before surgery are, in a few cases, recommended. Because of the high risk of recurrence in advanced cancers, chemotherapy is maintained after tumor resection. Chemotherapy is also indicated when the patient has metastases and in advanced cancer located in the rectum. In the last decade, the use of anticancer drugs in monotherapy or in combined regimens has markedly increased the survival of patients with CRC at stages III and IV. Although the rate of success is higher than in other gastrointestinal tumors, adverse effects and development of chemoresistance are important limitations to pharmacological therapy. Genetic profiling regarding mechanisms of chemoresistance are needed to carry out individualized prediction of the lack of effectiveness of pharmacological regimens. This would minimize side effects and prevent the selection of aggressive, cross-resistant clones, as well as avoiding undesirable delays in the use of the most efficient therapeutic approaches to treat these patients.

Tumour eradication using synchronous thermal ablation and Hsp90 chemotherapy with protein engineered triblock biopolymer-geldanamycin conjugates.

Science.gov (United States)

Chen, Yizhe; Youn, Pilju; Pysher, Theodore J; Scaife, Courtney L; Furgeson, Darin Y

2014-12-01

Hepatocellular carcinoma (HCC) suffers high tumour recurrence rate after thermal ablation. Heat shock protein 90 (Hsp90) induced post-ablation is critical for tumour survival and progression. A combination therapy of thermal ablation and polymer conjugated Hsp90 chemotherapy was designed and evaluated for complete tumour eradication of HCC. A thermo-responsive, elastin-like polypeptide (ELP)-based tri-block biopolymer was developed and conjugated with a potent Hsp90 inhibitor, geldanamycin (GA). The anti-cancer efficacy of conjugates was evaluated in HCC cell cultures with and without hyperthermia (43 °C). The conjugates were also administered twice weekly in a murine HCC model as a single treatment or in combination with single electrocautery as the ablation method. ELP-GA conjugates displayed enhanced cytotoxicity in vitro and effective heat shock inhibition under hyperthermia. The conjugates alone significantly slowed the tumour growth without systemic toxicity. Four doses of thermo-responsive ELP-GA conjugates with concomitant simple electrocautery accomplished significant Hsp90 inhibition and sustained tumour suppression. Hsp90 inhibition plays a key role in preventing the recurrence of HCC, and the combination of ablation with targeted therapy holds great potential to improve prognosis and survival of HCC patients.

Comparative effects of inhaled relatively insoluble forms of 90Y, 144Ce, and 90Sr on canine peripheral lymphocyte function

International Nuclear Information System (INIS)

Benjamin, S.A.; Jones, R.K.; Snipes, M.B.; Lustgarten, C.S.

1976-01-01

Dogs that have inhaled relatively insoluble forms of either alpha- or beta-emitting radionuclides manifest a peripheral lymphopenia, the development and course of which depends on both total dose and dose rate. The remaining peripheral lymphocytes in dogs exposed to longer lived beta-emitting radionuclides showed a depressed function as measured by the ability to respond to plant mitogens in vitro. This experiment was designed to evaluate the effect of dose rate on peripheral lymphocyte function by exposing dogs to aerosols of radionuclides with varied effective half-lives in the lung: 90 Y (2.6 days), 144 Ce (170 days), and 90 Sr (650 days). Three groups of four adult beagle dogs each were exposed by inhalation to 90 Y, 144 Ce, or 90 Sr in fused-clay particles. Two controls were matched with each group. Initial lung burdens and initial dose rates to the lung were 520 to 610 μCi/kg of body weight and 2200 to 2600 rads/day in the 90 Y group, 33 to 60 μCi/kg and 200 to 350 rads/day in the 144 Ce group, and 25 to 32 μCi/kg and 130 to 170 rads/day in the 90 Sr group. Hematologic parameters and lymphocyte function as measured by the ability of lymphocytes to respond to plant mitogen stimulation were evaluated on a weekly or biweekly basis for 8 weeks after exposure and on a monthly basis thereafter. The 90 Y-exposed dogs showed a marked lymphopenia within 1 week with a return to control levels by 20 weeks after exposure. The remaining peripheral lymphocytes, however, showed no functional changes in these dogs. Animals exposed to 144 Ce or 90 Sr developed a progressive and persisent lymphopenia and showed functional depression of the remaining lymphocytes as well. The relationships among dose pattern, lymphopenia, and lymphocyte-function depression are discussed

Thermoluminescent dosimetry of beta radiations of {sup 90} Sr/ {sup 90} Y using ZrO{sub 2}: Eu; Dosimetria termoluminiscente de radiaciones beta de {sup 90} Sr/ {sup 90} Y usando ZrO{sub 2}: Eu

Energy Technology Data Exchange (ETDEWEB)

Olvera T, L.; Azorin N, J.; Barrera S, M.; Soto E, A.M. [UAM-I, 09340 Mexico D.F. (Mexico); Rivera M, T. [CICATA-IPN, Legaria 694, 11500 Mexico D.F. (Mexico)

2005-07-01

In this work the results of studying the thermoluminescent properties (TL) of the doped zirconium oxide with europium (ZrO{sub 2}: Eu{sup 3+}) before beta radiations of {sup 90}Sr/ {sup 90}Y are presented. The powders of ZrO{sub 2}: Eu{sup 3+} were obtained by means of the sol-gel technique and they were characterized by means of thermal analysis and by X-ray diffraction. The powders of ZrO{sub 2}: Eu{sup 3+}, previously irradiated with beta particles of {sup 90}Sr/ {sup 90}Y, presented a thermoluminescent curve with two peaks at 204 and 292 C respectively. The TL response of the ZrO{sub 2}: Eu{sup 3+} as function of the absorbed dose was lineal from 2 Gy up to 90 Gy. The fading of the information of the ZrO{sub 2}: Eu{sup 3+} was of 10% the first 2 hours remaining almost constant the information by the following 30 days. The ZrO{sub 2} doped with the (Eu{sup 3+}) ion it was found more sensitive to the beta radiation that the one of zirconium oxide without doping (ZrO{sub 2}) obtained by the same method. Those studied characteristics allow to propose to the doped zirconium oxide with europium like thermoluminescent dosemeter for the detection of the beta radiation. (Author)

Development of 90Y-DOTA-nimotuzumab Fab fragment for radioimmunotherapy

International Nuclear Information System (INIS)

Alonso Martinez, L.M.; Marylaine Perez-Malo Cruz; Rene Leyva Montana; Calzada Falcon, V.N.; Minely Zamora Barrabi; Alejandro Arbesu Valdivia; Ignacio Hernandez Gonzalez; Mariela Leon Perez

2014-01-01

Yttrium-90-( 90 Y) labeled monoclonal antibodies prepared with a chelating agent, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), have been used for radioimmunotherapy of cancer. In the present work, the Fab fragment of anti-EGFR monoclonal antibody nimotuzumab was prepared with high purity, integrity and biological activity. The Fab fragment with high specific recognition of EGFR in NCI-H125 human lung adenocarcinoma cells was derivatized with DOTA-NHS applying a simple procedure. DOTA-nimotuzumab Fab fragment was successfully radiolabeled with 90 Y with high radiochemical yield. The in vitro stability of labeled product was optimal over 24 h in buffered solution at 37 deg C. Biodistribution and pharmacokinetic studies correctly evaluated the in vivo non-tumor uptake, dosage regimen and excretion pathway in normal Wistar rats. (author)

Phase III study comparing chemotherapy and radiotherapy with preoperative chemotherapy and surgical resection in patients with non-small-cell lung cancer with spread to mediastinal lymph nodes (N2); final report of RTOG 89-01

International Nuclear Information System (INIS)

Johnstone, David W.; Byhardt, Roger W.; Ettinger, David; Scott, Charles B.

2002-01-01

Purpose: To compare the outcome of treatment of mediastinoscopy-verified N2 non-small-cell lung cancer treated with induction chemotherapy followed by either surgery or radiotherapy (RT), with both options followed by consolidation chemotherapy. Methods and Materials: A randomized Phase III trial for Stage IIIA (T1-T3N2M0) non-small cell lung cancer was conducted by the Radiation Therapy Oncology Group (RTOG) and Eastern Cooperative Oncology Group between April 1990 and April 1994. After documentation of N2 disease by mediastinoscopy or anterior mediastinotomy, patients received induction chemotherapy with cisplatin, vinblastine, and mitomycin-C. Mitomycin-C was later dropped from the induction regimen. Patients were then randomized to surgery or RT (64 Gy in 7 weeks) followed by cisplatin and vinblastine. Results: RTOG 89-01 accrued 75 patients, of whom 73 were eligible and analyzable. Twelve patients received induction chemotherapy but were not randomized to RT or surgery thereafter. Forty-five patients were randomized to postinduction RT or surgery. Of the analyzable patients, 90% had a Karnofsky performance score of 90-100, 18% had weight loss >5%, 37% had squamous cell histologic features, and 54% had bulky N2 disease. The distribution of bulky N2 disease was uniform among the treatment arms. The incidence of Grade 4 toxicity was 56% in patients receiving mitomycin-C and 29% in those who did not. Only 1 patient in each group had acute nonhematologic toxicity greater than Grade 3 (nausea and vomiting). No acute Grade 4 radiation toxicity developed. The incidences of long-term toxicity were equivalent across the arms. Three treatment-related deaths occurred: 2 patients in the surgical arms (one late pulmonary toxicity and one pulmonary embolus), and 1 patient in the radiation arm (radiation pneumonitis). Induction chemotherapy was completed in 78% of the patients. Complete resection was performed in 73% of 26 patients undergoing thoracotomy. Consolidation

Chinese expert consensus on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal malignancies

Science.gov (United States)

Li, Yan; Zhou, Yun-Feng; Liang, Han; Wang, Hua-Qing; Hao, Ji-Hui; Zhu, Zheng-Gang; Wan, De-Seng; Qin, Lun-Xiu; Cui, Shu-Zhong; Ji, Jia-Fu; Xu, Hui-Mian; Wei, Shao-Zhong; Xu, Hong-Bin; Suo, Tao; Yang, Shu-Jun; Xie, Cong-Hua; Yang, Xiao-Jun; Yang, Guo-Liang

2016-01-01

Locoregional spread of abdominopelvic malignant tumors frequently results in peritoneal carcinomatosis (PC). The prognosis of PC patients treated by conventional systemic chemotherapy is poor, with a median survival of < 6 mo. However, over the past three decades, an integrated treatment strategy of cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) has been developed by the pioneering oncologists, with proved efficacy and safety in selected patients. Supported by several lines of clinical evidence from phases I, II and III clinical trials, CRS + HIPEC has been regarded as the standard treatment for selected patients with PC in many established cancer centers worldwide. In China, an expert consensus on CRS + HIPEC has been reached by the leading surgical and medical oncologists, under the framework of the China Anti-Cancer Association. This expert consensus has summarized the progress in PC clinical studies and systematically evaluated the CRS + HIPEC procedures in China as well as across the world, so as to lay the foundation for formulating PC treatment guidelines specific to the national conditions of China. PMID:27570426

Response of pulmonary artery intimal sarcoma to surgery, radiotherapy and chemotherapy: a case report

Directory of Open Access Journals (Sweden)

Long Hong-qing

2008-06-01

Full Text Available Abstract Introduction Pulmonary artery intimal sarcoma is a rare disease with no characteristic symptoms. It is difficult to diagnose early and is frequently misdiagnosed as a pulmonary embolism. Case presentation Here we report a case of pulmonary artery intimal sarcoma in a 54-year-old woman presenting with complaints of shortness of breath on exertion. Echocardiography and a computed tomography scan showed that the right pulmonary artery trunk was blocked by a low-density mass. The patient was diagnosed with pulmonary artery intimal sarcoma by pathology and a complete mass resection was performed. After experiencing 10 months of disease-free survival, she was re-admitted because of the recurrence and metastasis of the tumor. Radiotherapy and chemotherapy were performed; however, only limited success was achieved. The patient died 15 months after the initial onset of symptoms. Conclusion Some patients with intimal sarcoma of the pulmonary artery can benefit from radiotherapy and chemotherapy as well as surgery.

Peptide receptor radionuclide therapy with {sup 177}Lu-DOTATATE: the IEO phase I-II study

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Bodei, Lisa; Grana, Chiara M.; Baio, Silvia M.; Lombardo, Dario; Chinol, Marco; Paganelli, Giovanni [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Cremonesi, Marta; Ferrari, Mahila E. [European Institute of Oncology, Division of Medical Physics, Milan (Italy); Fazio, Nicola [European Institute of Oncology, Division of Medical Oncology, Milan (Italy); Iodice, Simona [European Institute of Oncology, Division of Epidemiology and Biostatistics, Milan (Italy); Bartolomei, Mirco [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); M. Bufalini Hospital, Division of Nuclear Medicine, Cesena, FC (Italy); Sansovini, Maddalena [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Unit of Radiometabolic Medicine, Meldola, FC (Italy)

2011-12-15

Peptide receptor radionuclide therapy (PRRT) is used in tumours expressing type 2 somatostatin receptors (sst{sub 2}), mainly neuroendocrine. The aim of this prospective phase I-II study was to evaluate the toxicity and efficacy of {sup 177}Lu-DOTATATE in multiple cycles. Fifty-one consecutive patients with unresectable/metastatic sst{sub 2}-positive tumours, divided into two groups, received escalating activities (3.7-5.18 GBq/cycle, group 1; 5.18-7.4 GBq/cycle, group 2) of {sup 177}Lu-DOTATATE. Cumulative activities ranged from 3.7 to 29.2 GBq (median 26.4 GBq in median 6 cycles, group 1, 21 patients) and 5.55 to 28.9 GBq (median 25.2 GBq in 4 cycles, group 2, 30 patients), based on dosimetry. No major acute or delayed renal or haematological toxicity occurred (one grade 3 leukopenia and thrombocytopenia). Cumulative renal absorbed doses were 8-37 Gy (9-41 Gy bioeffective doses). A median decrease of creatinine clearance of 21.7% 6 months after PRRT, 23.9% after 1 year and 27.6% after 2 years was observed. Higher losses (>20%) occurred in patients with risk factors for renal toxicity, particularly hypertension and diabetes. Cumulative bone marrow doses were <1.5 Gy. Blood elements showed a progressive mild drop during cycles and recovered during follow-up (median 30 months). Thirty-nine patients were progressive at enrolment. Partial and complete responses occurred in 15 of 46 (32.6%) assessable patients. The median time to progression was 36 months. Overall survival was 68% at 36 months. Non-responders and patients with extensive tumour involvement had lower survival. {sup 177}Lu-DOTATATE was well tolerated up to 29 GBq cumulative activity (up to 7.4 GBq/cycle). The maximum tolerated dose/cycle was not reached. However, considering the individual bone marrow function and the presence of risk factors for kidney toxicity, it seems safer to divide cumulative activities into lower activity cycles. (orig.)

PET optimization for improved assessment and accurate quantification of {sup 90}Y-microsphere biodistribution after radioembolization

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Martí-Climent, Josep M., E-mail: jmmartic@unav.es; Prieto, Elena; Elosúa, César; Rodríguez-Fraile, Macarena; Domínguez-Prado, Inés; Vigil, Carmen; García-Velloso, María J.; Arbizu, Javier; Peñuelas, Iván; Richter, José A. [Nuclear Medicine Department, Clínica Universidad de Navarra, 36, Pío XII Avenue, 31008 Pamplona (Spain)

2014-09-15

Purpose: {sup 90}Y-microspheres are widely used for the radioembolization of metastatic liver cancer or hepatocellular carcinoma and there is a growing interest for imaging {sup 90}Y-microspheres with PET. The aim of this study is to evaluate the performance of a current generation PET/CT scanner for {sup 90}Y imaging and to optimize the PET protocol to improve the assessment and the quantification of {sup 90}Y-microsphere biodistribution after radioembolization. Methods: Data were acquired on a Biograph mCT-TrueV scanner with time of flight (TOF) and point spread function (PSF) modeling. Spatial resolution was measured with a{sup 90}Y point source. Sensitivity was evaluated using the NEMA 70 cm line source filled with {sup 90}Y. To evaluate the count rate performance, {sup 90}Y vials with activity ranging from 3.64 to 0.035 GBq were measured in the center of the field of view (CFOV). The energy spectrum was evaluated. Image quality with different reconstructions was studied using the Jaszczak phantom containing six hollow spheres (diameters: 31.3, 28.1, 21.8, 16.1, 13.3, and 10.5 mm), filled with a 207 kBq/ml {sup 90}Y concentration and a 5:1 sphere-to-background ratio. Acquisition time was adjusted to simulate the quality of a realistic clinical PET acquisition of a patient treated with SIR-Spheres{sup ®}. The developed methodology was applied to ten patients after SIR-Spheres{sup ®} treatment acquiring a 10 min per bed PET. Results: The energy spectrum showed the{sup 90}Y bremsstrahlung radiation. The {sup 90}Y transverse resolution, with filtered backprojection reconstruction, was 4.5 mm in the CFOV and degraded to 5.0 mm at 10 cm off-axis. {sup 90}Y absolute sensitivity was 0.40 kcps/MBq in the center of the field of view. Tendency of true and random rates as a function of the {sup 90}Y activity could be accurately described using linear and quadratic models, respectively. Phantom studies demonstrated that, due to low count statistics in {sup 90}Y PET

Splenectomy Increases Postoperative Complications Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

Science.gov (United States)

Dagbert, Francois; Thievenaz, Remy; Decullier, Evelyne; Bakrin, Naoual; Cotte, Eddy; Rousset, Pascal; Vaudoyer, Delphine; Passot, Guillaume; Glehen, Olivier

2016-06-01

Complete cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) is increasingly performed on patients with peritoneal carcinomatosis of various origins. Splenectomy often is required in these patients to achieve complete tumor removal. Although splenectomy has been associated with increased morbidity in many major abdominal surgeries, its effect in patients undergoing CRS + HIPEC is unknown. The purpose of this study was to evaluate the impact of splenectomy during CRS + HIPEC on postoperative outcomes. We retrospectively identified 39 patients who underwent CRS + HIPEC with splenectomy during a 3-year study period from a prospective database. We compared them to case controls (CRS + HIPEC without splenectomy) that were matched for the complexity of the procedure. We evaluated the complication rate and outcomes of patients in each group. During the study period, splenectomy was performed in 32 % of patients undergoing CRS + HIPEC procedure. Patients in the splenectomy group experienced more grade 3-4 complications than patients in the control group (59 vs. 35.9 %, p = 0.041) as well as more pulmonary complications (41 vs. 7.7 %, p = 0.0006). Multivariate analysis identified splenectomy as the only predictor of overall major complications (odds ratio = 2.57, 95 % confidence interval = 1.03-6.40). Mortality was similar in both groups. Splenectomy increases major complication rate in patients undergoing CRS + HIPEC and efforts should be made to preserve the spleen during the surgery.

Y-90 PET imaging for radiation theragnosis using bootstrap event re sampling

International Nuclear Information System (INIS)

Nam, Taewon; Woo, Sangkeun; Min, Gyungju; Kim, Jimin; Kang, Joohyun; Lim, Sangmoo; Kim, Kyeongmin

2013-01-01

Surgical resection is the most effective method to recover the liver function. However, Yttrium-90 (Y-90) has been used as a new treatment due to the fact that it can be delivered to the tumors and results in greater radiation exposure to the tumors than using external radiation nowadays since most treatment is palliative in case of unresectable stage of hepatocellular carcinoma (HCC). Recently, Y-90 has been received much interest and studied by many researchers. Imaging of Y-90 has been conducted using most commonly gamma camera but PET imaging is required due to low sensitivity and resolution. The purpose of this study was to assess statistical characteristics and to improve count rate of image for enhancing image quality by using nonparametric bootstrap method. PET data was able to be improved using non-parametric bootstrap method and it was verified with showing improved uniformity and SNR. Uniformity showed more improvement under the condition of low count rate, i.e. Y-90, in case of phantom and also uniformity and SNR showed improvement of 15.6% and 33.8% in case of mouse, respectively. Bootstrap method performed in this study for PET data increased count rate of PET image and consequentially time for acquisition time can be reduced. It will be expected to improve performance for diagnosis

Combined chemotherapy including platinum derivatives for medulloblastoma. The usefulness as maintenance chemotherapy

International Nuclear Information System (INIS)

Sasaki, Hikaru; Otani, Mitsuhiro; Yoshida, Kazunari; Kagami, Hiroshi; Shimazaki, Kenji; Toya, Shigeo; Kawase, Takeshi

1997-01-01

The authors reviewed 24 cerebellar medulloblastoma patients treated at Keio University to determine usefulness of combined chemotherapy including platinum derivatives (cisplatin, carboplatin) as the induction and maintenance treatment. All patients underwent radical surgery and craniospinal irradiation. Ten received adjuvant chemotherapy other than platinum derivatives (mainly with nitrosourea compounds), five were treated by induction and maintenance chemotherapy including platinum derivatives, and nine patients did not undergo chemotherapy. The progression-free survival rate of patients treated with platinum derivatives was better than that of patients treated with other modes of chemotherapy and also that of patients who did not receive chemotherapy. The results were especially good in the case of four patients treated with maintenance chemotherapy consisting of carboplatin and etoposide, two of whom had been free from relapse beyond the risk period of Collins. The occurrences of toxicity in maintenance chemotherapy with carboplatin and etoposide were limited to transient leucopenia. The present study indicates combined chemotherapy including platinum derivatives benefits patients with medulloblastoma, and could be useful, especially as maintenance treatment. (author)

⁶⁴Cu-DOTATATE for Noninvasive Assessment of Atherosclerosis in Large Arteries and Its Correlation with Risk Factors

DEFF Research Database (Denmark)

Malmberg, Catarina; Ripa, Rasmus Sejersten; Johnbeck, Camilla Bardram

2015-01-01

UNLABELLED: The somatostatin receptor subtype 2 is expressed on macrophages, an abundant cell type in the atherosclerotic plaque. Visualization of somatostatin receptor subtype 2, for oncologic purposes, is frequently made using the DOTA-derived somatostatin analogs DOTATOC or DOTATATE for PET. We...

Country report: India. Development of Radiopharmaceuticals Based on {sup 188}Re and {sup 90}Y for Radionuclide Therapy

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Venkatesh, M.; Pandey, U.; Dhami, P. S.; Chakravarty, R.; Kameswaran, M.; Subramanian, S.; Dash, A.; Samuel, G. [Bhabha Atomic Research Centre, Trombay, Mumbai 400 085 (India)

2010-07-01

During the past decade, our group has focused attention on the development of therapeutic radiopharmaceuticals incorporating radioisotopes such as {sup 90}Y, {sup 188}Re etc. As the primary source of the radioisotopes {sup 90}Y and {sup 188}Re are the {sup 90}Sr/{sup 90}Y generators and {sup 188}W/{sup 188}Re generators respectively, the local availability of these generator systems is very important for the successful development of radiopharmaceuticals incorporating these radioisotopes. In this context, {sup 90}Sr/{sup 90}Y generators based on Supported Liquid Membrane (SLM) [1-3] and electrochemical techniques [4] could be designed and deployed in our laboratories for the elution of {sup 90}Y to be used for preparation of {sup 90}Y labeled products. This work formed a part of the IAEA co-ordinated CRP on “Development of Generator Technologies for Therapeutic Radionuclides: {sup 90}Y and {sup 188}Re”. In this report, work on the development of {sup 90}Y radiopharmaceuticals for treatment of liver cancer and non-Hodgkin’s lymphoma (NHL) is reported. In addition, comparison of the Extraction Paper Chromatography technique (EPC) developed for determination of {sup 90}Sr contamination in {sup 90}Y samples with the US Pharmacopeia recommended method as well as the validation of the EPC technique is presented.

Resin 90Y microsphere activity measurements for liver brachytherapy

International Nuclear Information System (INIS)

Dezarn, William A.; Kennedy, Andrew S.

2007-01-01

The measurement of the radioactivity administered to the patient is one of the major components of 90 Y microsphere liver brachytherapy. The activity of 90 Y microspheres in a glass delivery vial was measured in a dose calibrator. The calibration value to use for 90 Y in the dose calibrator was verified using an activity calibration standard provided by the microsphere manufacturer. This method allowed for the determination of a consistent, reproducible local activity standard. Additional measurements were made to determine some of the factors that could affect activity measurement. The axial response of the dose calibrator was determined by the ratio of activity measurements at the bottom and center of the dose calibrator. The axial response was 0.964 for a glass shipping vial, 1.001 for a glass V-vial, and 0.988 for a polycarbonate V-vial. Comparisons between activity measurements in the dose calibrator and those using a radiation survey meter were found to agree within 10%. It was determined that the dose calibrator method was superior to the survey meter method because the former allowed better defined measurement geometry and traceability of the activity standard back to the manufacturer. Part of the preparation of resin 90 Y microspheres for patient delivery is to draw out a predetermined activity from a shipping vial and place it into a V-vial for delivery to the patient. If the drawn activity was placed in a glass V-vial, the activity measured in the dose calibrator with a glass V-vial was 4% higher than the drawn activity from the shipping vial standard. If the drawn activity was placed in a polycarbonate V-vial, the activity measured in the dose calibrator with a polycarbonate V-vial activity was 20% higher than the drawn activity from the shipping vial standard. Careful characterization of the local activity measurement standard is recommended instead of simply accepting the calibration value of the dose calibrator manufacturer

Pilot trial of Y-90 glass microspheres in the treatment of primary hepatocellular carcinoma

International Nuclear Information System (INIS)

Houle, S.; Yip, T.C.K.; Shepherd, F.A.; Rotstein, L.E.; Theis, B.; Cawthorn, R.; Barnes, K.

1987-01-01

A pilot trial is currently under way at our institution to determine the potential of new Y-90 glass microspheres (Theraspheres, Theragenics Corp., Atlanta) for the treatment of primary hepatocellular carcinoma. The Y-90 microspheres are injected through a percutaneous hepatic artery catheter positioned angiographically. The injection is facilitated by a new delivery system. Prior to the injection of the Y-90 microspheres, the presence of shunting is assessed by injecting Tc-99m human albumin microspheres (HAM) via the hepatic artery catheter. Bremsstrahlung scans done after injection demonstrate the distribution the Y-90 microspheres within the liver and the lack of extrahepatic activity. In the first group of patients treated, no significant toxicity was demonstrated for absorbed doses between 5,000 and 10,000 rad to the liver, and up to 20,000 rad to the tumor itself

Preoperative Y-90 microsphere selective internal radiation treatment for tumor downsizing and future liver remnant recruitment: a novel approach to improving the safety of major hepatic resections.

Science.gov (United States)

Gulec, Seza A; Pennington, Kenneth; Hall, Michael; Fong, Yuman

2009-01-08

Extended liver resections are being performed more liberally than ever. The extent of resection of liver metastases, however, is restricted by the volume of the future liver remnant (FLR). An intervention that would both accomplish tumor control and induce compensatory hypertrophy, with good patient tolerability, could improve clinical outcomes. A 53-year-old woman with a history of cervical cancer presented with a large liver mass. Subsequent biopsy indicated poorly differentiated carcinoma with necrosis suggestive of squamous cell origin. A decision was made to proceed with pre-operative chemotherapy and Y-90 microsphere SIRT with the intent to obtain systemic control over the disease, downsize the hepatic lesion, and improve the FLR. A surgical exploration was performed six months after the first SIRT (three months after the second). There was no extrahepatic disease. The tumor was found to be significantly decreased in size with central and peripheral scarring. The left lobe was satisfactorily hypertrophied. A formal right hepatic lobectomy was performed with macroscopic negative margins. Selective internal radiation treatment (SIRT) with yttrium-90 (Y-90) microspheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. We present this case report to suggest that the portal vein radiation dose can be substantially increased with the intent of inducing portal/periportal fibrosis. Such a therapeutic manipulation in lobar Y-90 microsphere treatment could accomplish the end points of PVE with avoidance of the concern regarding tumor progression.

The solvent extraction of carrier-free 90Y from 90Sr with crown ethers

International Nuclear Information System (INIS)

Chuang, J.T.; Lo, J.G.

1995-01-01

A simple solvent extraction method has been developed for the separation of 90 Y from 90 Sr. Crown ether dissolved in chloroform was used as a selective reagent and organic picrate anion was chosen as a counter ion. The effect of various factors on the extraction equilibrium constant of strontium log K ex = 9.15 was obtained from the study of the distribution coefficient versus to crown ether concentration. The separation method was simple, resulted high purity (>99.9%) and quantitative yield, and took less than half an hour. (author) 27 refs.; 4 figs.; 4 tabs

Therapy with 90Y microspheres: radiation protection in new medical therapies

International Nuclear Information System (INIS)

Rojo, Ana; Puerta, Nancy

2013-01-01

Primary liver cancer is one of the most frequent in the world and with a low cure rate. Radioembolization using 90y spheres is a promising treatment of this pathology and involves the percutaneous vascular application of radioisotope-labeled the order of Micron size particles. The advantages of this technique include the permit administered high doses of radiation to small volumes with low relative toxicity, offer the possibility of treating all the liver including microscopic tumors, and finally, the feasibility of combined with other therapies. Radiation protection in new medical therapies requires justification and optimization, as requirements for their implementation. The application of the principle of optimization in the context of the protection of the patient must be the minimum that it can be reasonably reached compatible with the required doses of treatment dose to healthy tissue. With 90 Y microspheres therapy this optimization applies to the activity of 90y which is administered to the patient, and estimation methods are postulated. in this work are analyzed comparatively these methods, described the early physicists, equations and the limitations of each. Finally, it is concluded that the optimal method to be implemented for the evaluation of the activity of 90 Y manage must be based in a voxel dosimetric model specific for each patient, however, the partitional method may be a good alternative if you don't have the tools to apply the method

A case report of metastatic neuroendocrine carcinoma of the right adrenal gland successfully treated with chemotherapy and surgery.

Science.gov (United States)

Ochiai, Toshiya; Komiyama, Sosuke; Ikoma, Hisashi; Kubota, Takeshi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Kikuchi, Shojiro; Fujiwara, Hitoshi; Sakakura, Chohei; Kokuba, Yukihito; Sonoyama, Teruhisa; Otsuji, Eigo

2010-08-01

Poorly differentiated neuroendocrine carcinoma has a poor prognosis, especially when associated with distant metastasis. A 60-year-old man was admitted to a private hospital because of dyspnea at work in 2007. Computed tomography revealed lung infarction and a right adrenal tumor sized 12 cm in diameter that was tightly compressed against the inferior vena cava (IVC). Moreover, multiple lymph node metastases around the celiac axis and a solitary liver metastasis at the lateral segment were observed. Thus, we planned chemotherapy without surgery. We selected a combination therapy of irinotecan (CPT-11) and cisplatin (CDDP) (i.e., IP therapy): administration of CDDP [60 mg/m(2) body surface area (BSA)] on day 1 plus CPT-11 (80 mg/m(2)) BSA on days 1 and 8. Thereafter, this protocol was repeated at 3-week intervals. After 15 months of this chemotherapy strategy, the whole lesions showed a partial response by RECIST. The primary tumor had shrunk to 4.2 cm in diameter. In November 2008, we planned surgery to perform resection of the whole lesions. Histological diagnosis of the specimen was a poorly differentiated neuroendocrine carcinoma based on the immunostaining features, i.e., synaptophysin- and chromogranin positive. There were no viable tumor cells at the dissected lymph nodes or at the liver tumor. After surgery, CPT-11 administration was continued. The patient has remained well for 9 months without recurrence.

[Strategy of liver resection during chemotherapy for otherwise unresectable colorectal metastases].

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Tanaka, Kuniya; Kumamoto, Takafumi; Takeda, Kazuhisa; Nojiri, Kazunori; Endo, Itaru

2013-07-01

With multidisciplinary management of patients with effective chemotherapy that can downstage metastases, more patients with previously inoperable disease can benefit from surgery. Surgery in isolation may be approaching technical limits, but now is likely to help more patients because of success of complementary strategies, particularly newer chemotherapy and targeted therapy. Leaving behind disappearing metastases after chemotherapy, margin-positive resection, staged liver resection, and liver-first reversed management permit potentially curative surgery for patients previously unable to survive resection. Further, survival benefit from maximum debulking surgery, like ovarian cancer, for colorectal liver metastases is uncertain at present, but likely. Individualized multidisciplinary treatment planning using such strategies is essential.

Impact of Blood Transfusions on Survival of Locally Advanced Cervical Cancer Patients Undergoing Neoadjuvant Chemotherapy Plus Radical Surgery.

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Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Lopez, Carlos; Indini, Alice; Leone Roberti Maggiore, Umberto; Sabatucci, Ilaria; Lorusso, Domenica; Raspagliesi, Francesco

2017-03-01

Transfusions represent one of the main progresses of modern medicine. However, accumulating evidence supports that transfusions correlate with worse survival outcomes in patients affected by solid cancers. In the present study, we aimed to investigate the effects of perioperative blood transfusion in locally advanced cervical cancer. Data of consecutive patients affected by locally advanced cervical cancer scheduled to undergo neoadjuvant chemotherapy plus radical surgery were retrospectively searched to test the impact of perioperative transfusions on survival outcomes. Five-year survival outcomes were evaluated using Kaplan-Meier and Cox models. The study included 275 patients. Overall, 170 (62%) patients had blood transfusion. Via univariate analysis, we observed that transfusion correlated with an increased risk of developing recurrence (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.09-4.40; P = 0.02). Other factors associated with 5-year disease-free survival were noncomplete clinical response after neoadjuvant chemotherapy (HR, 2.99; 95% CI, 0.92-9.63; P = 0.06) and pathological (P = 0.03) response at neoadjuvant chemotherapy as well as parametrial (P = 0.004), vaginal (P < 0.001), and lymph node (P = 0.002) involvements. However, via multivariate analysis, only vaginal (HR, 3.07; 95% CI, 1.20-7.85; P = 0.01) and lymph node involvements (HR, 2.4; 95% CI, 1.00-6.06; P = 0.05) correlate with worse disease-free survival. No association with worse outcomes was observed for patients undergoing blood transfusion (HR, 2.71; 95% CI, 0.91-8.03; P = 0.07). Looking at factors influencing overall survival, we observed that lymph node status (P = 0.01) and vaginal involvement (P = 0.06) were independently associated with survival. The role of blood transfusions in increasing the risk of developing recurrence in LAAC patients treated by neoadjuvant chemotherapy plus radical surgery remains unclear; further prospective studies are warranted.

Thermoluminescent dosimetry of beta radiations of {sup 90} Sr/ {sup 90} Y using amorphous ZrO{sub 2}; Dosimetria termoluminiscente de radiaciones beta de {sup 90} Sr/ {sup 90} Y usando ZrO{sub 2} amorfo

Energy Technology Data Exchange (ETDEWEB)

Rivera M, T. [CICATA-Legaria, IPN, Legaria Num. 694, 11500 Mexico D.F. (Mexico); Olvera T, L.; Azorin N, J.; Barrera R, M.; Soto E, A.M. [UAM-I, 09340 Mexico D.F. (Mexico)

2005-07-01

In this work the results of studying the thermoluminescent properties (Tl) of the zirconium oxide in its amorphous state (ZrO{sub 2}-a) before beta radiations of {sup 90} Sr/ {sup 90} Y are presented. The amorphous powders of the zirconium oxide were synthesized by means of the sol-gel technique. The sol-gel process using alkoxides like precursors, is an efficient method to prepare a matrix of zirconium oxide by hydrolysis - condensation of the precursor to form chains of Zr-H{sub 3} and Zr-O{sub 2}. One of the advantages of this technique is the obtention of gels at low temperatures with very high purity and homogeneity. The powders were characterized by means of thermal analysis and by X-ray diffraction. The powders of ZrO{sub 2}-a, previously irradiated with beta particles of {sup 90} Sr/{sup 90} Y, presented a thermoluminescent curve with two peaks at 150 and 257 C. The dissipation of the information of the one ZrO{sub 2}-a was of 40% the first 2 hours remaining constant the information for the following 30 days. The reproducibility of the information was of {+-} 2.5% in standard deviation. The studied characteristics allow to propose to the amorphous zirconium oxide as thermoluminescent dosemeter for the detection of beta radiation. (Author)

Experimental and clinical research on the inhibition of scarring formation after glaucoma surgery 90Sr radiation

International Nuclear Information System (INIS)

Wei Meien; Wang Guzhu; Li Shuqing

1994-01-01

Beta radiation of 90 Sr can inhibit the scarring formation so that the success rate of filtration surgery may be improved. After success in animal experiment, trabeculectomy was performed with small sclera flap on 31 eyes of 23 cases of patients with a high risk of scarring formation. Local 90 Sr radiation with a total dosage of 30.24 Gy were given by several times 3 days postoperatively, combined with local use of steroids. The patients were followed-up at 1 to 24 months, averaging 7 months. The intraocular pressure were successfully controlled in 90.3% of the patients. No lens impairment and other complications were observed. This procedure is an adoptive method in preventing scarring formation after glaucoma filtering surgery

Peptide receptor radionuclide therapy in the management of gastrointestinal neuroendocrine tumors: efficacy profile, safety, and quality of life

Directory of Open Access Journals (Sweden)

Severi S

2017-01-01

Full Text Available Stefano Severi,1 Ilaria Grassi,1 Silvia Nicolini,1 Maddalena Sansovini,1 Alberto Bongiovanni,2 Giovanni Paganelli1 1Nuclear Medicine Unit, 2Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST IRCCS, Meldola, Italy Abstract: Peptide receptor radionuclide therapy (PRRT, developed over the last two decades, is carried out using radiopharmaceuticals such as 90Y-DOTA-Tyr3-octreotide and 177Lu-DOTA-Tyr3-octreotate (177Lu-Dotatate. These radiocompounds are obtained by labeling a synthetic somatostatin analog with a β-emitting radioisotope. The compounds differ from each other in terms of their energetic features (due to the radionuclide and peptide receptor affinity (due to the analog but share the common characteristic of binding specific membrane somatostatin receptors that are (generally overexpressed in neuroendocrine neoplasms (NENs and their metastases. NENs are tumors arising from diffuse neuroendocrine system cells that are classified according to grading based on Ki67 percentage values (Grades 1 and 2 are classed as neuroendocrine tumors [NETs] and to the anatomical site of occurrence (in this paper, we only deal with gastroenteropancreatic [GEP]-NETs, which account for 60%–70% of all NENs. They are also characterized by specific symptoms such as diarrhea and flushing (30% of cases. Despite substantial experience gained in the area of PRRT and its demonstrable effects in terms of efficacy, safety, and improvement in quality of life, these compounds are still not registered (registration of 177Lu-Dotatate for the treatment of midgut NETs is expected soon. Thus, PRRT can only be used in experimental protocols. We provide an overview of the work of leading groups with wide-ranging experience and continuity in data publication in the area of GEP-NET PRRT and report our own personal experience of using different dosage schedules based on the presence of kidney and bone marrow risk factors

Evaluation of cytotoxic and tumor targeting capability of (177)Lu-DOTATATE-nanoparticles: a trailblazing strategy in peptide receptor radionuclide therapy.

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Arora, Geetanjali; Dubey, Priyanka; Shukla, Jaya; Ghosh, Sourabh; Bandopadhyaya, Gurupad

2016-06-01

We propose an innovative strategy of nanoparticle-mediated-peptide receptor radionuclide therapy (PRRT) employing PLGA-nanoparticles together with anti-β-hCG antibodies that can protect kidneys from radiation damage while simultaneously enhancing its tumor targeting and cytotoxic ability for somatostatin receptor (SSR) positive tumors. PEG-coated-(177)Lu-DOTATATE-PLGA-nanoparticles (PEG-LuD-NP) were formulated and characterized. In vitro toxicity of these particles was tested on human glioblastoma cell line U87MG over a radiation dose range of 19-78 Gy, using MTT assay and flow cytometry. To further enhance cytotoxicity and test the feasibility of active tumor targeting, apoptosis-inducing anti-β-hCG monoclonal antibodies were employed in vitro, after confirming expression of β-hCG on U87MG. In vivo tumor targeting ability of these particles, in comparison to uncoated particles and un-encapsulated (177)Lu-DOTATATE, was assessed by intravenous administration in tumor-induced wistar rats. Rats were first imaged in a gamma camera followed by euthanasia for organ extraction and counting in gamma counter. The particles were spherical in shape with mean diameter of 300 nm. Highest cytotoxicity that could be achieved with PEG-LuD-NP, on radio-resistant U87MG cells, was 35.8 % due to complex cellular response triggered by ionizing radiation. Interestingly, synergistic action of antibodies and PEG-LuD-NP doubled the cytotoxicity (80 %). PEG-LuD-NP showed the highest tumor uptake (4.3 ± 0.46 % ID/g) as compared to (177)Lu-DOTATATE (3.5 ± 0.31 %) and uncoated-(177)Lu-DOTATATE-nanoparticles (3.4 ± 0.35 %) in tumor-inoculated wistar rats (p targeting SSR positive tumors for enhanced cytoxicity and reduced renal radiation dose associated with conventional PRRT. To our knowledge of literature, this is the first study to establish in vitro and in vivo efficacy profile of nanoparticles in PRRT providing a stepping-stone for undergoing and future research

Depth dose distribution in the water for clinical applicators of 90Sr + 90Y, with a extrapolation mini chamber

International Nuclear Information System (INIS)

Antonio, Patricia de Lara; Caldas, Linda V.E.; Oliveira, Mercia L.

2009-01-01

This work determines the depth dose in the water for clinical applicators of 90 Sr + 90 Y, using a extrapolation mini chamber developed at the IPEN, Sao Paulo, Brazil, and different thickness acrylic plates. The obtained results were compared with the international recommendations and were considered satisfactory

Time-integrated activity coefficient estimation for radionuclide therapy using PET and a pharmacokinetic model: A simulation study on the effect of sampling schedule and noise

Energy Technology Data Exchange (ETDEWEB)

Hardiansyah, Deni [Medical Radiation Physics/Radiation Protection, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim 68167, Germany and Department of Radiation Oncology, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim 68167 (Germany); Guo, Wei; Glatting, Gerhard, E-mail: gerhard.glatting@medma.uni-heidelberg.de [Medical Radiation Physics/Radiation Protection, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim 68167 (Germany); Kletting, Peter [Department of Nuclear Medicine, Ulm University, Ulm 89081 (Germany); Mottaghy, Felix M. [Department of Nuclear Medicine, University Hospital, RWTH Aachen University, Aachen 52074, Germany and Department of Nuclear Medicine, Maastricht University Medical Center MUMC+, Maastricht 6229 (Netherlands)

2016-09-15

Purpose: The aim of this study was to investigate the accuracy of PET-based treatment planning for predicting the time-integrated activity coefficients (TIACs). Methods: The parameters of a physiologically based pharmacokinetic (PBPK) model were fitted to the biokinetic data of 15 patients to derive assumed true parameters and were used to construct true mathematical patient phantoms (MPPs). Biokinetics of 150 MBq {sup 68}Ga-DOTATATE-PET was simulated with different noise levels [fractional standard deviation (FSD) 10%, 1%, 0.1%, and 0.01%], and seven combinations of measurements at 30 min, 1 h, and 4 h p.i. PBPK model parameters were fitted to the simulated noisy PET data using population-based Bayesian parameters to construct predicted MPPs. Therapy simulations were performed as 30 min infusion of {sup 90}Y-DOTATATE of 3.3 GBq in both true and predicted MPPs. Prediction accuracy was then calculated as relative variability v{sub organ} between TIACs from both MPPs. Results: Large variability values of one time-point protocols [e.g., FSD = 1%, 240 min p.i., v{sub kidneys} = (9 ± 6)%, and v{sub tumor} = (27 ± 26)%] show inaccurate prediction. Accurate TIAC prediction of the kidneys was obtained for the case of two measurements (1 and 4 h p.i.), e.g., FSD = 1%, v{sub kidneys} = (7 ± 3)%, and v{sub tumor} = (22 ± 10)%, or three measurements, e.g., FSD = 1%, v{sub kidneys} = (7 ± 3)%, and v{sub tumor} = (22 ± 9)%. Conclusions: {sup 68}Ga-DOTATATE-PET measurements could possibly be used to predict the TIACs of {sup 90}Y-DOTATATE when using a PBPK model and population-based Bayesian parameters. The two time-point measurement at 1 and 4 h p.i. with a noise up to FSD = 1% allows an accurate prediction of the TIACs in kidneys.

68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumor-induced osteomalacia but negative 111In-octreotide SPECT/CT.

Science.gov (United States)

Breer, Stefan; Brunkhorst, Thomas; Beil, F Timo; Peldschus, Kersten; Heiland, Max; Klutmann, Susanne; Barvencik, Florian; Zustin, Jozef; Gratz, Klaus-Friedrich; Amling, Michael

2014-07-01

Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia and low calcitriol levels as well as clinical symptoms like diffuse bone and muscle pain, fatigue fractures or increased fracture risk. Conventional imaging methods, however, often fail to detect the small tumors. Lately, tumor localization clearly improved by somatostatin-receptor (SSTR) imaging, such as octreotide scintigraphy or octreotide SPECT/CT. However, recent studies revealed that still a large number of tumors remained undetected by octreotide imaging. Hence, studies focused on different SSTR imaging methods such as 68Ga DOTA-NOC, 68Ga DOTA-TOC and 68Ga DOTA-TATE PET/CT with promising first results. Studies comparing different SSTR imaging methods for tumor localization in TIO are rare and thus little is known about diagnostic alternatives once a particular method failed to detect a tumor in patients with TIO. Here, we report the data of 5 consecutive patients suffering from TIO, who underwent both 111Indium-octreotide scintigraphy (111In-OCT) SPECT/CT as well as 68Ga DOTA-TATE PET/CT for tumor detection. While 111In-OCT SPECT/CT allowed tumor detection in only 1 of 5 patients, 68Ga DOTA-TATE PET/CT was able to localize the tumor in all patients. Afterwards, anatomical imaging of the region of interest was performed with CT and MRI. Thus, successful surgical resection of the tumor was achieved in all patients. Serum phosphate levels returned to normal and all patients reported relief of symptoms within weeks. Moreover, an iliac crest biopsy was obtained from every patient and revealed marked osteomalacia in all cases. Follow-up DXA revealed an increase in BMD of up to 34.5% 1-year postoperative, indicating remineralization. No recurrence was observed. In conclusion our data indicates that 68Ga DOTA-TATE PET/CT is an effective and promising diagnostic tool in the diagnosis of TIO, even in patients in whom 111In-OCT prior failed to detect

Efficacy of intensity-modulated radiotherapy combined with chemotherapy or surgery in locally advanced squamous cell carcinoma of the head-and-neck

Directory of Open Access Journals (Sweden)

Yang H

2013-10-01

Full Text Available Hua Yang,* Li-Qiong Diao,* Mei Shi, Rui Ma, Jian-Hua Wang, Jian-Ping Li, Feng Xiao, Ying Xue, Man Xu, Bin ZhouDepartment of Radiotherapy Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China*These authors contributed equally to this workObjectives: Long-term locoregional control following intensity-modulated radiotherapy (IMRT for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN remains challenging. This study aimed to assess the efficacy and toxicity of IMRT with and without chemotherapy or surgery in locally advanced SCCHN.Materials and methods: Between January 2007 and January 2011, 61 patients with locally advanced SCCHN were treated with curative IMRT in the Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University; 28% underwent definitive IMRT and 72% postoperative IMRT, combined with simultaneous cisplatin-based chemotherapy in 58%. The mean doses of definitive and postoperative IMRT were 70.8 Gy (range, 66–74 Gy. Outcomes were analyzed using Kaplan–Meier curves. Acute and late toxicities were graded according to Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer radiation morbidity scoring criteria.Results: At a median follow-up of 35 months, 3-year local recurrence-free survival (LRFS, regional recurrence-free survival (RRFS, distant metastasis-free survival (DMFS, disease-free survival (DFS, and overall survival (OS were 83.8%, 86.1%, 82.4%, 53.2%, and 62%, respectively. Postoperative IMRT (n = 44, 72% had significantly higher LRFS/OS/DMFS than definitive IMRT (n = 17, 28%; P < 0.05. IMRT combined with chemotherapy (n = 35, 58% had significantly higher LRFS/OS/DMFS than IMRT alone (n = 26, 42%; P < 0.05. One year after radiotherapy, the incidence of xerostomia of grade 1, 2, or 3 was 13.1%, 19.7%, and 1.6%, respectively. No grade 4 acute or late toxicity was observed.Conclusion: IMRT combined with

Treatment of advanced pancreatic carcinoma with 90Y-Clivatuzumab Tetraxetan: a phase I single-dose escalation trial.

Science.gov (United States)

Gulec, Seza A; Cohen, Steven J; Pennington, Kenneth L; Zuckier, Lionel S; Hauke, Ralph J; Horne, Heather; Wegener, William A; Teoh, Nick; Gold, David V; Sharkey, Robert M; Goldenberg, David M

2011-06-15

Humanized antibody hPAM4 specifically binds a mucin glycoprotein expressed in pancreatic adenocarcinomas. This phase I study evaluated a single dose of (90)Y-clivatuzumab tetraxetan ((90)Y-labeled hPAM4) in patients with advanced pancreatic cancer. Twenty-one patients (4 stage III; 17 stage IV) received (111)In-hPAM4 for imaging and serum sampling before (90)Y-hPAM4. Study procedures evaluated adverse events, safety laboratories, computed tomography (CT) scans, biomarkers, pharmacokinetics, radiation dosimetry, and immunogenicity (HAHA). (111)In-hPAM4 showed normal biodistribution with radiation dose estimates to red marrow and solid organs acceptable for radioimmunotherapy and with tumor targeting in 12 patients. One patient withdrew before (90)Y-hPAM4; otherwise, 20 patients received (90)Y doses of 15 (n = 7), 20 (n = 9), and 25 mCi/m(2) (n = 4). Treatment was well tolerated; the only significant drug-related toxicities were (NCI CTC v.3) grade 3 to 4 neutropenia and thrombocytopenia increasing with (90)Y dose. There were no bleeding events or serious infections, and most cytopenias recovered to grade 1 within 12 weeks. Three patients at 25 mCi/m(2) encountered dose-limiting toxicity with grade 4 cytopenias more than 7 days, establishing 20 mCi/m(2) as the maximal tolerated (90)Y dose. Two patients developed HAHA of uncertain clinical significance. Most patients progressed rapidly and with CA19-9 levels increasing within 1 month of therapy, but 7 remained progression-free by CT for 1.5 to 5.6 months, including 3 achieving transient partial responses (32%-52% tumor diameter shrinkage). (90)Y-Clivatuzumab tetraxetan was well tolerated with manageable hematologic toxicity at the maximal tolerated (90)Y dose, and is a potential new therapeutic for advanced pancreatic cancer. ©2011 AACR.

111In and 90Y labelled peptide radiopharmaceuticals for diagnosis and therapy

International Nuclear Information System (INIS)

Obenaus, E.; Crudo, J.L.; Castiglia, S.G. de

2004-01-01

Full text: The application of 111In-labelled octreotide to target somatostatin receptors on tumour cells has gained acceptance as a diagnostic procedure for demonstrating neuroendocrine and other SSTR-positive tumors. A further advance in the field of somatostatin analogues is the development of macrocyclic chelators that also bind beta particle emitters like 90Y and 177Lu. [90Y-DOTA, Tyr3] octreotide and [177Lu-DOTA, Tyr3] octreotate are currently being tried as the therapeutic agents. The aim of this work was to label two somatostatin analogues (Tyr3 Octreotide and Lanreotide) with 111In and 90Y using DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) as a chelating agent. DOTA in the form of the tri-t-butyl ester was coupled to the Lys5 (BOC) protected Tyr3octreotide and Lys5 (BOC) protected lanreotide in N,N-dimethylformamide, in a three-step reaction involving conjugation, using HATU and diisopropylethylamine as coupling reagents, de-protection with trifluoroacetic and HPLC purification of the conjugates. The DOTALAN and DOTATOC were labelled with 111In and 90Y and assayed by HPLC. In both cases solutions of gentisic acid in sodium acetate 0.4M pH=5.0 and conjugated peptides were added to the 111In or 90Y chloride. The final solution was heated at 90 deg. C for 25 minutes. We tried different amounts of the two peptide complexes per mCi of 111In/90Y and quality control of the labelled products was performed with the following HPLC system: reverse phase column, flow rate 1ml-min, UV/radiometric detection and a gradient solvent: solvent A: acetonitrile, solvent B: water TFA 0.1%, gradient: 0-3min 100% B, linear increase of eluent A to 50% from 3-13 min, 13-18 min 50% A, 18-20 min linear increase of eluent A to 70%. Serum stability was determined after 4 and 24 hr. incubation of the labeled peptide in human serum at 37 deg. C. After precipitation of proteins with acetonitrile the incubation mixture was analyzed by HPLC. Normal Wistar rats were

Successful treatment of Cushing's disease using yttrium-90 rods

International Nuclear Information System (INIS)

White, M.C.; Doyle, F.H.; Mashiter, K.; Joplin, G.F.

1982-01-01

Interstitial irradiation using yttrium-90 ( 90 Y) rods implanted by needle into the pituitary gland was used as primary treatment in 16 patients with pituitary dependent Cushing's disease. Clinical and biochemical remission was observed within three to six months in 13 and in the remaining three after a supplementary implant. There was no perioperative morbidity. Follow-up from the time of definitive operation ranged from six to 123 months (mean 39). No recurrence has been observed. The return of a normal diurnal cortisol rhythm has been observed in 10/12 patients studied after remission. Some form of long-term pituitary hormone replacement therapy was required in only the six patients who had received the largest irradiation dose. Implantation of 90 Y is safe and effective treatment for patients with Cushing's disease, comparing favourably with selective trans-sphenoidal pituitary surgery. (author)

Evidence-based guideline recommendations on treatment strategies for localized Ewing's sarcoma of bone following neo-adjuvant chemotherapy.

Science.gov (United States)

Werier, Joel; Yao, Xiaomei; Caudrelier, Jean-Michel; di Primio, Gina; Ghert, Michelle; Gupta, Abha A; Kandel, Rita; Verma, Shailendra

2016-06-01

(1) To provide recommendations regarding the choice of surgery, radiation therapy (RT), or the combination of surgery plus RT in patients with localized Ewing's sarcoma of bone following neoadjuvant chemotherapy. (2) To determine the appropriate surgical planning imaging (pre-chemotherapy magnetic resonance imaging [MRI] or post-chemotherapy MRI) to identify optimal resection margins in patients with localized Ewing's sarcoma who undergo surgery following neoadjuvant chemotherapy. MEDLINE, EMBASE, the Cochrane Library (1999 to February 2015), main guideline websites, and relevant annual meeting abstracts (2012 to January 2015) were searched. Internal and external reviews were conducted. 1. Recommendation (1) - In patients with localized Ewing's sarcoma of bone following neoadjuvant chemotherapy: (a) Surgery alone or RT alone are two reasonable treatment options; the combination of surgery plus RT is not recommended as an initial treatment option. (b) The local treatment for an individual patient should be decided by a multidisciplinary tumour board together with the patient after consideration of the following: (1) patient characteristics (e.g., age, tumour location, tumour size, response to neoadjuvant chemotherapy, and existing comorbidities), (2) the potential benefit weighed against the potential complications from surgery and/or toxicities associated with RT, and (3) patient preferences. 2. Recommendation (2) - In patients with localized Ewing's sarcoma who will undergo surgery: (a) Both pre-chemotherapy and post-chemotherapy MRI scans should be taken into consideration for surgical planning. In certain anatomic locations with good chemotherapy response, the post-chemotherapy MRI may be the appropriate imaging modality to plan surgical resection margins. Copyright © 2016 Elsevier Ltd. All rights reserved.

Role of diluent on the separation of {sup 90}Y from {sup 90}Sr by solvent extraction and supported liquid membrane using T2EHDGA as the extractant

Energy Technology Data Exchange (ETDEWEB)

Dutta, S. [Planning and Coordination Division, Bhabha Atomic Research Centre, Trombay, Mumbai - 400 085 (India); Raut, D.R. [Radiochemistry Division, Bhabha Atomic Research Centre, Trombay, Mumbai - 400 085 (India); Mohapatra, P.K., E-mail: mpatra@barc.gov.in [Radiochemistry Division, Bhabha Atomic Research Centre, Trombay, Mumbai - 400 085 (India)

2012-04-15

The separation behaviour of {sup 90}Y from {sup 90}Sr was investigated by diluent variation using solvent extraction and supported liquid membrane techniques employing N,N,N Prime ,N Prime -tetra-2-ethylhexyldiglycolamide (T2EHDGA) as the extractant. Both D{sub Y} (distribution ratio of Y(III)) and S.F. (separation factor) were found to be high in the solvent extraction studies when chloroform was used as the diluent. Subsequent supported liquid membrane (SLM) studies using PTFE flat sheet membranes containing 0.2 M T2EHDGA in various diluents indicated the trend of Y transport as xylene>hexone>chloroform>carbon tetrachloride>n-dodecane+30% iso-decanol mixture. However, the Sr(II) transport rates were also high with xylene, hexone, and carbon tetrachloride as the diluents which led us to carry out subsequent studies using chloroform and n-dodecane+30% iso-decanol mixture. Acid variation studies in chloroform system indicated an interesting phenomena of increasing Y(III) transport and decreasing Sr(II) transport with increasing acid concentration. Separation of {sup 90}Y from a mixture of {sup 90}Sr and {sup 90}Y was also attempted. - Highlights: Black-Right-Pointing-Pointer SLM studies using PTFE flat sheet membranes containing T2EHDGA as carrier was carried out for Y-90 separation from Sr-90. Black-Right-Pointing-Pointer The trend of Y transport as xylene>hexone>chloroform>carbon tetrachloride>n-dodecane+30% iso-decanol mixture. Black-Right-Pointing-Pointer Acid variation studies in chloroform system indicated an interesting phenomena of increasing Y(III) transport and decreasing Sr(II) transport with increasing acid concentration. Black-Right-Pointing-Pointer The present studies suggested that T2EHDGA-SLM show limited promise if coupled to another separation method such as extraction chromatography.

Comparative Investigation of Postoperative Complications in Patients With Gastroesophageal Junction Cancer Treated With Preoperative Chemotherapy or Surgery Alone

DEFF Research Database (Denmark)

Achiam, M P; Jensen, L.B.; Larsson, H.

2016-01-01

complications of patients with cancer at the gastroesophageal junction treated with either neoadjuvant chemotherapy or surgery alone in patients from "The Danish Clinical Registry of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach." MATERIALS AND METHODS: A historical follow-up study......BACKGROUND AND AIM: Gastroesophageal junction cancer is one of the leading causes to cancer-related death and the prognosis is poor. However, progress has been made over the last couple of decades with the introduction of multimodality treatment and optimized surgery. Three-year survival rates have...... of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach. No difference was found in demographics between the two groups, except for alcohol consumption and a lower T and N stage in the surgery-only group, and no difference in complication rates was found. Furthermore, no variable...

Therapy of neuroendocrine carcinoma with Y-90 DOTA- preliminary results

International Nuclear Information System (INIS)

Artiko, V.; Obradovic, V.; Nadezda, N.; Djokic, D.; Jankovic, D.; Popovic, B.; Damjanovic, S.; Mikolajczak, R.; Pawlak, D.

2007-01-01

Full text: Aim: Cell membrane-specific somatostatin receptors are usually expressed by neuroendocrine tumors. Radiolabelled receptor-binding somatostatin analogues target tissues expressing these receptors and can be used for visualization and treatment. After the localization of tumors bearing somatostatin receptors with 111In or 99mTc labeled somatostatin analogues, in the case of high tumor uptake related to non target tissues, different radioisotopes have been used for their treatment. Thus, application of high doses of 111In- DTPA-octreotide had an impact on improvement of the clinical symptoms, without significant reduction of the tumor mass. However, 90Y somatostatin analogues (DOTA TOC, lanreotide) may be more effective for reduction of the tissue of the larger tumors while 177Lu labeled ones may be applied in smaller tumors. Combination of both of them seems to be the most effective therapy, particularly in tumors bearing both small and large lesions. The aim of this work is presentation of the preliminary results of the therapy of NETs with another octreotide analogue, 90Y DOTA TATE, which so far has been proved to have high therapeutic potential when labeled with 177Lu. Patients and methods: We investigated 7 patients with neuroendocrine tumors (two patients had neuroendocrine pancreatic carcinomas with liver metastases (one of them had metastases in peritoneal lymph nodes), one patient with operated (resected) bronchial carcinoid and liver metastases, three patients with neuroendocrine carcinomas of unknown origin and hepatic metastases (one with skeletal metastases) and one with pancreatic gastrinoma without metastases (surgery was impossible to perform). In all of them, together with other laboratory analyses and imaging methods, scintigraphy with somatostatin analogues was performed (in 3 with 111In Octreoscan and in the other 4 with 99mTc HYNIC TOC) and high tumor uptake was observed. The therapy was performed with 2- 4,5 GBq 90Y DOTA TATE per

Phase I/II 90Y-Zevalin (yttrium-90 ibritumomab tiuxetan, IDEC-Y2B8) radioimmunotherapy dosimetry results in relapsed or refractory non-Hodgkin's lymphoma

International Nuclear Information System (INIS)

Wiseman, G.A.; Dunn, W.L.; White, C.A.; Berlfein, J.R.; Ding, E.; Grillo-Lopez, A.J.; Stabin, M.; Erwin, W.; Spies, S.; Dahlbom, M.; Silverman, D.H.S.; Raubitschek, A.; Karvelis, K.; Schultheiss, T.; Witzig, T.E.; Belanger, R.

2000-01-01

Dosimetry studies in patients with non-Hodgkin's lymphoma were performed to estimate the radiation absorbed dose to normal organs and bone marrow from 90 Y-Zevalin (yttrium-90 ibritumomab tiuxetan, IDEC-Y2B8) treatment in this phase I/II, multicenter trial. The trial was designed to determine the dose of Rituximab (chimeric anti-CD20, Rituxan, IDEC-C2B8, MabThera), the unlabeled antibody given prior to the radioconjugate to clear peripheral blood B cells and optimize distribution, and to determine the maximum tolerated dose of 90 Y-Zevalin [7.4, 11, or 15 MBq/kg (0.2, 0.3, or 0.4 mCi/kg)]. Patients received 111 In-Zevalin (indium-111 ibritumomab tiuxetan, IDEC-In2B8) on day 0 followed by a therapeutic dose of 90 Y-Zevalin on day 7. Both doses were preceded by an infusion of the chimeric, unlabeled antibody Rituximab. Following administration of 111 In-Zevalin, serial anterior/posterior whole-body scans were acquired. Major-organ radioactivity versus time estimates were calculated using regions of interest. Residence times were computed and entered into the MIRDOSE3 computer software program to calculate estimated radiation absorbed dose to each organ. Initial analyses of estimated radiation absorbed dose were completed at the clinical site. An additional, centralized dosimetry analysis was performed subsequently to provide a consistent analysis of data collected from the seven clinical sites. In all patients with dosimetry data (n=56), normal organ and red marrow radiation absorbed doses were estimated to be well under the protocol-defined upper limit of 20 Gy and 3 Gy, respectively. Median estimated radiation absorbed dose was 3.4 Gy to liver (range 1.2-7.8 Gy), 2.6 Gy to lungs (range 0.72-4.4 Gy), and 0.38 Gy to kidneys (range 0.07-0.61 Gy). Median estimated tumor radiation absorbed dose was 17 Gy (range 5.8-67 Gy). No correlation was noted between hematologic toxicity and the following variables: red marrow radiation absorbed dose, blood T 1/2 , blood AUC

Neoadjuvant intra-arterial chemotherapy combined with radiotherapy and surgery in patients with advanced maxillary sinus cancer

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Kim, Won Tae; Kim, Yong Kan; Lee, Ju Hye; Kim, Dong Hyun; Park, Dahl; Cho, Kyu Sup; Kim, Dong Won [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Nam, Ji Ho; Roh, Hwan Jung [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

2013-09-15

The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, 500 mg/m2) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.

Metastatic hidradenocarcinoma: Surgery and chemotherapy.

Science.gov (United States)

Amel, Trabelsi; Olfa, Gharbi; Faten, Hammedi; Makrem, Hochlef; Slim, Ben Ahmed; Moncef, Mokni

2009-12-01

Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies particularly for recurrent and metastatic forms.

Metastatic hidradenocarcinoma: Surgery and chemotherapy

OpenAIRE

Trabelsi Amel; Gharbi Olfa; Hammedi Faten; Hochlef Makrem; Ben Ahmed Slim; Mokni Moncef

2009-01-01

Context: Hidradenocarcinoma is a rare carcinoma of high malignant potential. It most metastasizes to regional lymph nodes and distant viscera. Case report: We report a case of 52-year-old woman who presented with an invasive hidradenocarcinoma of the finger, treated with surgical excision. The patient presented with skin and lymph node metastases four years after, treated by chemotherapy. Conclusion: Hidradenocarcinoma is an aggressive tumor. It seems important to use adjuvant therapies parti...

Avascular necrosis of the hips with increased activity on 68Ga-DOTATATE PET/CT

Science.gov (United States)

Papadakis, Georgios Z.; Millo, Corina; Karantanas, Apostolos H.; Bagci, Ulas; Patronas, Nicholas J.

2016-01-01

Prolonged exposure to cortisol is one of the major causes of avascular bone necrosis (AVN). We report on a case of a woman with Cushing’s syndrome attributed to ectopic ACTH secreting tumor who was evaluated with whole body PET/CT study using 68Ga-DOTATATE. The scan showed increased activity by both femoral heads, corresponding to the margins of bilateral AVN seen on MRI. The presented data suggests AVN-induced reactive inflammatory alterations adjacent to the necrotic segment of the bone which can be effectively targeted using radiolabeled somatostatin (SST) analogues. PMID:28033218

Neoadjuvant Chemotherapy for Locally Advanced Squamous Carcinoma of Oral Cavity: a Pilot Study.

Directory of Open Access Journals (Sweden)

Sanambar Sadighi

2015-06-01

Full Text Available To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SPSS version 17 was used for data analysis. Median follow-up was 16 months. The median age of the patients was 62 years old (23-75 years. Man/woman ratio was 1.13. The primary site of the tumor was the tongue in most patients (48%. No significant difference was observed between pathologic characteristics of the two groups. Chemotherapy group showed 16% complete pathologic response to TPF. No significant difference in organ preservation surgery or overall survival was detected. However, the patients in the chemotherapy group had longer progression-free-survival (P=0.014. Surgery followed by chemoradiotherapy with or without TPF induction results in similar survival time. However, progression-free-survival improves with the TPF induction chemotherapy. Studies with more patents and new strategies are recommended to evaluate organ preservation improvement and long-term outcomes.

Toxicity of 90Y in a relatively insoluble form inhaled by Beagle dogs. XIV

International Nuclear Information System (INIS)

Hahn, F.F.; Hobbs, C.H.; Kusewitt, D.F.; McClellan, R.O.; Mauderly, J.L.; Pickrell, J.A.

1982-01-01

The metabolism, dosimetry and biological effects of inhaled 90 Y in fused aluminosilicate particles in Beagle dogs are being studied. Eighty-nine dogs with initial lung burdens ranging from 80 to 5200 μCi 90 Y/kg body weight and 12 control dogs are being maintained for life span observations. The lung burdens achieved, short physical half-life and relative insolubility of the 90 Y in this vector resulted in a relatively high, rapidly decreasing radiation dose rate to the lung. To date, 69 exposed dogs have died; 38 from radiation pneumonitis, seven with pulmonary neoplasms and 24 from other causes. Four control dogs have died. Twenty-nine surviving exposed and eight control dogs are being studied for their life spans

90Sr- 90Y and 89Sr beta radioactivity measurement in milk samples using a proportional counter

International Nuclear Information System (INIS)

Mananes, A.; Perez Santos, C.; Martinez Churiaque, F.

1987-01-01

A thin window glas flow proportional counter is used to measure the 90 Sr- 90 Y and 89 Sr beta radioactivity in milk samples. A chemical procedure is used to separate strontium-yttrium from the other radionuclides present in milk. A calculation of the total efficiency of the system is performed which includes an empirical estimation of the backscattering factor. The calibration of the whole process allows the determination of the 90 Sr activity within 10% relative error in spite of uncertainties in the recovery yields of strontium and yttrium. No 89 Sr activity has been detected, and the mean value obtained for the 90 Sr activity in nine milk samples of Cantabria is 0.115 Bq/1 with a minimum detectable activity of 0.0105 Bq. (author) 18 refs

Labeling an anti-CD20 monoclonal antibody with 90Y

International Nuclear Information System (INIS)

Perera Pintado, Alejandro; Leyva Montaña, René; Prats Capote, Anaís; Góngora Bravo, Magdiel; Alberti Ramírez, Alejandro; León, Mariela; Hernández González, Ignacio; Dorvignit, Denise

2016-01-01

Lymphomas are among the 10 leading causes of death, both in Cuba and in the world, with an increasing incidence in recent years. Follicular lymphoma low-grade (indolent) is one of the most common in the Western world, representing 1/3 of all non-Hodgkin lymphomas (NHL). More than 90% of patients present with disseminated disease at diagnosis and generally have a slow evolution and good response to conventional treatment; but radically changed its forecast to relapse, resistance to therapeutic and histologic transformation can occur. The monoclonal antibody therapy has been a promising therapeutic. In this respect CD20 antigen it has been considered one of the most attractive targets in the therapy of follicular B cell lymphoma This is expressed in more than 90% of cases, while not present in stem cells and lines progenitors. Despite the success of immunotherapy, the relapse rate is still considerable. In order to increase the cytotoxic potential of immunotherapy, marked with beta emitting radionuclides alpha particles or monoclonal antibodies are used today. Despite encouraging results in patients with non-Hodgkin lymphomas refractory to other treatments, the extremely high costs of these commercial radiopharmaceuticals have greatly limited its application, even in the first world. A sustainable alternative is the marking of other anti-CD20 monoclonal antibodies, so researchers from several countries have concentrated their efforts on rituximaby other similar antibodies labeled with therapeutic radionuclides, as a possible cost-effectively to more problem. Today in Cuba it has an electrolytic generator 90 Sr- 90 Y Isotope Center, which ensures the availability of the radionuclide. In addition, the chimeric MAb rituximab is applied as part of the therapy of NHL in its health system and, recently, the Center for Molecular Immunology has obtained a chimeric monoclonal anti-CD20 antibody biosimilar rituximab, which is in phase clinical trial; which opens prospects for

PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response

Energy Technology Data Exchange (ETDEWEB)

Fowler, Kathryn J. [Washington University, Department of Radiology (United States); Maughan, Nichole M. [Washington University, Department of Biomedical Engineering (United States); Laforest, Richard [Washington University, Department of Nuclear Medicine (United States); Saad, Nael E. [Washington University, Department of Radiology (United States); Sharma, Akash [Washington University, Department of Nuclear Medicine (United States); Olsen, Jeffrey; Speirs, Christina K.; Parikh, Parag J., E-mail: parikh@wustl.edu [Washington University, Department of Radiation Oncology (United States)

2016-06-15

PurposeThe purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 ({sup 90}Y) microsphere radioembolization.Materials and Methods26 patients undergoing lobar treatment with {sup 90}Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria.ResultsA total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p < 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response.ConclusionsPET/MRI of {sup 90}Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of {sup 90}Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.

Uterine/Endometrial Cancer: Chemotherapy

Science.gov (United States)

... with Your Treatment Team Treatment Surgery Surgical Staging Pathology of Ovarian Cancer Chemotherapy Radiation Therapy Hormone Therapy ... 20, 2016 January 17, 2017 February 21, 2017 March 22, 2017 April 18, 2017 May 16, 2017 ...

Country report: Cuba. Local Production of 90Y And 188Re Radionuclides and Development of Radiopharmaceuticals for Therapy

International Nuclear Information System (INIS)

Xiques, Abmel; Hernández, Ignacio; Leyva, René; Pérez, Marylaine; Alonso, Luis Michel; Zamora, Minelys

2010-01-01

During the first period of this CRP we could test an efficient and reliable generator system based on ion-chromatography to obtain 90 Y from its parent radionuclide 90 Sr. This production scheme for 90 Y was outlined in the previous CRP related with the development of generator technologies. Quality parameters such as trace metals that can potentially interfere in the labeling of biomoléculas, 90 Y recovery, 90 Sr/ 90 Y ratio and radiation dose to bed matrix were evaluated. The results showed that high recovery and radionuclidic purity could be obtained for 90 Y during its repeated separation from the 90 Sr cow. No replacement or treatment of the cow were necessary and low waste generation and 90 Sr losses less that 0.1% after each run were also observed during the present study. A Fab’ fragment was enzimatically produced and purified from the monoclonal antibody h-R3 (Nimotuzumab®). The fragment and the parent antibody were successfully conjugated with DOTA and labeled with 90 Y. The radioinmunoconjugate thus obtained also exhibited a good 24 h in-vitro stability in an excess of DTPA. A 90 Y radiocoloid was prepared in a cromic phosphate particle for radiosynoviorthesis with promising results in animal models. Two alumina based 188 W/ 188 Re generators were prepared and their eluates were used in the labeling of hR3-DOTA conjugates. Quality control and in vivo evaluation in comparison with 99m Tc-hR3 showed very good results and similar pattern of distribution and pharmacokinetic and will be used in clinical trials for cancer patients. (author)

Chemotherapy alone versus chemotherapy plus radiotherapy for adults with early stage Hodgkin lymphoma (Review)

DEFF Research Database (Denmark)

Blank, Oliver; von Tresckow, Bastian; Monsef, Ina

2017-01-01

BACKGROUND: Combined modality treatment consisting of chemotherapy followed by localised radiotherapy is the standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long- term adverse effects such as secondary malignancies the role of radiotherapy has been questioned...... recently and some clinical study groups advocate chemotherapy only for this indication. OBJECTIVES: To assess the effects of chemotherapy alone compared to chemotherapy plus radiotherapy in adults with early stage HL . SEARCH METHODS: For the or i ginal version of this review, we searched MEDLINE, Embase......-related mortality (RR 0.99; 95% CI 0.14 to 6.90; P = 0.99; low-quality evidence), there is no evidence for a difference between the use of chemotherapy alone and chemotherapy plus radiotherapy. CRR rate was not reported. AUTHORS' CONCLUSIONS: This systematic review compared the effects of chemotherapy alone...

{sup 90}Y microspheres prepared by sol-gel method, promising medical material for radioembolization of liver malignancies

Energy Technology Data Exchange (ETDEWEB)

Łada, Wiesława, E-mail: w.lada@ichtj.waw.pl [Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Dorodna 16 (Poland); Iller, Edward [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland); Wawszczak, Danuta [Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Dorodna 16 (Poland); Konior, Marcin, E-mail: marcin.konior@polatom.pl [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland); Dziel, Tomasz [National Centre for Nuclear Research, Radioisotope Centre POLATOM, 05-400 Otwock, Andrzej Sołtan 7 (Poland)

2016-10-01

A new technology for the production of radiopharmaceutical {sup 90}Y microspheres in the form of spherical yttrium oxide grains obtained by sol-gel method has been described. The authors present and discuss the results of investigations performed in the development of new production technology of yttrium microspheres and determination of their physic-chemical properties. The final product has the structure of spherical yttrium oxide grains with a diameter 25–100 μm, is stable and free from contaminants. Irradiation of 20 mg samples of grains with diameter of 20–50 μm in the thermal neutron flux of 1.7 × 10{sup 14} cm{sup −2} s{sup −1} at the core of MARIA research nuclear reactor allowed to obtain microspheres labelled with the {sup 90}Y isotope on the way of the nuclear reaction {sup 89}Y(n, γ){sup 90}Y. Specific activity of irradiated microspheres has been determined by application of absolute triple to double coincidence ratio method (TDCR) and has been evaluated at 190 MBq/mg Y. {sup 90}Y microspheres prepared by the proposed technique can be regarded as a promising medical material for radioembolization of liver malignancies. - Highlights: • Sol-gel methods for preparation of spherical yttrium trioxide grains have been proposed. • Determination condition for irradiation {sup 89}Y{sub 2}O{sub 3} grains in nuclear reactor • Evaluation of specific activity of {sup 90}Y microspheres • Estimation of {sup 90}Y microspheres as promising medical material for radioembolization.

Progress in treatment of head and neck cancer. Pt. 1. Chemotherapy

International Nuclear Information System (INIS)

Stupp, R.; Vokes, E.E.; Chicago Univ., IL

1995-01-01

Cancer of the head and neck is commonly diagnosed in an advanced stage with a poor prognosis. New active agents and combinations have recently been identified. By adding chemotherapy to a multimodality approach with surgery and radiation therapy the outcome may be altered. We reviewed the more recently published literature on induction and adjuvant chemotherapy. No survival advantage has been shown for adjuvant chemotherapy. Organ preservation can be achieved with induction chemotherapy followed by limited surgery and radiation in approximately two thirds of the patients with laryngeal carcinoma. Patients achieving a complete response after induction chemotherapy have a better prognosis. Chemotherpy has consistently shown to reduce the frequency of distant metastases. Chemotherapy is indicated only in recurrent or metastatic disease. Induction chemotherapy is limited to laryngeal carcinoma with organ preservation as intent. Local recurrences and intercurrent morbidity are the main reasons for treatment failures. (orig.) [de

Total Lesion Glycolysis and Sequential (90)Y-Selective Internal Radiation Therapy in Breast Cancer Liver Metastases: Preliminary Results.

Science.gov (United States)

Bagni, Oreste; Filippi, Luca; Pelle, Giuseppe; Cianni, Roberto; Schillaci, Orazio

2015-12-01

To assess the prognostic role of total lesion glycolysis (TLG) in patients with breast cancer liver metastases (BCLM) after sequential lobar (90)Y-radioembolization ((90)Y-RE). Seventeen patients with bilobar BCLM underwent FDG PET/CT and TLG calculation before (90)Y-RE. The hepatic lobe with the highest TLG was treated in the first session. PET was performed 6 weeks postprocedure and decrease in TLG (ΔTLG) in the treated lobe was calculated before the second (90)Y administration. Subjects were divided in two groups (group 1: ΔTLG >50%, group 2: ΔTLG 50% and seven had a ΔTLG value 50% and ΔTLG <50% had a mean OS of 16.4 ± 0.6 and 10.3 ± 0.4 months, respectively (p < 0.001). Cox regression analysis demonstrated hepatic tumor load (p = 0.048) and ΔTLG as the only significant (p = 0.005) predictors of survival. ΔTLG after the first (90)Y administration agrees with final outcome in BCLM patients after separate sequential lobar (90)Y-RE.

Emotional state and coping style among gynecologic patients undergoing surgery.

Science.gov (United States)

Matsushita, Toshiko; Murata, Hinako; Matsushima, Eisuke; Sakata, Yu; Miyasaka, Naoyuki; Aso, Takeshi

2007-02-01

The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.

Process improvement for the safe delivery of multidisciplinary-executed treatments-A case in Y-90 microspheres therapy.

Science.gov (United States)

Cai, Bin; Altman, Michael B; Garcia-Ramirez, Jose; LaBrash, Jason; Goddu, S Murty; Mutic, Sasa; Parikh, Parag J; Olsen, Jeffrey R; Saad, Nael; Zoberi, Jacqueline E

To develop a safe and robust workflow for yttrium-90 (Y-90) radioembolization procedures in a multidisciplinary team environment. A generalized Define-Measure-Analyze-Improve-Control (DMAIC)-based approach to process improvement was applied to a Y-90 radioembolization workflow. In the first DMAIC cycle, events with the Y-90 workflow were defined and analyzed. To improve the workflow, a web-based interactive electronic white board (EWB) system was adopted as the central communication platform and information processing hub. The EWB-based Y-90 workflow then underwent a second DMAIC cycle. Out of 245 treatments, three misses that went undetected until treatment initiation were recorded over a period of 21 months, and root-cause-analysis was performed to determine causes of each incident and opportunities for improvement. The EWB-based Y-90 process was further improved via new rules to define reliable sources of information as inputs into the planning process, as well as new check points to ensure this information was communicated correctly throughout the process flow. After implementation of the revised EWB-based Y-90 workflow, after two DMAIC-like cycles, there were zero misses out of 153 patient treatments in 1 year. The DMAIC-based approach adopted here allowed the iterative development of a robust workflow to achieve an adaptable, event-minimizing planning process despite a complex setting which requires the participation of multiple teams for Y-90 microspheres therapy. Implementation of such a workflow using the EWB or similar platform with a DMAIC-based process improvement approach could be expanded to other treatment procedures, especially those requiring multidisciplinary management. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

The somatostatin receptor-targeted radiotherapeutic [90Y-DOTA-dPhe1,Tyr3]octreotide (90Y-SMT 487) eradicates experimental rat pancreatic CA 20948 tumours

International Nuclear Information System (INIS)

Stolz, B.; Weckbecker, G.; Smith-Jones, P.M.; Albert, R.; Raulf, F.; Bruns, C.

1998-01-01

Somatostatin receptor-expressing tumours are potential targets for therapy with radiolabelled somatostatin analogues. We have synthesized a number of such analogues in the past and identified [DOTA-dPhe 1 , Tyr 3 ]octreotide (SMT 487) as the most promising candidate molecule because of its advantageous properties in cellular and in vivo tumour models. In the current paper we describe the radiotherapeutic effect of yttrium-90 labelled SMT 487 in Lewis rats bearing the somatostatin receptor-positive rat pancreatic tumour CA 20948. SMT 487 binds with nanomolar affinity to both the human and the rat somatostatin receptor subtype 2 (sst 2 ) (human sst 2 IC 50 =0.9 nM, rat sst 2 IC 50 =0.5 nM). In vivo, 90 Y-SMT 487 distributed rapidly to the sst 2 expressing CA 20948 rat pancreatic tumour, with a tumour-to-blood ratio of 49.15 at 24 h post injection. A single intravenous administration of 10 mCi/kg 90 Y-SMT 487 resulted in a complete remission of the tumours in five out of seven CA 20948 tumour-bearing Lewis rats. No regrowth of the tumours occurred 8 months post injection. Control animals that were treated with 30 μg/kg of unlabelled SMT 487 had to be sacrificed 10 days post injection due to excessive growth or necrotic areas on the tumour surface. Upon re-inoculation of tumour cells into those rats that had shown complete remission, the tumours disappeared after 3-4 weeks of moderate growth without any further treatment. The present study shows for the first time the curative potential of 90 Y-SMT 487-based radiotherapy for somatostatin receptor-expressing tumours. Clinical phase I studies with yttrium-labelled SMT 487 have started in September 1997. (orig.)

Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours

International Nuclear Information System (INIS)

Romer, A.; Seiler, D.; Brunner, P.; Ng, Q.K.T.; Mueller-Brand, J.; Marincek, N.; Walter, M.A.; Koller, M.T.; Maecke, H.R.; Rochlitz, C.; Briel, M.; Schindler, C.

2014-01-01

Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides 90 Y or 177 Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [ 90 Y-DOTA]-TOC or [ 177 Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Overall, 910 patients underwent 1,804 cycles of [ 90 Y-DOTA]-TOC and 141 patients underwent 259 cycles of [ 177 Lu-DOTA]-TOC. The median survival after [ 177 Lu-DOTA]-TOC and after [ 90 Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95 % confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [ 177 Lu-DOTA]-TOC over [ 90 Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [ 177 Lu-DOTA]-TOC treatment (1.4 vs 10.1 %, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8 %, p = 0.32). The present results revealed no difference in median overall survival after [ 177 Lu-DOTA]-TOC and [ 90 Y-DOTA]-TOC. Furthermore, [ 177 Lu-DOTA]-TOC was less haematotoxic than [ 90 Y-DOTA]-TOC. (orig.)

Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours.

Science.gov (United States)

Romer, A; Seiler, D; Marincek, N; Brunner, P; Koller, M T; Ng, Q K T; Maecke, H R; Müller-Brand, J; Rochlitz, C; Briel, M; Schindler, C; Walter, M A

2014-02-01

Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides (90)Y or (177)Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [(90)Y-DOTA]-TOC or [(177)Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Overall, 910 patients underwent 1,804 cycles of [(90)Y-DOTA]-TOC and 141 patients underwent 259 cycles of [(177)Lu-DOTA]-TOC. The median survival after [(177)Lu-DOTA]-TOC and after [(90)Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [(177)Lu-DOTA]-TOC over [(90)Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [(177)Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). The present results revealed no difference in median overall survival after [(177)Lu-DOTA]-TOC and [(90)Y-DOTA]-TOC. Furthermore, [(177)Lu-DOTA]-TOC was less haematotoxic than [(90)Y-DOTA]-TOC.

64Cu-DOTATATE PET for Neuroendocrine Tumors: a Prospective Head-to-Head Comparison with 111In-DTPA-octreotide in 112 Patients

DEFF Research Database (Denmark)

Pfeifer, Andreas Klaus; Knigge, Ulrich; Binderup, Tina

2015-01-01

Neuroendocrine tumors (NETs) can be visualized using radiolabeled somatostatin analogs. We have previously shown the clinical potential of (64)Cu-DOTATATE in a small first-in-human feasibility study. The aim of the present study was, in a larger prospective design, to compare on a head-to-head ba...

Combined conservative surgery, chemotherapy and radiation therapy in treatment of the breast cancer patient: the influence of the interval between surgery and start of irradiation

International Nuclear Information System (INIS)

Willers, Henning; Wuerschmidt, F.; Janik, I.; Buenemann, H.; Heilmann, H.-P.

1996-01-01

Purpose: To analyze our experience treating breast cancer patients with combined breast conserving surgery, chemotherapy and radiation therapy in the light of considerable discussion on the role of the interval between surgery and radiation therapy (S-RT). Materials and Methods: Between 1985 and 1992, 100 patients with invasive breast cancer underwent radiation treatment at our institution after conservative surgery with axillary dissection and some form of chemotherapy. Criteria for inclusion in this retrospective analysis were: Stage M0, no simultaneous malignancies, gross total resection of primary and involved lymph nodes, at least three cycles of postoperative polychemotherapy, complete radiation treatment, complete follow-up information. Seventy-four patients fulfilling these criteria form the basis of this report. For patients alive at last observation date, median follow-up time was five years (i.e., 59 months; range, 36-112 months). Age at diagnosis ranged between 20 and 69 years (median, 48 years). Fifty-four patients were pre- or perimenopausal (73%) and 20 were postmenopausal (27%). Tumors were staged using the AJCC-system. Distribution of T-Stage was: T1 (n=36), T2 (n=37), T3 (n=1). In 95% of patients, axillary lymph nodes were positive: 1-3 nodes (n=50), ≥ 4 nodes (n=20), and 0 nodes (n=3). Thus, 91% of patients were Stage II. In 65% of patients, final pathological margins were negative. Margins showed invasive and intraductal carcinoma in 5 and 11% of cases, respectively (margins unknown in 19%). Chemotherapy regimens and doses varied according to the referring physicians as well as during the study period. Seventy percent of patients received six cycles of chemotherapy (predominan CMF) before onset of irradiation. The median S-RT interval was 20.5 weeks (range, 8.4-31.9 weeks). Usually, the breast was treated to 50 Gy, 2 Gy per fraction, five fractions per week, using Cobalt-60 (n=66) or 5 MeV photons (n=8). Then the tumor bed was boosted with

A collimator optimization method for quantitative imaging: application to Y-90 bremsstrahlung SPECT.

Science.gov (United States)

Rong, Xing; Frey, Eric C

2013-08-01

Post-therapy quantitative 90Y bremsstrahlung single photon emission computed tomography (SPECT) has shown great potential to provide reliable activity estimates, which are essential for dose verification. Typically 90Y imaging is performed with high- or medium-energy collimators. However, the energy spectrum of 90Y bremsstrahlung photons is substantially different than typical for these collimators. In addition, dosimetry requires quantitative images, and collimators are not typically optimized for such tasks. Optimizing a collimator for 90Y imaging is both novel and potentially important. Conventional optimization methods are not appropriate for 90Y bremsstrahlung photons, which have a continuous and broad energy distribution. In this work, the authors developed a parallel-hole collimator optimization method for quantitative tasks that is particularly applicable to radionuclides with complex emission energy spectra. The authors applied the proposed method to develop an optimal collimator for quantitative 90Y bremsstrahlung SPECT in the context of microsphere radioembolization. To account for the effects of the collimator on both the bias and the variance of the activity estimates, the authors used the root mean squared error (RMSE) of the volume of interest activity estimates as the figure of merit (FOM). In the FOM, the bias due to the null space of the image formation process was taken in account. The RMSE was weighted by the inverse mass to reflect the application to dosimetry; for a different application, more relevant weighting could easily be adopted. The authors proposed a parameterization for the collimator that facilitates the incorporation of the important factors (geometric sensitivity, geometric resolution, and septal penetration fraction) determining collimator performance, while keeping the number of free parameters describing the collimator small (i.e., two parameters). To make the optimization results for quantitative 90Y bremsstrahlung SPECT more

Evaluation of 2 amino acid protocols for kidney protection in patients treated with 90Y-DOTATOC for neuroendocrine tumors

International Nuclear Information System (INIS)

Arveschoug, A.K.; Kramer, S.M.J.; Iversen, P.; Froekiaer, J.; Groenbaek, H.

2015-01-01

Full text of publication follows. Background: peptide receptor radionuclide therapy (PRRT) is an established treatment for progressive neuroendocrine tumours (NET). Nephrotoxicity is the limiting factor using 90 Y-DOTATOC. Although administration of amino acids lowers the radioactive dose to the kidneys, delayed renal damage is a concern following therapy. Studies have indicated that prolonging the infusion of amino acids offers improved kidney protection. The intermittent infusion of amino acids up two days after PRRT has also been shown to further reduce renal uptake of radioactivity in pilot studies. Aim: We evaluated whether differences could be detected in GFR in patients treated with two different protocols for kidney protection using commercially available (Vamin-18) amino acid mixture (AAM); a standard protocol with 2 litres of AAM infused over 4 hours or a 24-hour infusion protocol with 3 litres of AAM. Material and method: GFR in 18 patients treated with infusion of 2 litres AAM of 4 hours was compared with GFR in 13 patients treated with 3 litres of AAM over 24 hours at 3 months, 6 months and 12 months after therapy with 90 Y DOTATOC. The majority of patients received the standard treatment of 3.7 GBq/m 2 90 Y DOTATOC every 8-10 weeks. The glomerular filtration rate (GFR) was estimated using the 51 Cr-EDTA plasma clearance by a single sample technique according to Groth and Aasted. Results: pre-existing risk factors associated with kidney failure were seen in 84 % of the patients. Other identified risk factors associated with kidney failure were former treatment with 90 Y-DOTATOC and/or chemotherapy, hypertension and diabetes. In the whole group of patients a significant fall in renal function was seen up to twelve months after PRRT. The median loss of kidney function was 30 ml/min/1.73m 2 (27 %) 12 months after treatment compared to pre-therapeutic values. Although no significant statistical difference was found comparing the two amino acid protocols

90Y/90 Sr electron induced damages in an essential eucalyptus oil related to the absorbed dose

International Nuclear Information System (INIS)

Heredia Cardona, J.A.; Diaz Rizo, O.; Martinez Luzardo, F.; Quert, R.

2007-01-01

A good irradiation geometry was achieved in order to carry out the irradiation of an essential eucalyptus oil with a 90 Y/ 90 Sr electron source. The Monte Carlo simulation code MCNP-4C was employed to determine the absorbed doses in this particular experimental configuration. It also helped us to understand which electrons (from an energetic point of view) were responsible for the damages. In order to identify the induced damages, the irradiated samples were studied by mass spectrometry. The obtained results were related to the absorbed doses determined by the computational simulation

Absorbed doses to the main parts of eyeball due to use 90Sr + 90Y ophthalmic applicator

International Nuclear Information System (INIS)

Chen Lishu

1993-05-01

The ophthalmic radiotherapy dosimetry and some affecting factors are introduced. The distributions of absorbed doses to the main parts of a fresh eyeball such as the cornea, sclera, lens and anterior chamber, during the radiotherapy by using a 90 Sr + 90 Y ophthalmic applicator are presented. An tissue-equivalent extrapolation ionization chamber was used in the dose measurement. The reasonable doses during ophthalmic radiotherapy for different depths have been obtained. Therefore, the absorbed dose to the lens, the most sensitive organ, can be given. These data are useful for radiation protection in ophthalmic radiotherapy

Which patients benefit most from primary surgery or neoadjuvant chemotherapy in stage IIIC or IV ovarian cancer? An exploratory analysis of the European Organisation for Research and Treatment of Cancer 55971 randomised trial.

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van Meurs, Hannah S; Tajik, Parvin; Hof, Michel H P; Vergote, Ignace; Kenter, Gemma G; Mol, Ben Willem J; Buist, Marrije R; Bossuyt, Patrick M

2013-10-01

To investigate whether biomarkers consisting of baseline characteristics of advanced stage ovarian cancer patients can help in identifying subgroups of patients who would benefit more from primary surgery or neoadjuvant chemotherapy. We used data of the European Organisation for Research and Treatment of Cancer (EORTC) 55971 trial in which 670 patients were randomly assigned to primary surgery or neoadjuvant chemotherapy. The primary outcome was overall survival. Ten baseline clinical and pathological characteristics were selected as potential biomarkers. Using Subpopulation Treatment Effect Pattern Plots (STEPP), biomarkers with a statistically significant qualitative additive interaction with treatment were considered as potentially informative for treatment selection. We also combined selected biomarkers to form a multimarker treatment selection rule. The size of the largest metastatic tumour and clinical stage were significantly associated with the magnitude of the benefit from treatment, in terms of five-year survival (p for interaction: 0.008 and 0.016, respectively). Stage IIIC patients with metastatic tumours ⩽45 mm benefited more from primary surgery while stage IV patients with metastatic tumours >45 mm benefited more from neoadjuvant chemotherapy. In stage IIIC patients with larger metastatic tumours and in stage IV patients with less extensive metastatic tumours both treatments were equally effective. We estimated that by selecting treatments for patients based on largest metastatic tumour and clinical stage, the potential five-year survival rate in the population of treated patients would be 27.3% (95% confidence interval (CI) 21.9-33.0), 7.8% higher than if all were treated with primary surgery, and 5.6% higher if all were treated with neoadjuvant chemotherapy. Although survival was comparable after primary surgery and neoadjuvant chemotherapy in the overall group of patients with ovarian cancer in the EORTC 55971 trial, we found in this exploratory

Large-scale purification of 90Sr from nuclear waste materials for production of 90Y, a therapeutic medical radioisotope.

Science.gov (United States)

Wester, Dennis W; Steele, Richard T; Rinehart, Donald E; DesChane, Jaquetta R; Carson, Katharine J; Rapko, Brian M; Tenforde, Thomas S

2003-07-01

A major limitation on the supply of the short-lived medical isotope 90Y (t1/2 = 64 h) is the available quantity of highly purified 90Sr generator material. A radiochemical production campaign was therefore undertaken to purify 1,500 Ci of 90Sr that had been isolated from fission waste materials. A series of alkaline precipitation steps removed all detectable traces of 137Cs, alpha emitters, and uranium and transuranic elements. Technical obstacles such as the buildup of gas pressure generated upon mixing large quantities of acid with solid 90Sr carbonate were overcome through safety features incorporated into the custom-built equipment used for 90Sr purification. Methods are described for analyzing the chemical and radiochemical purity of the final product and for accurately determining by gravimetry the quantities of 90Sr immobilized on stainless steel filters for future use.

Large-scale purification of 90Sr from nuclear waste materials for production of 90Y, a therapeutic medical radioisotope

International Nuclear Information System (INIS)

Wester, D.W.; Steele, R.T.; Rinehart, D.E.; DesChane, J.R.; Carson, K.J.; Rapko, B.M.; Tenforde, T.S.

2003-01-01

A major limitation on the supply of the short-lived medical isotope 90 Y (t 1/2 =64 h) is the available quantity of highly purified 90 Sr generator material. A radiochemical production campaign was therefore undertaken to purify 1500 Ci of 90 Sr that had been isolated from fission waste materials. A series of alkaline precipitation steps removed all detectable traces of 137 Cs, alpha emitters, and uranium and transuranic elements. Technical obstacles such as the buildup of gas pressure generated upon mixing large quantities of acid with solid 90 Sr carbonate were overcome through safety features incorporated into the custom-built equipment used for 90 Sr purification. Methods are described for analyzing the chemical and radiochemical purity of the final product and for accurately determining by gravimetry the quantities of 90 Sr immobilized on stainless steel filters for future use

Hospital readmission rates and risk factors for readmission following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies.

Science.gov (United States)

Dreznik, Yael; Hoffman, Aviad; Hamburger, Tamar; Ben-Yaacov, Almog; Dux, Yossi; Jacoby, Harel; Berger, Yaniv; Nissan, Aviram; Gutman, Mordechai

2018-02-08

Cytoreductive surgery and Hyperthermic intra-peritoneal chemotherapy (CRS/HIPEC) for peritoneal surface malignancies is associated with high morbidity. The increased numbers of patients undergoing CRS/HIPEC in recent years mandates risk analysis and quality assurance. However, only scarce data exist regarding causative parameters for readmission. The aim of this study was to assess readmission rates and risk factors associated with readmission. A retrospective-cohort study including patients from two high-volume centers who underwent CRS/HIPEC surgery between the years 2007-2016 was performed. Patients' demographics, peri-operative data and readmission rates were recorded. 223 patients were included in the study. The 7 and 30-day readmission rates were 3.5% (n = 8) and 11% (n = 25), respectively. Late readmission rates (up to 90 days) were 11% (n = 25). The most common causes of readmission were surgical related infections (35%), small bowel obstruction (17.5%) and dehydration (14%). Post-operative complications were associated with higher readmission rates (p = 0.0001). PCI score was not associated with higher rates of readmission. Readmissions following CRS/HIPEC occur mainly due to infectious complications and dehydrations. Patients following CRS/HIPEC should be discharged after careful investigation to a community based continuing care with access for IV fluid replacement or antibiotics administration when required. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Investigation of pharmaceuticals and medical devices containing 90Y extracted from high radioactive liquid waste in spent-fuel reprocessing

International Nuclear Information System (INIS)

Hosoma, Takashi

2012-07-01

Pharmaceuticals and medical devices containing radioactive 90 Y are realized, approved and placed on the international market where three products are available in Europe and the United States, and one product in Japan. These products are used not for diagnosis but for treatment by internal irradiation. It was estimated from the deliberative report of the approval in Japan that 90 Y was extracted in Europe from high radioactive liquid waste (HALW) yielded in spent-fuel reprocessing. In this report, products placed on the market and physical properties were reviewed, reasons of the realization and conditions to realize succeeding products were estimated, extraction method was compared with other methods, technical subjects, and relevant regulations were investigated. Although a medical device containing radioactive 90 Y has been studied in Japan and one pharmaceutical product was approved, a breakthrough would be necessary to put 90 Y utilization beyond alternative treatments. The breakthrough would become be promising; for example, if conventional treatments could be supported by technical development to deliver 90 Y more sharply to the target with shorter serum half-life. Extraction of 90 Y nuclide from HALW has advantages over thermal neutron irradiation of natural nuclide, a system is envisioned where 90 Sr as a parent nuclide is separated in the reprocessing then transported to and stored in a factory of radiopharmaceuticals followed by 90 Y extraction on demand. (author)

Phase II trial of induction chemotherapy followed by surgery for squamous cell carcinoma of the oral tongue in young adults.

Science.gov (United States)

Kies, Merrill S; Boatright, Dowin H; Li, Guojun; Blumenschein, George; El-Naggar, Adel K; Brandon Gunn, G; Lewin, Jan S; Steinhaus, Ganene D; Sturgis, Erich M

2012-09-01

We conducted a phase II clinical trial of induction chemotherapy followed by surgery ± radiotherapy for squamous cell carcinoma of the oral tongue (SCCOT) in young adults. From September 2001 to October 2004, 23 patients aged 18 to 49 years with clinical T2-3 N0-2 M0 SCCOT and no prior radiotherapy, chemotherapy, or neck dissection underwent induction chemotherapy (paclitaxel, ifosfamide, and carboplatin) followed by glossectomy and neck dissection ± radiotherapy and chemotherapy. On final surgical pathology, 9 patients (39%) had a complete/major (2 complete) histologic response at the primary tumor site; 8 patients (35%) had no response or progression. Similarly, 9 patients (39%) had a complete response in the neck or remained node negative; 6 patients (26%) had an increase in nodal category. No treatment-associated deaths occurred, and toxicity was modest. At a median follow-up from the end of treatment of 52 months (minimum, 23 months), 10 patients (43%) developed recurrence, and all 10 died of cancer. Crude recurrence/cancer death rates were associated with ≤ a partial response at the tongue (p = .029), poor histologic differentiation (p = .012), and multiple adverse features on final surgical pathology (p = .040). Response rates and overall survival with this induction chemotherapy regimen were limited, but complete/major response at the tongue was associated with excellent prognosis. Additionally, improved patient selection and predictive tumor biomarkers will be needed for induction chemotherapy to be routinely incorporated into the treatment of oral tongue cancer in young adults. Copyright © 2011 Wiley Periodicals, Inc.

Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer

International Nuclear Information System (INIS)

Avendano Juan; Buitrago, Giancarlo; Ramos, Pedro; Suescun Oscar

2010-01-01

Objective: To describe the experience at the National Cancer Institute (NCI) on the use of neoadjuvant chemotherapy as primary treatment for epithelial ovarian cancer among patients in stages IIIC and IV. Methods: We conducted a descriptive retrospective study (case series type) of patients diagnosed with epithelial ovarian cancer in stages IIIC and IV, treated at the NCI from January 1, 2003 to December 31,2006, who underwent neoadjuvant chemotherapy as primary treatment. Demographic characteristics and clinical outcomes are described. Results: Seventeen patients who fulfilled the above mentioned criteria were selected. Once neoadjuvant chemotherapy ended, 5 patients (29.4%) achieved complete or partial clinical response; 4 (23.8%) remained in stable condition, and 8 (47.6%) showed signs of progressive illness. Interval debulking surgery was performed on objective response patients. Maximum cytoreduction was achieved in 5 patients (100%); first relapse was reported at month 18 of follow-up; 2 disease-free survivors were identified in December, 2007; 8 (49%) reported some degree of non-severe chemotherapy-related toxicity. No mortality was related to chemotherapy, no post surgical complications were observed and no patient required advanced support management. Conclusions: Neoadjuvant chemotherapy, followed by optimal interval debulking surgery among selected patients, can be an alternative treatment for advanced epithelial ovarian cancer among women with irresecability or the critically ill. Further studies with improved design are required to confirm these findings.

Radioimmunotherapy with Y-90-epratuzumab in patients with previously treated B-cell lymphoma. A fractionated dose-escalation study

International Nuclear Information System (INIS)

Linden, O.; Cavallin-Stahl, E.; Tennvall, J.; Hindorf, C.; Olsson, T.; Strand, S.E.; Stenberg, L.; Wingardh, K.

2002-01-01

Aim: Fractionated RIT may improve outcome by decreasing heterogeneity in absorbed dose and by increasing therapeutic window. The humanised anti-CD22 antibody, Epratuzumab, (Immunomedics, Inc., Morris Plains, NJ) can be given repeatedly with minimal risk of neutralising Ab (HAHA), making fractionated treatment with 90 Y-labelled epratuzumab possible. Materials and Methods: Patients with previously treated B-cell lymphoma received increasing number (2-4) of weekly infusions of 90 Y-epratuzumab. Patients received either 185 MBq/m 2 per infusion (group A), or, if they had a history of high-dose chemotherapy with stem-cell rescue, 92.5 MBq/m 2 per infusion (group B). The first infusion included 150 MBq of 111 Indium for scintigraphic verification of tumour targeting and dosimetry. 1.5 mg/kg epratuzumab was administered with each infusion. The treatment could be repeated once after 3 m. Results: Of 23 patients, 16 in group A and 6 in group B were evaluable for response. The RR in group A was 62% objective response (OR) and 25% CR/CRu. One patient in group B showed OR. OR was seen in aggressive and indolent lymphoma. Response was also long-lasting and event-free survival of patients showing CR/CRu was 14 to 25+ months. In group A all seven patient, receiving three infusions, showed less than grade 3 platelet and neutrophil toxicity, except for two patients suffering grade 3 neutropenia. Of five patients with 4 weekly infusions there were two patients with dose-limiting haematological toxicity (DLT), both recently treated with high dose cytosar before RIT. With criteria used the maximal tolerated dose was three infusions 185 MBq/m 2 . In group B no patient suffered DLT and one patient exhibited OR. Seven patients were retreated after 3 months with minor toxicity, but improvement in OR in two cases. No patient has developed HAHA. CD22 expression on tumour cells, as assessed by flow cytometry, is available in 18 of 22 patients. In group A, seven of eight patients with

Open heart surgery with deep hypothermic cardiopulmonary bypass and more than 90 minutes of aortic cross clamp time in 10 small dogs

Directory of Open Access Journals (Sweden)

Kippei Mihara

2017-04-01

Full Text Available No previous reports have described cardiopulmonary bypass (CPB techniques involving long aortic cross clamp (ACC times in small-breed dogs. We previously described open heart surgery under deep hypothermic CPB in small and toy dogs with an approximate ACC time limit of 1 hour, given the low success rate beyond 90 minutes of ACC time. Herein, we describe improvements in cardiac anesthesia, CPB, and cardioplegia that led to a high success rate of open heart surgery with a long ACC time in small dogs. Ten small-breed dogs with severe mitral regurgitation were subjected to mitral valve plasty that necessitated cardiopulmonary bypass (CPB beyond 90 minutes of ACC time. In the present study, all dogs survived surgery; 7 survived to discharge. In other words, we achieved a high success rate of 70% with mitral valve plasty beyond 90 minutes of ACC time (mean, 105.1 minutes: range, 90-117 minutes. For small dogs, successful open heart surgery with a long ACC time may require cardiac balanced anesthesia, CPB with increased drainage and, importantly, thorough cardioplegia without hemodilution.

Radiolabeling optimization and reduced staff radiation exposure for high-dose 90Y-ibritumomab tiuxetan (HD-Zevalin)

International Nuclear Information System (INIS)

Papi, Stefano; Martano, Luigi; Garaboldi, Lucia; Rossi, Annalisa; Cremonesi, Marta; Grana, Chiara Maria; Paolucci, Daniele; Sansovini, Maddalena; Paganelli, Giovanni; Chinol, Marco

2010-01-01

Introduction: 90 Y-Zevalin labeling may cause severe finger radiation exposure, especially in high-dose protocols (HD-Zevalin), where up to 7.4 GBq could be injected. In this work, we optimized the labeling of HD-Zevalin with special regard to simplicity, speed, safety and radiation protection. Methods: Factors influencing labeling outcome (activity, specific activity, time, final volume, stability) were studied separately. The critical steps of a standard radiolabeling procedure were optimized to reduce finger exposure, developing an alternative labeling procedure and including a different 90 Y supplier. Finger doses were monitored by thermoluminescent dosimeters at each fingertip under anti-X gloves, considering both absolute values and values after normalization to 1.48 GBq. Results: Labeling of 90 Y-Zevalin was safe and reproducible up to 7.4 GBq with a simple and single-step procedure offering good stability for several hours. Radiolabeling specific activity was found critical, being kept at 740 MBq.mg -1 . Radiochemical purity values ≥98% were routinely achieved. The alternative procedure allowed a sensible reduction of finger dose, due to both the different 90 Y vial and the handling. Finger exposure was reduced from 6.6±4.3 to 3.1±0.8 mSv/1.48 GBq in the case of the original 90 Y vial and from 1.5±0.9 to 0.3±0.1 mSv/1.48 GBq using a shielded 90 Y vial. Conclusions: HD-Zevalin can be prepared in a safe and reproducible way, giving high radiochemical purity values, good stability and low finger exposure. This study may improve the safety of nuclear medicine professionals involved in the preparation of Zevalin.

Factors associated with thromboembolic events following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Science.gov (United States)

Rottenstreich, Amihai; Kalish, Yosef; Kleinstern, Geffen; Yaacov, Almog Ben; Dux, Joseph; Nissan, Aviram

2017-12-01

We investigated the risk factors, incidence, and role of thromboprophylaxis in the development of thrombosis following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We reviewed data of patients with CRS/HIPEC in three hospitals. Overall, 192 patients underwent CRS/HIPEC during 2007-2016. Mechanical (thigh-length pneumatic compression stockings) and pharmacologic thromboprophylaxis (40 mg enoxaparin daily, starting 12 h before surgery until discharge) was provided for all patients; and 116 (60.4%) also received an extended course of enoxaparin for 2-4 weeks after discharge. Twenty-six patients experienced thrombotic complications (13.5%) including portal-splenic-mesenteric venous thrombosis (n = 11, 5.7%), pulmonary embolism (n = 10, 5.2%), and deep vein thrombosis (n = 5, 2.6%); most (n = 21, 80.8%) occurred after hospital discharge. Univariate analysis identified Peritoneal Cancer Index, intraoperative transfusion requirement, operative blood loss, operative time, lengths of hospital, and intensive care unit stay, and lack of administration of anticoagulation at discharge as significantly associated with thrombosis. With multivariate analysis, only the lack of anticoagulation therapy at discharge remained significantly associated with thrombosis (P = 0.0001). Thromboembolic complications are common following CRS/HIPEC. As significantly lower rates of thrombosis were found in patients who received an extended course of anticoagulation, we support its use for at least 2 weeks after discharge. © 2017 Wiley Periodicals, Inc.

Meta-analysis: adjusted indirect comparison of drug-eluting bead transarterial chemoembolization versus 90Y-radioembolization for hepatocellular carcinoma

International Nuclear Information System (INIS)

Ludwig, Johannes M.; Xing, Minzhi; Zhang, Di; Kim, Hyun S.

2017-01-01

To investigate comparative effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus Yttrium-90 ( 90 Y)-radioembolization for hepatocellular carcinoma (HCC). Studies comparing conventional (c)TACE versus 90 Y-radioembolization or DEB-TACE for HCC treatment were identified using PubMed/Medline, Embase, and Cochrane databases. The adjusted indirect meta-analytic method for effectiveness comparison of DEB-TACE versus 90 Y-radioembolization was used. Wilcoxon rank-sum test was used to compare baseline characteristics. A priori defined sensitivity analysis of stratified study subgroups was performed for primary outcome analyses. Publication bias was tested by Egger's and Begg's tests. Fourteen studies comparing DEB-TACE or 90 Y-radioembolization with cTACE were included. Analysis revealed a 1-year overall survival benefit for DEB-TACE over 90 Y-radioembolization (79 % vs. 54.8 %; OR: 0.57; 95 %CI: 0.355-0.915; p = 0.02; I-squared: 0 %; p > 0.5), but not for the 2-year (61 % vs. 34 %; OR: 0.65; 95%CI: 0.294-1.437; p = 0.29) and 3-year survival (56.4 % vs. 20.9 %; OR: 0.713; 95 % CI: 0.21-2.548; p = 0.62). There was significant heterogeneity in the 2- and 3-year survival analyses. The pooled median overall survival was longer for DEB-TACE (22.6 vs. 14.7 months). There was no significant difference in tumour response rate. DEB-TACE and 90 Y-radioembolization are efficacious treatments for patients suffering from HCC; DEB-TACE demonstrated survival benefit at 1-year compared to 90 Y-radioembolization but direct comparison is warranted for further evaluation. (orig.)

Anti-CD45 radioimmunotherapy with 90Y but not 177Lu is effective treatment in a syngeneic murine leukemia model.

Directory of Open Access Journals (Sweden)

Johnnie J Orozco

Full Text Available Radioimmunotherapy (RIT for treatment of hematologic malignancies has primarily employed monoclonal antibodies (Ab labeled with 131I or 90Y which have limitations, and alternative radionuclides are needed to facilitate wider adoption of RIT. We therefore compared the relative therapeutic efficacy and toxicity of anti-CD45 RIT employing 90Y and 177Lu in a syngeneic, disseminated murine myeloid leukemia (B6SJLF1/J model. Biodistribution studies showed that both 90Y- and 177Lu-anti-murine CD45 Ab conjugates (DOTA-30F11 targeted hematologic tissues, as at 24 hours 48.8 ± 21.2 and 156 ± 14.6% injected dose per gram of tissue (% ID/g of 90Y-DOTA-30F11 and 54.2 ± 9.5 and 199 ± 11.7% ID/g of 177Lu-DOTA-30F11 accumulated in bone marrow (BM and spleen, respectively. However, 90Y-DOTA-30F11 RIT demonstrated a dose-dependent survival benefit: 60% of mice treated with 300 µCi 90Y-DOTA-30F11 lived over 180 days after therapy, and mice treated with 100 µCi 90Y-DOTA-30F11 had a median survival 66 days. 90Y-anti-CD45 RIT was associated with transient, mild myelotoxicity without hepatic or renal toxicity. Conversely, 177Lu- anti-CD45 RIT yielded no long-term survivors. Thus, 90Y was more effective than 177Lu for anti-CD45 RIT of AML in this murine leukemia model.

Induction Chemotherapy for p16 Positive Oropharyngeal Squamous Cell Carcinoma.

Science.gov (United States)

Saito, Yuki; Ando, Mizuo; Omura, Go; Yasuhara, Kazuo; Yoshida, Masafumi; Takahashi, Wataru; Yamasoba, Tatsuya

2016-04-01

We aimed to determine the effectiveness of induction chemotherapy for treating p16-positive oropharyngeal cancer in our department. This was a retrospective case series to assess treatment effectiveness. We administered induction chemotherapy to patients with stage III to IV oropharyngeal p16-positive squamous cell carcinoma between 2008 and 2013. Induction chemotherapy was administered using combinations of docetaxel, cisplatin, and 5-fluorouracil. We measured the survival rates using the Kaplan-Meier method and log-rank test. We reviewed 23 patients (18 men and 5 women; age, 42-79 years). Induction chemotherapy resulted in partial or complete remission (20 patients) and in stable (2 patients) or progressive (1 patient) disease. In partial or complete remission, subsequent radiotherapy was performed in 16 patients, chemoradiotherapy in two, and transoral resection in two. In stable or progressive disease, subsequent open surgery was performed. Overall, one patient died of cervical lymph node metastasis, one died of kidney cancer, and one died of myocardial infarction. Event-free, distant-metastasis-free survival was present for 20 patients. The 3-year disease-specific survival was 95%; the overall survival was 87%. Two patients required gastrostomies during chemoradiotherapy and three required tracheotomies, but these were closed in all patients. The therapeutic response to induction chemotherapy for p16-positive oropharyngeal cancer was good. Partial or complete remission was achieved in almost 90% patients, and control of local and distant metastases was possible when it was followed by radiotherapy alone or with transoral resection of the primary tumor. A multicenter study is required to confirm these findings. 4.

Peptide receptor radionuclide therapy of Merkel cell carcinoma using 177lutetium-labeled somatostatin analogs in combination with radiosensitizing chemotherapy. A potential novel treatment based on molecular pathology

International Nuclear Information System (INIS)

Salavati, A.; Prasad, V.; Baum, R.P.; Schneider, C.P.; Herbst, R.

2012-01-01

Few studies have been published on the safety and feasibility of synchronous use of peptide receptor radionuclide therapy (PRRNT), as source of internal radiation therapy, in combination with chemotherapy. In this study we reported a 53-year-old man with stage IV Merkel cell carcinoma (MCC), who underwent synchronous internal radiation therapy and chemotherapy. Based on presumable poor prognosis with chemotherapy only, functional similarities of MCC with other neuroendocrine tumors and available evidence of effectiveness and safety of synchronous use of external beam radiation therapy and chemotherapy in treatment of high-risk MCC patients, our interdisciplinary neuroendocrine tumor board recommended him to add PRRNT to his ongoing chemotherapy. He received 2 courses of 177 Lu-DOTATATE(1, 4, 7, 10-Tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-1-D-Phe1-Tyr3-Thr8-octreotide) in combination with ongoing 8 cycles of liposomal doxorubicin based on standard protocols. Response to therapy was evaluated by 18 F-fluorodeoxyglucose ( 18 F-FDG) and 68 gallium-somatostatin-receptor PET/CT. There was an impressive improvement of the clinical symptoms. However, follow-up positron emission tomography (PET)/CT studies showed mixed pattern of response. Synchronous use of PRRNT and radiosensitizing chemotherapy seems safe and feasible in high risk MCC patients, however, further prospective studies and clinical trials are warranted to provide reliable evidence of possible pitfalls and effectiveness of PRRNT and 68 Ga-somatostatin-receptor PET/CT in the management of MCC. (author)

Evaluation of a pyrex glass shield for the dose reduction in extremities to manipulate a 90 Sr- 90 Y generator

International Nuclear Information System (INIS)

Ayra P, F.E.; Xiques C, A.; Torres B, M.B.

2006-01-01

The production of Y-90 of high activity it specifies (free of payee) for their use in radioimmunotherapy uses the Strontium 90 as isotope source. Depending on the method employee for the separation of both isotopes several types of generators are described in different bibliographies. The column generator used in the facilities of the Center of Isotopes requires of a frequent manipulation causing significant dose in the skin of the extremities due to the exhibition to the radiation beta of high energy. The properties of the shieldings for this radiation type have been well studied Y they consist in several publications. To be in correspondence with requirements of radiological protection in the Cuban legislation, the column was covered with a tube of glass pyrex of 5 mm of thickness and it was monitored the exposure with an ionization chamber. At the own time, the shielding using the Monte Carlo method was evaluated. It was used the MCNP 4C code to simulate the absorption of the beta particles generated in the process of disintegration of the Sr-90 and Y-90 in the glass shielding. The column generator and the fluence of beta particles were modeled in different points inside the shielding to determine if the experimentally measured values correspond to electrons that were not absorbed or to the weak stopping radiation generated in the glass due to the deceleration of these particles. A cylinder of 4 mm of diameter simulates the source (it dilutes) and a tube of walls of 6 mm of thickness simulates the shielding more the wall of the column around the generator. This it was divided in cells of 1 mm of thickness and the energy deposited in them was evaluated. The results show that all the electrons generated in the source are absorbed in the shielding and the exposure rates decrease in more of 78 times using the 5 mm of pyrex glass. The doses in extremities to the operators of the generator don't surpass the 70 mSv by year that is the dose restriction imposed in the

Two-stage supported liquid membrane method for the separation of carrier-free {sup 90}Y from {sup 90}Sr using KSM-17 and CMPO as carriers

Energy Technology Data Exchange (ETDEWEB)

Dhami, P S; Naik, P W; Dudwadkar, N L; Kannan, R; Achuthan, P V; Dakshinamoorthy, A; Jambunathan, U; Munshi, S K; Dey, P K [Fuel Reprocessing Division, Bhabha Atomic Research Centre, Mumbai (India); Pandey, Usha; Venkatesh, Meera [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai (India)

2007-07-01

A two stage supported liquid membrane system is developed for the separation of carrier free {sup 90}Y from {sup 90}Sr for therapeutic applications. The feed containing {sup 90}Sr-{sup 90}Y in nitric acid solution at pH 2 is placed in the feed compartment and transported across a polytetrafluoroethylene membrane containing 2-ethyhexyl2ethylhexyl phosphonic acid to a 4M HNO{sub 3} receiver phase. This is then transported across another polytetrafluoroethylene membrane containing octyl phenyl N,N-diisobutylcarbamoyl methylphosphene oxide to another receiving phase, 1 M acetic acid. This has been implemented on simultaneous and sequential modes with very good yield. The second stage will act as a barrier for {sup 90}Sr, and will improve the product purity. (author)

Time optimization of 90Sr measurements: Sequential measurement of multiple samples during ingrowth of 90Y

International Nuclear Information System (INIS)

Holmgren, Stina; Tovedal, Annika; Björnham, Oscar; Ramebäck, Henrik

2016-01-01

The aim of this paper is to contribute to a more rapid determination of a series of samples containing 90 Sr by making the Cherenkov measurement of the daughter nuclide 90 Y more time efficient. There are many instances when an optimization of the measurement method might be favorable, such as; situations requiring rapid results in order to make urgent decisions or, on the other hand, to maximize the throughput of samples in a limited available time span. In order to minimize the total analysis time, a mathematical model was developed which calculates the time of ingrowth as well as individual measurement times for n samples in a series. This work is focused on the measurement of 90 Y during ingrowth, after an initial chemical separation of strontium, in which it is assumed that no other radioactive strontium isotopes are present. By using a fixed minimum detectable activity (MDA) and iterating the measurement time for each consecutive sample the total analysis time will be less, compared to using the same measurement time for all samples. It was found that by optimization, the total analysis time for 10 samples can be decreased greatly, from 21 h to 6.5 h, when assuming a MDA of 1 Bq/L and at a background count rate of approximately 0.8 cpm. - Highlights: • An approach roughly a factor of three more efficient than an un-optimized method. • The optimization gives a more efficient use of instrument time. • The efficiency increase ranges from a factor of three to 10, for 10 to 40 samples.

POMB/ACE chemotherapy for mediastinal germ cell tumours.

Science.gov (United States)

Bower, M; Brock, C; Holden, L; Nelstrop, A; Makey, A R; Rustin, G J; Newlands, E S

1997-05-01

Mediastinal germ cell tumours (MGCT) are rare and most published series reflect the experiences of individual institutions over many years. Since 1979, we have treated 16 men (12 non-seminomatous germ cell tumours and 4 seminomas) with newly diagnosed primary MGCT with POMB/ACE chemotherapy and elective surgical resection of residual masses. This approach yielded complete remissions in 15/16 (94%) patients. The median follow-up was 6.0 years and no relapses occurred more than 2 years after treatment. The 5 year overall survival in the non-seminomatous germ cell tumours (NSGCT) is 73% (95% confidence interval 43-90%). One patient with NSGCT developed drug-resistant disease and died without achieving remission and 2 patients died of relapsed disease. In addition, 4 patients with bulky and/or metastatic seminoma were treated with POMB/ACE. One died of treatment-related neutropenic sepsis in complete remission and one died of relapsed disease. Finally, 4 patients (2 NSGCT and 2 seminomas) referred at relapse were treated with POMB/ACE and one was successfully salvaged. The combination of POMB/ACE chemotherapy and surgery is effective management for MGCT producing high long-term survival rates.

A comparison of multimodal therapy and surgery for esophageal adenocarcinoma.

LENUS (Irish Health Repository)

Walsh, T N

1996-08-15

Uncontrolled studies suggest that a combination of chemotherapy and radiotherapy improves the survival of patients with esophageal adenocarcinoma. We conducted a prospective, randomized trial comparing surgery alone with combined chemotherapy, radiotherapy, and surgery.

Surgery for chronic subdural hematoma in nonagenarians

DEFF Research Database (Denmark)

Bartek, J; Sjåvik, K; Ståhl, F

2017-01-01

OBJECTIVE: Chronic subdural hematoma (cSDH) is a prevalent condition often seen in the elderly, with surgery being the treatment of choice when symptomatic. So far, few have explored the surgical outcomes in patients 90 years or older. The aim of this study was to investigate outcome after c...... neurosurgical centers. In a comparative analysis, the primary end-point was difference in hematoma recurrence rates between the ≥90 y/o and

Anaesthetic management and perioperative outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: A retrospective analysis

Directory of Open Access Journals (Sweden)

Kalpana P Balakrishnan

2018-01-01

Full Text Available Background and Aims: Cytoreductive surgery (CRS combined with hyperthermic intraperitoneal chemotherapy (HIPEC is becoming the standard treatment option for peritoneal carcinomatosis but is associated with high rates of morbidity and mortality. Our aim was to retrospectively analyse and evaluate intra-operative factors associated with morbidity and mortality of CRS and HIPEC. Methods: Intra-operative data were collected for cases done over 1 year (24 cases and analysed for the primary outcome of post-operative ventilation >24 h, and secondary outcome of length of the Intensive Care Unit (ICU stay >5 days. Statistical analysis was carried out in STATA 11 software. Results: Higher peritoneal carcinoma index (PCI, (P = 0.0047, longer duration of surgery (P = 0.0016, higher delta temperatures (P = 0.0119, increased estimated blood loss (EBL (P = 0.0054, high intraoperative fluid requirement (P = 0.0038, lower mean arterial pressure (MAP (P = 0.0021 and higher blood products requirement were associated with >24 h ventilation. These factors were also associated with longer ICU stay. All these factors associated with >24 h ventilation and prolonged ICU stay are related to the PCI which is an indicator of the extent of surgery. Conclusion: Higher PCI, longer duration of surgery, higher delta temperatures, increased EBL, high intraoperative fluid requirement, lower mean arterial pressure and higher blood products requirement were associated with >24 h postoperative ventilation as well as ICU stay >5 days. All these factors are related to the PCI, which is a major predictor of post-operative morbidity.

Investigation on the influence of metal ion impurities on the complexation behavior of generator produced {sup 90}Y with bifunctional chelators

Energy Technology Data Exchange (ETDEWEB)

Pandey, Usha; Gamre, Naresh; Dash, Ashutosh [Isotope Applications and Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai (India)

2014-05-01

The {sup 90}Sr/ {sup 90}Y generator is the exclusive source of 'no carrier added' {sup 90}Y for targeted therapy. However, the concomitant presence of trace metals diminishes the complexation of {sup 90}Y with bifunctional chelators (BFCs). A systematic investigation was performed to evaluate the influence of trace metals on the complexation of {sup 90}Y (from an electrochemical generator) with BFCs such as p-SCN-Bn-PCTA, p-SCN-Bn-DTPA and p-SCN-Bn-DOTA. Our study indicates that while p-SCN-Bn-DTPA was least affected by most of the trace metals studied, p-SCN-Bn-PCTA was most sensitive to their presence and hence could be the ligand of choice for assessing the chemical purity of generator derived {sup 90}Y. (author)

A data acquisition system for indentification of 90Sr/ 90Y in environmental samples

International Nuclear Information System (INIS)

Medin, G.; Brajnik, D.; Starcic, M.; Stanovnik, A.

1996-01-01

Often, in the stage of research and development of new techniques for detection of ionizing radiation, elaborate electronic systems are required. In this paper, we describe the relatively complex detector and electronic system used for a relatively simple but nevertheless demanding measurement of the beta emitting radionuclides 90 Sr/ 90 Y in environmental samples. The detection limit of 1 Bq in a thin, disc-shaped sample, was obtained by careful elimination of background. Contribution of other radionuclides in the sample, were eliminated or at least considerably reduced by using a silica aerogel as Cherenkov radiator and thin multiwire chamber in coincidence. Cosmic ray signals were reduced by large scintillation counters in anticoincidence. Finally, persisting RF pick-up signals were eliminated by using the signal from a wire antenna and identical MWPC preamplifier and discriminator for a veto to the master coincidence. For each accepted event, both timing and pulse height information was recorded with a personal computer

Characterization of an extrapolation chamber in a 90Sr/90Y beta radiation field

International Nuclear Information System (INIS)

Oramas Polo, I.; Tamayo Garcia, J. A.

2015-01-01

The extrapolation chamber is a parallel plate chamber and variable volume based on the Bragg-Gray theory. It determines in absolute mode, with high accuracy the dose absorbed by the extrapolation of the ionization current measured for a null distance between the electrodes. This camera is used for dosimetry of external beta rays for radiation protection. This paper presents the characterization of an extrapolation chamber in a 90 Sr/ 90 Y beta radiation field. The absorbed dose rate to tissue at a depth of 0.07 mm was calculated and is (0.13206±0.0028) μGy. The extrapolation chamber null depth was determined and its value is 60 μm. The influence of temperature, pressure and humidity on the value of the corrected current was also evaluated. Temperature is the parameter that has more influence on this value and the influence of pressure and the humidity is not very significant. Extrapolation curves were obtained. (Author)

Dramatic Response of a Case ofRecurrent Basal Cell Carcinoma toSystemic Chemotherapy

Directory of Open Access Journals (Sweden)

Mohammad Mohammadianpanah

2010-10-01

Full Text Available Basal cell carcinoma (BCC is the most common cancer among humans, and the standard treatment is surgery. Other modalities are reserved as a second line of treatment. Topical chemotherapy may be used in primary BCC. Systemic chemotherapy has no role in the primary treatment of BCC, although it may be efficacious in metastatic cases. We report the case of a patient with persistent recurrent BCC following multiple surgeries and radiotherapy, who achieved a dramatic response with a cisplatinand 5-flourouracil chemotherapy regimen.

Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Lewandowski, Robert J.; Memon, Khairuddin; Hickey, Ryan; Gates, Vanessa L.; Atassi, Bassel; Vouche, Michael; Atassi, Rohi; Desai, Kush; Hohlastos, Elias; Sato, Kent; Habib, Ali [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Mulcahy, Mary F.; Kircher, Sheetal; Newman, Steven B.; Nimeiri, Halla; Benson, Al B. [Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States); Marshall, Karen; Williams, Melissa; Salzig, Krystina; Salem, Riad [Robert H. Lurie Comprehensive Cancer Center, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL (United States); Northwestern University, Department of Medicine, Division of Hematology and Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL (United States)

2014-10-15

The aim of this study was to analyze the safety, treatment characteristics and survival outcomes of Yttrium-90 (Y90) radioembolization for unresectable colorectal carcinoma (CRC) liver metastases refractory to standard of care therapy. A total of 214 patients with CRC metastases were treated with Y90 radioembolization over 12 years. Toxicity was assessed using National Cancer Institute common terminology criteria. Overall survival was analyzed from date of diagnosis of primary cancer, hepatic metastases and from the first Y90. Uni/multivariate analyses were performed. Substratification by era of chemotherapeutics was performed. Most patients were male (60 %) and <65 years old (61 %). Of them, 98 % had been exposed to chemotherapy. Grade 3 lymphocyte, bilirubin, albumin, ALP and AST toxicities were observed in 39 %, 11 %, 10 %, 8 % and 4 % of patients, respectively. Grade 4 lymphocyte and ALP toxicities were observed in 5 % and 3 % of patients, respectively. Median overall survival was 43.0, 34.6, and 10.6 months from date of diagnosis of primary cancer, hepatic metastases and first Y90, respectively. Survival was significantly longer in patients: (1) who received ≤2 cytotoxic drugs (n = 104) than those who received 3 (n = 110) (15.2 vs. 7.5 months, p = 0.0001); and (2) who received no biologic agents (n = 52) compared with those that did (n = 162) (18.6 vs. 9.4 months, p = 0.0001). Multivariate analyses identified ≤2 cytotoxic agents, no exposure to biologics, ECOG 0, tumor burden <25 %, lack of extrahepatic disease and albumin >3 g/dL as independent predictors of survival. In this largest metastatic CRC series published to date, Y90 radioembolization was found to be safe; survival varied by prior therapy. Further studies are required to further refine the role of Y90 in metastatic CRC. (orig.)

Meta-analysis: adjusted indirect comparison of drug-eluting bead transarterial chemoembolization versus {sup 90}Y-radioembolization for hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Ludwig, Johannes M.; Xing, Minzhi [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Zhang, Di [University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA (United States); Kim, Hyun S. [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Yale School of Medicine, Yale Cancer Center, New Haven, CT (United States)

2017-05-15

To investigate comparative effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus Yttrium-90 ({sup 90}Y)-radioembolization for hepatocellular carcinoma (HCC). Studies comparing conventional (c)TACE versus {sup 90}Y-radioembolization or DEB-TACE for HCC treatment were identified using PubMed/Medline, Embase, and Cochrane databases. The adjusted indirect meta-analytic method for effectiveness comparison of DEB-TACE versus {sup 90}Y-radioembolization was used. Wilcoxon rank-sum test was used to compare baseline characteristics. A priori defined sensitivity analysis of stratified study subgroups was performed for primary outcome analyses. Publication bias was tested by Egger's and Begg's tests. Fourteen studies comparing DEB-TACE or {sup 90}Y-radioembolization with cTACE were included. Analysis revealed a 1-year overall survival benefit for DEB-TACE over {sup 90}Y-radioembolization (79 % vs. 54.8 %; OR: 0.57; 95 %CI: 0.355-0.915; p = 0.02; I-squared: 0 %; p > 0.5), but not for the 2-year (61 % vs. 34 %; OR: 0.65; 95%CI: 0.294-1.437; p = 0.29) and 3-year survival (56.4 % vs. 20.9 %; OR: 0.713; 95 % CI: 0.21-2.548; p = 0.62). There was significant heterogeneity in the 2- and 3-year survival analyses. The pooled median overall survival was longer for DEB-TACE (22.6 vs. 14.7 months). There was no significant difference in tumour response rate. DEB-TACE and {sup 90}Y-radioembolization are efficacious treatments for patients suffering from HCC; DEB-TACE demonstrated survival benefit at 1-year compared to {sup 90}Y-radioembolization but direct comparison is warranted for further evaluation. (orig.)

Efficiency calibration of a liquid scintillation counter for 90Y Cherenkov counting

International Nuclear Information System (INIS)

Vaca, F.; Garcia-Leon, M.

1998-01-01

In this paper a complete and self-consistent method for 90 Sr determination in environmental samples is presented. It is based on the Cherenkov counting of 90 Y with a conventional liquid scintillation counter. The effects of color quenching on the counting efficiency and background are carefully studied. A working curve is presented which allows to quantify the correction in the counting efficiency depending on the color quenching strength. (orig.)

Modulation of chemotherapy-induced cytotoxicity in SH-SY5Y neuroblastoma cells by caffeine and chlorogenic acid.

Science.gov (United States)

Hall, Susan; Anoopkumar-Dukie, Shailendra; Grant, Gary D; Desbrow, Ben; Lai, Richard; Arora, Devinder; Hong, Yinna

2017-06-01

Chemotherapy is an important treatment modality for malignancy but is limited by significant toxicity and it susceptibility to numerous drug interactions. While the interacting effects with medications are well known, there is limited evidence on the interaction with commonly consumed food and natural products. The aim of this study was to evaluate the bioactive constituents of coffee (caffeine and chlorogenic acid) on the cytotoxicity of doxorubicin, gemcitabine, and paclitaxel in vitro. Pretreatment with caffeine (100 nM and 10 μM) sensitized SH-SY5Y cells to doxorubicin-induced toxicity and increased apoptosis and sensitized PC3 cells to gemcitabine-induced toxicity. Pretreatment with 10 μM caffeine decreased total cell reactive oxygen species (ROS) production but increased mitochondrial ROS production. In contrast, caffeine (10 nM and 10 μM) protected cells against gemcitabine-induced toxicity and apoptosis. Similarly, 1 μM and 10 μM caffeine protected cells against paclitaxel-induced toxicity and mitochondrial ROS production. Chlorogenic acid had no effect on chemotherapy-induced toxicity in SH-SY5Y cells. In conclusion, this study provides preliminary evidence that caffeine, not chlorogenic acid, modulates the cytotoxicity of doxorubicin, gemcitabine, and paclitaxel in SH-SY5Y cells via different mechanisms.

Timing of adjuvant chemotherapy and its relation to survival among patients with stage III colon cancer.

Science.gov (United States)

Bos, A C R K; van Erning, F N; van Gestel, Y R B M; Creemers, G J M; Punt, C J A; van Oijen, M G H; Lemmens, V E P P

2015-11-01

Currently available data suggest that delaying the start of adjuvant chemotherapy in colon cancer patients has a detrimental effect on survival. We analysed which factors impact on the timing of adjuvant chemotherapy and evaluated the influence on overall survival (OS). Stage III colon cancer patients who underwent resection and received adjuvant chemotherapy between 2008 and 2013 were selected from the Netherlands Cancer Registry. Timing of adjuvant chemotherapy was subdivided into: ⩽ 4, 5-6, 7-8, 9-10, 11-12 and 13-16 weeks post-surgery. Multivariable regressions were performed to assess the influence of several factors on the probability of starting treatment within 8 weeks post-surgery and to evaluate the association of timing of adjuvant chemotherapy with 5-year OS. 6620 patients received adjuvant chemotherapy, 14% commenced after 8 weeks. Factors associated with starting treatment after 8 weeks were older age (Odds ratio (OR) 65-74 versus colon cancer patients within 8 weeks post-surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

Country report: Cuba. Local Production of {sup 90}Y And {sup 188}Re Radionuclides and Development of Radiopharmaceuticals for Therapy

Energy Technology Data Exchange (ETDEWEB)

Xiques, Abmel; Hernández, Ignacio; Leyva, René; Pérez, Marylaine; Alonso, Luis Michel; Zamora, Minelys [Centro de Isotopos (CENTIS) (Cuba)

2010-07-01

During the first period of this CRP we could test an efficient and reliable generator system based on ion-chromatography to obtain {sup 90}Y from its parent radionuclide {sup 90}Sr. This production scheme for {sup 90}Y was outlined in the previous CRP related with the development of generator technologies. Quality parameters such as trace metals that can potentially interfere in the labeling of biomoléculas, {sup 90}Y recovery, {sup 90}Sr/{sup 90}Y ratio and radiation dose to bed matrix were evaluated. The results showed that high recovery and radionuclidic purity could be obtained for {sup 90}Y during its repeated separation from the {sup 90}Sr cow. No replacement or treatment of the cow were necessary and low waste generation and {sup 90}Sr losses less that 0.1% after each run were also observed during the present study. A Fab’ fragment was enzimatically produced and purified from the monoclonal antibody h-R3 (Nimotuzumab®). The fragment and the parent antibody were successfully conjugated with DOTA and labeled with {sup 90}Y. The radioinmunoconjugate thus obtained also exhibited a good 24 h in-vitro stability in an excess of DTPA. A {sup 90}Y radiocoloid was prepared in a cromic phosphate particle for radiosynoviorthesis with promising results in animal models. Two alumina based {sup 188}W/{sup 188}Re generators were prepared and their eluates were used in the labeling of hR3-DOTA conjugates. Quality control and in vivo evaluation in comparison with {sup 99m}Tc-hR3 showed very good results and similar pattern of distribution and pharmacokinetic and will be used in clinical trials for cancer patients. (author)

Acute toxicity of postoperative IMRT and chemotherapy for endometrial cancer

International Nuclear Information System (INIS)

Tierney, R.M.; Powell, M.A.; Mutch, D.G.; Gibb, R.K.; Rader, J.S.; Grigsby, P.W.

2007-01-01

The aim of this study was to determine the acute toxicity of postoperative intensity-modulated radiotherapy (IMRT) with and without chemotherapy in patients with endometrial cancer. A total of 19 patients with stages IB-IVB endometrial cancer who underwent surgery and postoperative IMRT were reviewed. The treatment planning goal was to cover the tissue at risk and minimize the dose to the bladder, bowel, and bone marrow. Median dose was 50.4 Gy (range 49.6-51.2 Gy). Altogether, 14 patients underwent chemotherapy; most were given carboplatin and paclitaxel. Toxicity was scored according to the Common Terminology Criteria for Adverse Events version 3.0 (CTCAE). The prescribed radiation treatment was completed in all patients. The prescribed cycles of chemotherapy were completed in all 14 patients, except one who received five of six cycles limited by prolonged thrombocytopenia. Chemotherapy was delayed in two patients (14%). Three patients required growth factor support during chemotherapy, and one patient required a blood transfusion. Acute grades 3-4 hematological toxicity occurred in 9 of the 14 patients (64%) who underwent chemotherapy. None experienced acute grade 3 or 4 genitourinary or gastrointestinal toxicity. Adjuvant IMRT and chemotherapy following surgery in patients with endometrial cancer is well tolerated and did not lead to treatment modification in most patients. (author)

A Woman with Black Beads in Her Stomach: Severe Gastric Ulceration Caused by Yttrium-90 Radioembolization

Directory of Open Access Journals (Sweden)

Indu S. Voruganti

2018-01-01

Full Text Available Radioembolization (RE is a selective internal radiation therapy (SIRT delivering targeted, high-dose, intra-arterial radiation directly to the vascular supply of liver tumors. Complications can occur due to aberrant deposition or migration of radiation microspheres into nontarget locations, including normal hepatic parenchyma, lungs, pancreas, and upper gastrointestinal (UGI tract. We report a case of gastric ulcers due to yttrium-90 (90Y seed migration to the stomach to alert clinicians to this rare cause of gastric injury. A 57-year-old woman with stage IV breast cancer with liver and lung metastases presented to the hospital with 2 months of worsening nausea and vomiting. Two months prior, she had received SIRT with 90Y microspheres without complications. Upper GI endoscopy showed diffuse gastritis and extensive antral ulceration. Biopsies revealed black, spherical foreign bodies, consistent with 90Y microspheres, documenting radiation injury. Radiation-induced UGI ulceration is caused by direct radiation injury from beta-radiation. Delay in diagnosis may be due to the nonspecificity of symptoms and temporal delay of symptom onset from SIRT, which was 2 months in our patient. Also, complaints may be attributed erroneously to adjuvant chemotherapy or widespread metastatic disease. Clinicians must consider radiation-associated toxicity in any SIRT-treated patient developing abdominal symptoms.

Improved quantitative 90 Y bremsstrahlung SPECT/CT reconstruction with Monte Carlo scatter modeling.

Science.gov (United States)

Dewaraja, Yuni K; Chun, Se Young; Srinivasa, Ravi N; Kaza, Ravi K; Cuneo, Kyle C; Majdalany, Bill S; Novelli, Paula M; Ljungberg, Michael; Fessler, Jeffrey A

2017-12-01

In 90 Y microsphere radioembolization (RE), accurate post-therapy imaging-based dosimetry is important for establishing absorbed dose versus outcome relationships for developing future treatment planning strategies. Additionally, accurately assessing microsphere distributions is important because of concerns for unexpected activity deposition outside the liver. Quantitative 90 Y imaging by either SPECT or PET is challenging. In 90 Y SPECT model based methods are necessary for scatter correction because energy window-based methods are not feasible with the continuous bremsstrahlung energy spectrum. The objective of this work was to implement and evaluate a scatter estimation method for accurate 90 Y bremsstrahlung SPECT/CT imaging. Since a fully Monte Carlo (MC) approach to 90 Y SPECT reconstruction is computationally very demanding, in the present study the scatter estimate generated by a MC simulator was combined with an analytical projector in the 3D OS-EM reconstruction model. A single window (105 to 195-keV) was used for both the acquisition and the projector modeling. A liver/lung torso phantom with intrahepatic lesions and low-uptake extrahepatic objects was imaged to evaluate SPECT/CT reconstruction without and with scatter correction. Clinical application was demonstrated by applying the reconstruction approach to five patients treated with RE to determine lesion and normal liver activity concentrations using a (liver) relative calibration. There was convergence of the scatter estimate after just two updates, greatly reducing computational requirements. In the phantom study, compared with reconstruction without scatter correction, with MC scatter modeling there was substantial improvement in activity recovery in intrahepatic lesions (from > 55% to > 86%), normal liver (from 113% to 104%), and lungs (from 227% to 104%) with only a small degradation in noise (13% vs. 17%). Similarly, with scatter modeling contrast improved substantially both visually and in

Prognostic value of hemoglobin concentrations in patients with advanced head and neck cancer treated with combined radio-chemotherapy and surgery

International Nuclear Information System (INIS)

Wagner, W.; Hermann, R.; Koch, O.; Hartlapp, J.; Krech, R.

2000-01-01

Purpose: Hemoglobin levels are currently the focus of interest as prognostic factors in patients with head and neck cancer. Most published clinical trials have confirmed hemoglobin to process a significant influence on survival in patients treated with radiotherapy. In our study we have investigated the prognostic value of hemoglobin in a combined modality schedule. Patients and Methods: Forty-three patients with advanced head and neck tumors were treated with combined radiochemotherapy. The therapy comprised 2 courses of induction chemotherapy with ifosfamide (1,500 mg/m 2 , day 1 to 5) and cisplatin (60 mg/m 2 , day 5) followed by hyperfractionated accelerated radiotherapy with a total dose of only 30 Gy. Surgery involved tumor resection and neck dissection. Results: The 1-year overall survival rate and the 2-year survival rate were 79% and 56%, respectively. The 1- and 2-year recurrence-free survival rates were 68% and 49%, respectively. Prognostic factors with an impact on survival were seen in tumor size (T3 vs T4, p=0.0088), response to radio-chemotherapy at the primary site (no vital tumor rest vs vital tumor rest, p=0.045), response to lymph node radio-chemotherapy (no vital tumor cells vs vital tumor cells, p=0.013) and level of hemoglobin after radio-chemotherapy (Hb≥11.5 g/dl vs [de

Toxicity of inhaled 90Y in fused clay particles in beagle dogs. VI

International Nuclear Information System (INIS)

Hobbs, C.H.; Chiffelle, T.L.; Hahn, F.F.; Jones, R.K.; Mauderly, J.L.; McClellan, R.O.; Pickrell, J.A.

1974-01-01

Studies on the metabolism, dosimetry, and effects of inhaled 90 Y in fused clay in the Beagle dog are being continued to assess the consequences of inhalation of an energetic beta emitter that has a short effective half-life in the lung. A radiation dose pattern study in which 12 dogs were sacrificed in pairs at 0, 2, 4, 6, 8, and 12 days post-inhalation exposure has been completed. A longevity study in which 89 dogs have been exposed to 90 Y fused clay with initial lung burdens ranging from 80 to 5200 μCi/kg body weight and 12 control dogs were exposed to stable yttrium in fused clay is in progress. The 90 Y was retained in lung with a half-life similar to its physical half-life (64 hours) and with only small quantities translocated to tracheobronchial lymph nodes, skeleton, and liver. The infinite radiation doses to lung, tracheobronchial lymph nodes, skeleton, and liver for an initial lung burden of 100 μCi 90 Y/kg of body weight were estimated to be 1600, 170, 0.54, and 0.38 rads, respectively. Thirty-eight of 39 dogs with doses to lung from 9300 to 70,000 rads have died at 7.5 to 903 days post-exposure. The one surviving dog in this dose range has radiographic evidence of pulmonary fibrosis at 1316 days post-exposure. All the dogs that died had radiation pneumonitis. The dog that died at 903 days post-exposure with a dose to lung of 11,000 rads also had 2 small pulmonary adenomas. Fifty exposed dogs with doses to lung of 1300 to 7900 rads are surviving with no significant abnormalities at 1278 to 1834 days post-exposure and will be studied for the remainder of their lifespan. (U.S.)

Investigation on the influence of metal ion impurities on the complexation behavior of generator produced {sup 90}Y with different bifunctional chelators

Energy Technology Data Exchange (ETDEWEB)

Pandey, Usha; Gamre, Naresh; Chakravarty, Rubel; Pillai, Maroor Raghavan Ambikalmajan; Dash, Ashutosh [Bhabha Atomic Research Centre, Trombay, Mumbai (India). Radiopharmaceuticals Div.

2014-07-01

While the {sup 90}Sr/{sup 90}Y generator is the exclusive source of obtaining 'no carrier added' {sup 90}Y for targeted therapy, the presence of trace metals in the radiolabeling solutions poses a serious challenge owing to their ability to diminish the {sup 90}Y complexation yields with bifunctional chelators (BFCs). p-SCN-Bn-PCTA is a novel ligand having faster complexation kinetics with a number of radiometals. In this work, a systematic investigation was performed to evaluate the chelating ability of p-SCN-Bn-PCTA for {sup 90}Y and the influence of trace metal ions on it's complexation with {sup 90}Y in comparison to p-SCN-Bn-DTPA and p-SCN-Bn-DOTA using {sup 90}YCl{sub 3} obtained from an electrochemical generator. Results from our study indicate that while p-SCN-Bn-PCTA gave very good radiolabeling yields with {sup 90}Y when the reaction was carried out by heating for few minutes, it was most sensitive to the presence of trace metals, especially Fe(III). An independent and useful observation is that p-SCN-Bn-PCTA could be considered as the ligand of choice for assessing the chemical purity of generator derived {sup 90}Y.

Somatostatin-based radiopeptide therapy with [{sup 177}Lu-DOTA]-TOC versus [{sup 90}Y-DOTA]-TOC in neuroendocrine tumours

Energy Technology Data Exchange (ETDEWEB)

Romer, A.; Seiler, D.; Brunner, P.; Ng, Q.K.T.; Mueller-Brand, J. [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Marincek, N.; Walter, M.A. [University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); University Hospital Bern, Institute of Nuclear Medicine, Bern (Switzerland); Koller, M.T. [University Hospital Basel, Basel Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); Maecke, H.R. [University Hospital Basel, Division of Radiochemistry, Basel (Switzerland); Rochlitz, C. [University Hospital Basel, Department of Oncology, Basel (Switzerland); Briel, M. [University Hospital Bern, Institute of Nuclear Medicine, Bern (Switzerland); University Hospital Basel, Basel Institute for Clinical Epidemiology and Biostatistics, Basel (Switzerland); McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton (Canada); Schindler, C. [University of Basel, Swiss Tropical and Public Health Institute, Basel (Switzerland)

2014-02-15

Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides {sup 90}Y or {sup 177}Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [{sup 90}Y-DOTA]-TOC or [{sup 177}Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Overall, 910 patients underwent 1,804 cycles of [{sup 90}Y-DOTA]-TOC and 141 patients underwent 259 cycles of [{sup 177}Lu-DOTA]-TOC. The median survival after [{sup 177}Lu-DOTA]-TOC and after [{sup 90}Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95 % confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [{sup 177}Lu-DOTA]-TOC over [{sup 90}Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [{sup 177}Lu-DOTA]-TOC treatment (1.4 vs 10.1 %, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8 %, p = 0.32). The present results revealed no difference in median overall survival after [{sup 177}Lu-DOTA]-TOC and [{sup 90}Y-DOTA]-TOC. Furthermore, [{sup 177}Lu-DOTA]-TOC was less haematotoxic than [{sup 90}Y-DOTA]-TOC. (orig.)

Adjuvant Chemotherapy Seemed Not to Have Survival Benefit in Rectal Cancer Patients with ypTis-2N0 After Preoperative Radiotherapy and Surgery from a Population-Based Propensity Score Analysis.

Science.gov (United States)

Hu, Xiang; Li, Ya-Qi; Li, Qing-Guo; Ma, Yan-Lei; Peng, Jun-Jie; Cai, San-Jun

2018-04-19

Adjuvant chemotherapy is currently offered routinely, as standard, after radical resection for patients with rectal cancer receiving neo-adjuvant chemoradiation. However, the efficacy of adjuvant chemotherapy in patients with ypTis-2N0M0 has not been documented to the same extent, and the survival benefit remained controversial. The purpose of this work was to determine the role of chemotherapy in patients with ypTis-2N0M0 classification. Data were obtained from the Surveillance, Epidemiology, and End Results database ( n  = 4,217). A propensity score model was utilized to balance baseline covariates. Of the 4,217 included patients, 335 with ypTis-2N0M0 did not receive adjuvant chemotherapy. There were comparable cancer-specific survivals (CSS) between those undergoing adjuvant chemotherapy or not (log-rank test = 0.136, p  = .712) in the overall sample. After propensity score matching, the cancer-specific survival did not differ between the chemotherapy and observation groups (log-rank test = 0.089, p  = .765). Additionally, the Cox model did not demonstrate adjuvant chemotherapy as the prognostic factor, with hazard ratio = 0.95 (95% confidence interval 0.69-1.32) for CSS. Furthermore, the 10-year cumulative CSS was 78.7% and 79.4% between the chemotherapy and observation groups, indicating no significance, and no impact of adjuvant chemotherapy on survival was observed in different subgroups stratified by T stage, histological grade, histology, lymph nodes, and tumor size. Patients with ypTis-2N0 rectal cancer did not benefit from adjuvant chemotherapy after preoperative radiology and radical surgery in this cohort study. These results provided new insight into the routine use of adjuvant chemotherapy for patients with rectal cancer with completed neo-adjuvant radiotherapy and curative surgery. Inconsistent recommendations for patients with rectal cancer receiving neo-adjuvant chemoradiation are offered by clinical guidelines. Adjuvant

Dosimetry in radionuclide therapies with 90Y-conjugates. The IEO experience

International Nuclear Information System (INIS)

Cremonesi, M.; Ferrari, M.; Chinol, M.; Bartolomei, M.; Sacco, E.; Fiorenza, M.; Tosi, G.; Paganelli, G.; Stabin, M. G.

2000-01-01

The basis for successful radionuclide therapy is a high and stable uptake of the radiopharmaceutical in the target tissue along with low activity concentration in other normal organs. The contribution of dosimetry in radionuclide therapy is to predict before the treatment the absorbed doses in tumor and normal organs, to identify the critical organs, to minimize any possible toxicity and to evaluate the maximum tolerated dose. In this article is reported the experience concerning pharmacokinetics and dosimetry of two 90 Y-therapeutic protocols: 3-step pretargeting radioimmunotherapy (RIT) according to the biotin-avidin system and receptor mediated radionuclide therapy with the somatostatin analogue (DOTA-D-Phe 1 -Tyr 3 ) octreotide named DOTATOC. For the dosimetric analysis, analogous approaches for the two radiolabeled compounds due to the similar pharmacokinetic characteristics were adopted; the MIRD formalism was applied, taking into account both the physical and the biological characteristics of the radio conjugate and patients' metabolism. In order to determine biological clearance, serial blood samples and complete urine collection were obtained up to 48 hours after injection; to evaluate biodistribution, several whole body scans were acquired. Both therapies showed the advantageous characteristics of a fast blood clearance and a predominantly renal excretion of the radiopharmaceuticals thus lowering the irradiation of the total body. Although pharmacokinetic characteristics were similar, different critical organs were found for the two therapies: in particular, some considerations regarding red marrow, spleen and kidneys were required. The results of the studies indicate that high activities of 90 Y-biotin (3-step RIT) and 90 Y-DOTATOC can be administered with acceptable radiation doses to normal organs

Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia.

LENUS (Irish Health Repository)

Alazzam, Mo'iad

2012-12-01

Gestational trophoblastic neoplasia (GTN) is a highly curable group of pregnancy-related tumours; however, approximately 25% of GTN tumours will be resistant to, or will relapse after, initial chemotherapy. These resistant and relapsed lesions will require salvage chemotherapy with or without surgery. Various salvage regimens are used worldwide. It is unclear which regimens are the most effective and the least toxic.

{sup 68}Ga-DOTATATE PET/CT in recurrent medullary thyroid carcinoma: a lesion-by-lesion comparison with {sup 111}In-octreotide SPECT/CT and conventional imaging

Energy Technology Data Exchange (ETDEWEB)

Yamaga, Lilian Yuri Itaya; Cunha, Marcelo L.; Campos Neto, Guilherme C.; Garcia, Marcio R.T.; Wagner, Jairo; Funari, Marcelo B.G. [Hospital Israelita Albert Einstein, Imaging Department, Sao Paulo (Brazil); Yang, Ji H.; Camacho, Cleber P. [Universidade Federal de Sao Paulo, Multiple Neoplasia Outpatiet Clinic, Sao Paulo (Brazil)

2017-09-15

The aim of this study was to prospectively compare the detection rate of {sup 68}Ga-DOTATATE PET-CT with {sup 111}In-octreotide SPECT-CT and conventional imaging (CI) in medullary thyroid carcinoma (MTC) patients with increased calcitonin (Ctn) levels but negative CI after thyroidectomy. Fifteen patients with raised Ctn levels and/or CI evidence of recurrence underwent {sup 68}Ga-DOTATATE PET-CT, {sup 111}In-octreotide SPECT-CT and CI. Histopathology, CI and biochemical/clinical/imaging follow-up were used as the reference standard. PET/CT, SPECT/CT and CI were compared in a lesion-based and organ-based analysis. PET/CT evidenced recurrence in 14 of 15 patients. There were 13 true positive (TP), 1 true negative (TN), 1 false positive (FP) and no false negative (FN) cases, resulting in a sensitivity and accuracy of 100% and 93%. SPECT/CT was positive in 6 of 15 cases. There were 6 TP, 2 TN, 7 FN and no FP cases, resulting in a sensitivity of 46% and accuracy of 53%. CI procedures detected tumor lesions in 14 of 15 patients. There were 13 TP, 1TN, 1 FP and no FN cases with a sensitivity of 100% and accuracy of 93%. A significantly higher number of lesions was detected by PET/CT (112 lesions, p = 0.005) and CI (109 lesions, p = 0.005) in comparison to SPECT/CT (16 lesions). There was no significant difference between PET/CT and CI for the total number of detected lesions (p = 0.734). PET/CT detected more lesions than SPECT/CT regardless of the organ. PET/CT detected more bone lesions but missed some neck nodal metastases evidenced by CI. The number of lesions per region demonstrated by PET/CT and CI were similar in the other sites. {sup 68}Ga-DOTATATE PET/CT is superior to {sup 111}In-octreotide SPECT/CT for the detection of recurrent MTC demonstrating a significantly higher number of lesions. {sup 68}Ga-DOTATATE PET/CT showed a superior detection rate compared to CI in demonstrating bone metastases. (orig.)

Evaluation of a pyrex glass shield for the dose reduction in extremities to manipulate a {sup 90} Sr- {sup 90} Y generator; Evaluacion de un blindaje de vidrio pyrex para la reduccion de las dosis en extremidades al manipular un generador de {sup 90} Sr- {sup 90} Y

Energy Technology Data Exchange (ETDEWEB)

Ayra P, F.E.; Xiques C, A.; Torres B, M.B. [Centro de Isotopos, Carretera La Rada, Km 3 1/2, Guanabacoa, La Habana (Cuba)]. e-mail: feayra@centis.edu.cu

2006-07-01

The production of Y-90 of high activity it specifies (free of payee) for their use in radioimmunotherapy uses the Strontium 90 as isotope source. Depending on the method employee for the separation of both isotopes several types of generators are described in different bibliographies. The column generator used in the facilities of the Center of Isotopes requires of a frequent manipulation causing significant dose in the skin of the extremities due to the exhibition to the radiation beta of high energy. The properties of the shieldings for this radiation type have been well studied Y they consist in several publications. To be in correspondence with requirements of radiological protection in the Cuban legislation, the column was covered with a tube of glass pyrex of 5 mm of thickness and it was monitored the exposure with an ionization chamber. At the own time, the shielding using the Monte Carlo method was evaluated. It was used the MCNP 4C code to simulate the absorption of the beta particles generated in the process of disintegration of the Sr-90 and Y-90 in the glass shielding. The column generator and the fluence of beta particles were modeled in different points inside the shielding to determine if the experimentally measured values correspond to electrons that were not absorbed or to the weak stopping radiation generated in the glass due to the deceleration of these particles. A cylinder of 4 mm of diameter simulates the source (it dilutes) and a tube of walls of 6 mm of thickness simulates the shielding more the wall of the column around the generator. This it was divided in cells of 1 mm of thickness and the energy deposited in them was evaluated. The results show that all the electrons generated in the source are absorbed in the shielding and the exposure rates decrease in more of 78 times using the 5 mm of pyrex glass. The doses in extremities to the operators of the generator don't surpass the 70 mSv by year that is the dose restriction imposed in

Country report: Brazil. Development of Radiopharmaceuticals Based on {sup 188}Re and {sup 90}Y for Radionuclide Therapy at IPEN-CNEN/SP

Energy Technology Data Exchange (ETDEWEB)

Osso, Jr., J. A.; Barrio, G.; Dias, C. R.B.R.; Brambilla, T. P.; Dantas, D. M.; Suzuki, K. N.; Barboza, M. F.S.; Bortoleti, E.; Fukumori, N. T.; Mengatti, J. [Radiopharmacy Center – Institute of Energetic and Nuclear Research – IPE N-CNEN/SP, São Paulo – Brazil (Brazil)

2010-07-01

The overall objective of this CRP is to develop radiopharmaceuticals for targeted therapy using {sup 188}Re and {sup 90}Y and to study the performance of generators with long lived parent radionuclides as well as to validate the QC control procedures for estimating the purity of generator eluents. The CRP is expected to enhance the capability in production of {sup 90}Y and {sup 188}Re radiopharmaceuticals to meet the increasing demand of therapeutic products for clinical applications, in particular in Brazil. In this period efforts were made towards the assembling of {sup 90}Sr-{sup 90}Y generators, quality control of {sup 90}Y, the labelling of DMSA(V) and anti-CD20 with {sup 188}Re and the labelling of Hydroxiapatite(HA) with {sup 90}Y. (author)

Large-scale purification of {sup 90}Sr from nuclear waste materials for production of {sup 90}Y, a therapeutic medical radioisotope

Energy Technology Data Exchange (ETDEWEB)

Wester, D.W.; Steele, R.T.; Rinehart, D.E.; DesChane, J.R.; Carson, K.J.; Rapko, B.M.; Tenforde, T.S. E-mail: tenforde@ncrp.com

2003-07-01

A major limitation on the supply of the short-lived medical isotope {sup 90}Y (t{sub 1/2}=64 h) is the available quantity of highly purified {sup 90}Sr generator material. A radiochemical production campaign was therefore undertaken to purify 1500 Ci of {sup 90}Sr that had been isolated from fission waste materials. A series of alkaline precipitation steps removed all detectable traces of {sup 137}Cs, alpha emitters, and uranium and transuranic elements. Technical obstacles such as the buildup of gas pressure generated upon mixing large quantities of acid with solid {sup 90}Sr carbonate were overcome through safety features incorporated into the custom-built equipment used for {sup 90}Sr purification. Methods are described for analyzing the chemical and radiochemical purity of the final product and for accurately determining by gravimetry the quantities of {sup 90}Sr immobilized on stainless steel filters for future use.

Adjuvant chemotherapy for rectal cancer: Is it needed?

Science.gov (United States)

Milinis, Kristijonas; Thornton, Michael; Montazeri, Amir; Rooney, Paul S

2015-01-01

Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies. PMID:26677436

Country report: Pakistan. Second Research Co-ordination Meeting on Development of Radiopharmaceuticals Based on 188Re and 90Y for Radionuclide Therapy, 22-26 March 2010, Vienna

International Nuclear Information System (INIS)

Mansur, M.S.; Mushtaq, A.

2010-01-01

Various experiments were carried out for the separation of 90 Y from 90 Sr using colloid formation behavior of 90 Y in basic pH range. When the acidic solution of 90 Sr/ 90 Y was treated with NaOH and passed through a small glass wool column, more than 95% 90 Y was retained on glass wool, which was further washed with 0.1 M NaOH. The 90 Y was extracted in 1 M HCl. Radionuclidic purity was determined by half life measurement. The contamination of parent was less than 0.0001%. Similarly when the colloid was passed through membrane filter more than 95% 90 Y was retained which was recovered by 1 M HCl. The contamination of 90 Sr was less than 0.0001%. The stock solution of 90 Sr/ 90 Y in NH 4 OH/NaOH was again passed through Millipore filter paper or glass wool after one week. The retention of 90Y was insignificant. The equilibrium mixture of 90 Sr/ 90 Y was acidified with HCl and again precipitated with addition of NH 4 OH or NaOH. The basic solution was passed through the Millipore filter or glass wool. More than 90% activity of 90 Y was retained, which was finally extracted in 1 M HCl It was concluded that for recovery of 90 Y from 90 Sr by colloid formation, the acidic solution of 90 Sr/ 90 Y shall be freshly precipitated by NH 4 OH or NaOH. It was also observed that the adsorption of 90 Y was quite high when the 90 Sr solution was left in a glass vial for the growth of 90 Y. However it can be easily extracted after keeping it in boiling water bath for few minutes. The separated 90 Y via colloid formation was used for the labeling of EDTMP. Labeling efficiency of 90 Y-EDTMP was more than 98%

Sequential response patterns to chemotherapy and radiotherapy in head and neck cancer

International Nuclear Information System (INIS)

Hong, W.K.; O'Donoghue, G.M.; Sheetz, S.

1985-01-01

Surgery and/or radiotherapy have been the standard therapies for locally advanced squamous cell carcinoma of the head and neck region. Despite major improvement in these therapeutic techniques, the control rate in cases of advanced cancer remains poor. More recently, induction chemotherapy as initial treatment has been used in previously untreated squamous cell carcinoma of the head and neck. For the last 6 years at the Boston Veterans Administration (V.A.) Medical Center, initial induction chemotherapy followed by surgery and/or radiotherapy has been employed in the treatment of advanced head and neck cancer. The use of chemotherapy and radiotherapy has allowed the authors to monitor and correlate sequential response patterns produced by each modality of treatment. The authors have observed that responders to chemotherapy can be predicted to have further response to subsequent radiotherapy

Dosimetry analysis of distributions radials dose profiles of {sup 90}Sr + {sup 90}Y beta therapy applicators using the MCNP-4C code and radio chromium films; Analise dosimetrica de perfis de distribuicoes radias de doses relativas de um aplicador de betaterapia de {sup 90}Sr + {sup 90}Y utilizando o codigo MCNP-4C e filmes radiocromicos

Energy Technology Data Exchange (ETDEWEB)

Coelho, Talita S.; Yoriyaz, Helio [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Fernandes, Marco A.R., E-mail: tasallesc@gmail.co [UNESP, Botucatu, SP (Brazil). Faculdade de Medicina. Servico de Radioterapia; Louzada, Mario J.Q. [UNESP, Aracatuba, SP (Brazil). Curso de Medicina Veterinaria

2011-07-01

Although they are no longer manufactured, the applicators of {sup 90}Sr + {sup 90}Y acquired in the decades of 1990 are still in use, by having half-life of 28.5 years. These applicators have calibration certificate given by their manufacturers, where few have been re calibrated. Thus it becomes necessary to accomplish thorough dosimetry of these applicators. This paper presents a dosimetric analysis distribution radial dose profiles for emitted by an {sup 90}Sr + {sup 90}Y beta therapy applicator, using the MCNP-4C code to simulate the distribution radial dose profiles and radio chromium films to get them experimentally . The results with the simulated values were compared with the results of experimental measurements, where both curves show similar behavior, which may validate the use of MCNP-4C and radio chromium films for this type of dosimetry. (author)

Dosimetry analysis of distribution radial dose profiles of {sup 90}Sr + {sup 90}Y beta therapy applicators using the MCNP-4C code and radio chromium films; Analise dosimetrica de perfis de distribuicoes radiais de doses relativas de um aplicador de betaterapia de {sup 90}Sr + {sup 90}Y utilizando o codigo MCNP-4C e filmes radiocromicos

Energy Technology Data Exchange (ETDEWEB)

Coelho, T.S.; Yoriyaz, H. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Fernandes, M.A.R. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Fac. de Medicina. Servico de Radioterapia; Louzada, M.J.Q. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Aracatuba, SP (Brazil). Curso de Medicina Veterinaria

2010-07-01

Although they are no longer manufactured, the applicators of {sup 90}Sr +{sup 90}Y acquired in the decades of 1990 are still in use, by having half-life of 28.5 years. These applicators have calibration certificate given by their manufacturers, where few have been recalibrated. Thus it becomes necessary to accomplish thorough dosimetry of these applicators. This paper presents a dosimetric analysis distribution radial dose profiles for emitted by an {sup 90}Sr+{sup 90}Y beta therapy applicator, using the MCNP-4C code to simulate the distribution radial dose profiles and radiochromium films to get them experimentally . The results with the simulated values were compared with the results of experimental measurements, where both curves show similar behavior, which may validate the use of MCNP-4C and radiochromium films for this type of dosimetry. (author)

Studying on process for labeling of EDTMP with 90Y using for bone pain palliation

International Nuclear Information System (INIS)

Pham Ngoc Dien; Duong Van Dong; Dang Ho Hong Quang; Nguyen Thanh Binh; Bui Van Cuong; Nguyen Dang Khoa; Nguyen Thi Thu; Mai Phuoc Tho; Vo Cam Hoa

2013-01-01

This Study describes the method for preparation of labelling compound Ethylene diamine tetramethylene phosphonic acid (EDTMP) with 90 Y. Malignant cancer is one of the most important resulting in human death. Bone metastases in nearly 25% of all cancer patients; so it is useful to develop radiopharmaceuticals for the treatment of bone cancer. Yttrium-90 is high energy (2.3 MeV) beta emitter required with a physical haft life of 2.7 days which has limited bone-seeking properties. Its physical properties make it ideal for therapeutic application, the most energetic beta emission being able to penetrate to 1 cm from the site of deposition in soft tissue with an average range of approximately 4 mm. Theoretically, therefore, it can penetrate all marrow spaces in normal trabecular bone and conceivably even to the centre of large tumours where bone destruction may be extensive. Specific deposition of 90 Y into the skeleton demands its delivery in a chemical form with affinity for bone mineral alone. Compounds with these properties are the phosphonate analogues of polyaminocarboxylic acids, and one in particular EDTMP (ethylen diamine tetra methylene phosphonate) has already been used to target 153 Sm to bone mineral with success. Because of chemical similarities between 90 Y and the rare earths, EDTMP should form stable complexes with 90 Y and carry it specifically to the bone with comparable efficiency. Skeletal uptake of β - emitting radionuclides may be used for bone pain palliation or myeloablation. The physical characteristics of the β - particles required for the two conditions are, however, different, that is, higher energies are favorable for destruction of bone marrow. (author)

The somatostatin receptor-targeted radiotherapeutic [{sup 90}Y-DOTA-dPhe{sup 1},Tyr{sup 3}]octreotide ({sup 90}Y-SMT 487) eradicates experimental rat pancreatic CA 20948 tumours

Energy Technology Data Exchange (ETDEWEB)

Stolz, B.; Weckbecker, G.; Smith-Jones, P.M.; Albert, R.; Raulf, F.; Bruns, C. [Novartis Pharma AG, Basel (Switzerland)

1998-07-01

Somatostatin receptor-expressing tumours are potential targets for therapy with radiolabelled somatostatin analogues. We have synthesized a number of such analogues in the past and identified [DOTA-dPhe{sup 1}, Tyr{sup 3}]octreotide (SMT 487) as the most promising candidate molecule because of its advantageous properties in cellular and in vivo tumour models. In the current paper we describe the radiotherapeutic effect of yttrium-90 labelled SMT 487 in Lewis rats bearing the somatostatin receptor-positive rat pancreatic tumour CA 20948. SMT 487 binds with nanomolar affinity to both the human and the rat somatostatin receptor subtype 2 (sst{sub 2}) (human sst{sub 2} IC{sub 50}=0.9 nM, rat sst{sub 2} IC{sub 50}=0.5 nM). In vivo, {sup 90}Y-SMT 487 distributed rapidly to the sst{sub 2} expressing CA 20948 rat pancreatic tumour, with a tumour-to-blood ratio of 49.15 at 24 h post injection. A single intravenous administration of 10 mCi/kg {sup 90}Y-SMT 487 resulted in a complete remission of the tumours in five out of seven CA 20948 tumour-bearing Lewis rats. No regrowth of the tumours occurred 8 months post injection. Control animals that were treated with 30 {mu}g/kg of unlabelled SMT 487 had to be sacrificed 10 days post injection due to excessive growth or necrotic areas on the tumour surface. Upon re-inoculation of tumour cells into those rats that had shown complete remission, the tumours disappeared after 3-4 weeks of moderate growth without any further treatment. The present study shows for the first time the curative potential of {sup 90}Y-SMT 487-based radiotherapy for somatostatin receptor-expressing tumours. Clinical phase I studies with yttrium-labelled SMT 487 have started in September 1997. (orig.) With 4 figs., 2 tabs., 29 refs.

Predictive test for chemotherapy response in resectable gastric cancer: a multi-cohort, retrospective analysis.

Science.gov (United States)

Cheong, Jae-Ho; Yang, Han-Kwang; Kim, Hyunki; Kim, Woo Ho; Kim, Young-Woo; Kook, Myeong-Cherl; Park, Young-Kyu; Kim, Hyung-Ho; Lee, Hye Seung; Lee, Kyung Hee; Gu, Mi Jin; Kim, Ha Yan; Lee, Jinae; Choi, Seung Ho; Hong, Soonwon; Kim, Jong Won; Choi, Yoon Young; Hyung, Woo Jin; Jang, Eunji; Kim, Hyeseon; Huh, Yong-Min; Noh, Sung Hoon

2018-05-01

Adjuvant chemotherapy after surgery improves survival of patients with stage II-III, resectable gastric cancer. However, the overall survival benefit observed after adjuvant chemotherapy is moderate, suggesting that not all patients with resectable gastric cancer treated with adjuvant chemotherapy benefit from it. We aimed to develop and validate a predictive test for adjuvant chemotherapy response in patients with resectable, stage II-III gastric cancer. In this multi-cohort, retrospective study, we developed through a multi-step strategy a predictive test consisting of two rule-based classifier algorithms with predictive value for adjuvant chemotherapy response and prognosis. Exploratory bioinformatics analyses identified biologically relevant candidate genes in gastric cancer transcriptome datasets. In the discovery analysis, a four-gene, real-time RT-PCR assay was developed and analytically validated in formalin-fixed, paraffin-embedded (FFPE) tumour tissues from an internal cohort of 307 patients with stage II-III gastric cancer treated at the Yonsei Cancer Center with D2 gastrectomy plus adjuvant fluorouracil-based chemotherapy (n=193) or surgery alone (n=114). The same internal cohort was used to evaluate the prognostic and chemotherapy response predictive value of the single patient classifier genes using associations with 5-year overall survival. The results were validated with a subset (n=625) of FFPE tumour samples from an independent cohort of patients treated in the CLASSIC trial (NCT00411229), who received D2 gastrectomy plus capecitabine and oxaliplatin chemotherapy (n=323) or surgery alone (n=302). The primary endpoint was 5-year overall survival. We identified four classifier genes related to relevant gastric cancer features (GZMB, WARS, SFRP4, and CDX1) that formed the single patient classifier assay. In the validation cohort, the prognostic single patient classifier (based on the expression of GZMB, WARS, and SFRP4) identified 79 (13%) of 625

Occupational doses in neuroendocrine tumors by using 177Lu DOTATATE

International Nuclear Information System (INIS)

Costa, Gustavo Coelho Alves; Sa, Lidia Vasconcellos de

2011-01-01

This paper investigated the treatment of neuroendocrine tumors (abdominal tumors) using of 177 Lu DOTATATE radiopharmaceutical which is a type of treatment presently used in the experimental form in Brazil and, therefore, not contemplated in norms or specific use. This research studied the occupational doses of this treatment and suggested guidelines or rules of procedures viewing the radiological protection of workers involved and the public. The treatment were followed up by using two types of radiation detection, one a scintillator and a Geiger-Muller, and the measurements were performed in a public hospital at Rio de Janeiro and the other in a private hospital at Sao Paulo. It was observed that the equivalent occupational doses can variate from 160 μSv to 450 μSv, in function of operator, of stage of manipulation, and of the administration method, which can be through the use of infusion pump or manual injection. The use of infusion pump is highly recommended and the hospitalization of the patient until the dose rate measured at 1 m does not surpass 20 μSv/h

Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers.

Science.gov (United States)

Imhof, Anna; Brunner, Philippe; Marincek, Nicolas; Briel, Matthias; Schindler, Christian; Rasch, Helmut; Mäcke, Helmut R; Rochlitz, Christoph; Müller-Brand, Jan; Walter, Martin A

2011-06-10

To investigate response, survival, and safety profile of the somatostatin-based radiopeptide (90)yttrium-labeled tetraazacyclododecane-tetraacetic acid modified Tyr-octreotide ([(90)Y-DOTA]-TOC) in neuroendocrine cancers. In a clinical phase II single-center open-label trial, patients with neuroendocrine cancers were treated with repeated cycles of [(90)Y-DOTA]-TOC. Each cycle consisted of a single intravenous injection of 3.7GBq/m(2) body-surface [(90)Y-DOTA]-TOC. Additional cycles were withheld in case of tumor progression and/or permanent toxicity. Overall, 1,109 patients received 2,472 cycles of [(90)Y-DOTA]-TOC (median, two; range, one to 10 cycles per patient). Of the 1,109 patients, 378 (34.1%) experienced morphologic response; 172 (15.5%), biochemical response; and 329 (29.7%), clinical response. During a median follow-up of 23 months, 491 patients (44.3%) died. Longer survival was correlated with each: morphologic (hazard ratio [HR], 0.46; 95% CI, 0.38 to 0.56; median survival, 44.7 v 18.3 months; P TOC treatment in a large cohort. Response to [(90)Y-DOTA]-TOC is associated with longer survival. Somatostatin receptor imaging is predictive for both survival after [(90)Y-DOTA]-TOC treatment and occurrence of renal toxicity.

Adjuvant chemotherapy and cancer cure

International Nuclear Information System (INIS)

Bertino, J.R.

1983-01-01

The use of chemotherapy as an adjuvant to surgery and/or radiotherapy is well founded in experimental tumor systems and appears to be effective in patients in some circumstances. It is clear from both clinical and experimental studies that (1) the dose is important, (2) the earlier chemotherapy is started after primary therapy the better, and (3) combination chemotherapy may be more effective than single-agent treatment. The better the estimation of risk of recurrence, the better the assessment of the risk-benefit ratio with adjuvant therapy. Salvage therapy as well as relative risk of recurrence are considerations in the choice of patients to be treated. Finally, some evidence is presented to indicate that alkylating agents may not be necessary in combination regimens for adjuvant therapy if effective antimetabolite combinations are available

Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis

Energy Technology Data Exchange (ETDEWEB)

Bajpai, Jyoti; Bakhshi, Sameer [Dr. B. R. A. Institute Rotary Cancer Hospital, Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi (India); Gamnagatti, Shivanand [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Kumar, Rakesh; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Sreenivas, Vishnubhatla [All India Institute of Medical Sciences, Department of Biostatistics, New Delhi (India); Sharma, Mehar Chand; Safaya, Rajni [All India Institute of Medical Sciences, Department of Pathology, New Delhi (India); Khan, Shah Alam; Rastogi, Shishir [All India Institute of Medical Sciences, Department of Orthopedics, New Delhi (India)

2011-04-15

Histological necrosis, the current standard for response evaluation in osteosarcoma, is attainable after neoadjuvant chemotherapy. To establish the role of surrogate markers of response prediction and evaluation using MRI in the early phases of the disease. Thirty-one treatment-naive osteosarcoma patients received three cycles of neoadjuvant chemotherapy followed by surgery during 2006-2008. All patients underwent baseline and post-chemotherapy conventional, diffusion-weighted and dynamic contrast-enhanced MRI. Taking histological response (good response {>=}90% necrosis) as the reference standard, various parameters of MRI were compared to it. A tumor was considered ellipsoidal; volume, average tumor plane and its relative value (average tumor plane relative/body surface area) was calculated using the standard formula for ellipse. Receiver operating characteristic curves were generated to assess best threshold and predictability. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Both pre-and post-chemotherapy absolute and relative-size parameters correlated well with necrosis. Apparent diffusion coefficient did not correlate with necrosis; however, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter: diffusion per unit volume. In osteosarcoma, chemotherapy response can be predicted and evaluated by conventional and diffusion-weighted MRI early in the disease course and it correlates well with necrosis. Further, newly derived parameter diffusion per unit volume appears to be a sensitive substitute for response evaluation in osteosarcoma. (orig.)

Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis

International Nuclear Information System (INIS)

Bajpai, Jyoti; Bakhshi, Sameer; Gamnagatti, Shivanand; Kumar, Rakesh; Malhotra, Arun; Sreenivas, Vishnubhatla; Sharma, Mehar Chand; Safaya, Rajni; Khan, Shah Alam; Rastogi, Shishir

2011-01-01

Histological necrosis, the current standard for response evaluation in osteosarcoma, is attainable after neoadjuvant chemotherapy. To establish the role of surrogate markers of response prediction and evaluation using MRI in the early phases of the disease. Thirty-one treatment-naive osteosarcoma patients received three cycles of neoadjuvant chemotherapy followed by surgery during 2006-2008. All patients underwent baseline and post-chemotherapy conventional, diffusion-weighted and dynamic contrast-enhanced MRI. Taking histological response (good response ≥90% necrosis) as the reference standard, various parameters of MRI were compared to it. A tumor was considered ellipsoidal; volume, average tumor plane and its relative value (average tumor plane relative/body surface area) was calculated using the standard formula for ellipse. Receiver operating characteristic curves were generated to assess best threshold and predictability. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Both pre-and post-chemotherapy absolute and relative-size parameters correlated well with necrosis. Apparent diffusion coefficient did not correlate with necrosis; however, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter: diffusion per unit volume. In osteosarcoma, chemotherapy response can be predicted and evaluated by conventional and diffusion-weighted MRI early in the disease course and it correlates well with necrosis. Further, newly derived parameter diffusion per unit volume appears to be a sensitive substitute for response evaluation in osteosarcoma. (orig.)

Does 99mTc MAA study accurately predict the Hepatopulmonary shunt fraction of 90Y theraspheres?

International Nuclear Information System (INIS)

Jha, Ashish; Zade, A.; Monteiro, P.; Shah, S.; Purandare, N.C.; Rangarajan, V.; Kulkarni, S.; Kulkarni, A.; Shetty, Nitin

2010-01-01

Full text: Transarterial-radioembolisation (TARE) is FDA approved therapeutic option for primary and metastatic liver malignancy when patient is inoperable; which in addition to the embolic effect (as seen with Transarterial- chemoembolisation-TACE) also gives the benefit of selectively irradiation to the target lesions with minimal toxicity to adjacent normal hepatocytes. However there is a risk of shunting of radioactive spheres to pulmonary circulation and subsequent pulmonary toxicity if the hepatopulmonary shunt fraction is high. The estimated lung dose becomes the limiting factor for the dose that can be delivered trans-arterially for radioembolisation of hepatic neoplasms.This is achieved by a pretreatment 99m Tc MAA study. Aim: The accuracy of 99m Tc-MAA Scintigraphy to predict the hepatopulmonary shunt fraction of 90 Y Theraspheres was evaluated by comparing it with that obtained by post therapeutic Bremsstrahlung imaging. Materials and Methods: Patients: 13 patients who underwent 90 Y Theraspheres radioembolisation of hepatic malignancies (both primary and secondary) underwent pre therapeutic 99m Tc- MAA Scintigraphy and post therapeutic 90 Y Bremsstrahlung Scintigraphy. 10-12 mCi of freshly prepared 99m Tc MAA was administered by selective hepatic artery cauterization. Planar and tomographic images were acquired within 1hr of radiopharmaceutical administration. IMAGE ACQUISITION 99m Tc MAA static images were acquired in 256 x 256 matrix (1000 KCnts) and SPECT were a 128 x 128 matrix with 64 frames (20 s/frame). The scan parameters for CT were 140 kV, 2.5 mAs, and 1-cm slices. SPECT images were corrected for attenuation and scatter. Post therapeutic 90 Y Bremsstrahlung imaging was done with HEGP collimator with photo peak centered at 140 KeV - 64.29% and +56% window width. SPECT/CT images were obtained using a dual-detector gamma-camera with a mounted 1-row CT scanner (Infinia Hawkeye; GE medical systems) to evaluate hepatic and extra hepatic tracer

Occupational doses in neuroendocrine tumors by using {sup 177}Lu DOTATATE; Doses ocupacionais em tratamento de tumores neuroendocrinos utilizando {sup 17'}7Lu DOTATATE

Energy Technology Data Exchange (ETDEWEB)

Costa, Gustavo Coelho Alves; Sa, Lidia Vasconcellos de, E-mail: gustavo@ird.gov.b, E-mail: lidia@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

2011-10-26

This paper investigated the treatment of neuroendocrine tumors (abdominal tumors) using of {sup 177}Lu DOTATATE radiopharmaceutical which is a type of treatment presently used in the experimental form in Brazil and, therefore, not contemplated in norms or specific use. This research studied the occupational doses of this treatment and suggested guidelines or rules of procedures viewing the radiological protection of workers involved and the public. The treatment were followed up by using two types of radiation detection, one a scintillator and a Geiger-Muller, and the measurements were performed in a public hospital at Rio de Janeiro and the other in a private hospital at Sao Paulo. It was observed that the equivalent occupational doses can variate from 160 {mu}Sv to 450 {mu}Sv, in function of operator, of stage of manipulation, and of the administration method, which can be through the use of infusion pump or manual injection. The use of infusion pump is highly recommended and the hospitalization of the patient until the dose rate measured at 1 m does not surpass 20 {mu}Sv/h

Dosimetry of a 90Y-hydroxide liquid brachytherapy treatment approach to canine osteosarcoma using PET/CT

International Nuclear Information System (INIS)

Zhou, Jien Jie; Gonzalez, Arnulfo; Lenox, Mark W.; Fossum, Theresa W.; Frank, R. Keith; Simon, Jaime; Stearns, Stan; Ruoff, Catherine M.; Wendt, Richard E.; Akabani, Gamal

2015-01-01

A new treatment strategy based on direct injections of 90 Y-hydroxide into the tumor bed in dogs with osteosarcoma was studied. Direct injections of the radiopharmaceutical into the tumor bed were made according to a pretreatment plan established using 18 F-FDG images. Using a special drill, cannulas were inserted going through tissue, tumor and bone. Using these cannulas, direct injections of the radiopharmaceutical were made. The in vivo biodistribution of 90 Y-hydroxide and the anatomical tumor bed were imaged using a time-of-flight (TOF) PET/CT scanner. The material properties of the tissues were estimated from corresponding CT numbers using an electron-density calibration. Radiation absorbed dose estimates were calculated using Monte Carlo methods where the biodistribution of the pharmaceutical from PET images was sampled using a collapsing 3-D rejection technique. Dose distributions in the tumor bed and surrounding tissues were calculated, showing significant heterogeneity with multiple hot spots at injection sites. Dose volume histograms showed that approximately 33.9% of bone and tumor and 70.2% of bone marrow and trabecular bone received an absorbed dose over 200 Gy; approximately 3.2% of bone and tumor and 31.0% of bone marrow and trabecular bone received a total dose of over 1000 Gy. - Graphical abstract: Treatment of canine osteosarcoma using 90 Y-hydroxide using localized liquid brachytherapy. A 3-D co-registered PET/CT image showing the distribution of 90 Y in the left tibia of a dog with osteosarcoma. Multiple high activity hotspots are shown within bone marrow and isolated hotspots within the tumor bed, corresponding to the sites of administration. Absorbed doses were estimated to be as high as 2000 Gy to tumor. - Highlights: • A liquid brachytherapy treatment of canine osteosarcoma using 90 Y hydroxyapatite is presented. • Dosimetry of 90 Y hydroxyapatite liquid brachytherapy was carried out using PET-CT. • Activity distribution correlated

Inflammation-induced synergetic enhancement of nanoparticle treatments with DOXIL{sup ®} and {sup 90}Y-Lactosome for orthotopic mammary tumor

Energy Technology Data Exchange (ETDEWEB)

Kurihara, Kensuke; Ueda, Motoki [Graduate School of Medicine, Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine (Japan); Hara, Isao [Shimadzu Corporation, Technology Research Laboratory (Japan); Hara, Eri [Kyoto University Hospital, Department of Experimental Therapeutics, Institute for Advancement of Clinical and Translational Science (Japan); Sano, Kohei [Graduate School of Medicine, Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine (Japan); Makino, Akira [University of Fukui, Division of Molecular Imaging, Biomedical Imaging Research Center (Japan); Ozeki, Eiichi [Shimadzu Corporation, Technology Research Laboratory (Japan); Yamamoto, Fumihiko [Tohoku Pharmaceutical University, Department of Radiopharmacy (Japan); Saji, Hideo [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences (Japan); Togashi, Kaori [Graduate School of Medicine, Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine (Japan); Kimura, Shunsaku, E-mail: shun@scl.kyoto-u.ac.jp [Kyoto University, Department of Material Chemistry, Graduate School of Engineering (Japan)

2016-05-15

Polymeric micelles (Lactosome) in the size of 20–30 nm were labeled with radionuclides of {sup 111}In ({sup 111}In-DOTA-Lactosome) for SPECT imaging and {sup 90}Y ({sup 90}Y-DOTA-Lactosome) for β-ray irradiation for mammary tumor in mice. The tumor site at the femoral right leg grafted with 4T1 cells was clearly imaged at 24 h after the intravenous injection. Biodistribution revealed that the half-life time of {sup 111}In-DOTA-Lactosome was 11 h, which enabled the nanoparticle selectively accumulated in tumor site due to the enhanced permeability and retention (EPR) effect. The anti-tumor therapeutic effect of {sup 90}Y-DOTA-Lactosome was observed depending on the dose frequency and amount. Under the condition of the percutaneous ethanol injection treatment, the therapeutic effect of {sup 90}Y-DOTA-Lactosome was enhanced due to the super EPR effect. Owing to the super EPR effect, co-administration of {sup 90}Y-DOTA-Lactosome and DOXIL{sup ®} inhibited the tumor growth during 15 days with their administrations.

Cellular and molecular properties of 90Y-labeled cetuximab in combination with radiotherapy on human tumor cells in vitro

International Nuclear Information System (INIS)

Saki, M.; Toulany, M.; Rodemann, H.P.; Sihver, W.; Zenker, M.; Heldt, J.M.; Mosch, B.; Pietzsch, H.J.; Steinbach, J.; Baumann, M.

2012-01-01

Purpose: Anti-EGFR antibody cetuximab (C225) is used in combination with radiotherapy of head and neck squamous cell carcinoma (HNSCC) patients. We investigated whether conjugation of cetuximab with trans-cyclohexyl-diethylene-triamine-pentaacetic acid (CHX-A''-DTPA) and radiolabeling with 90 Yttrium affect the molecular and cellular function of cetuximab and improve its combined effect with external-beam irradiation (EBI). Methods: The following cell lines were used: HNSCC UT5, SAS, FaDu, as well as A43, Chinese hamster ovary cells (CHO), and human skin fibroblast HSF7. Binding affinity and kinetics, specificity, retention, and the combination of 90 Y-cetuximab with EBI were evaluated. Results: Control cetuximab and CHX-A''-DTPA-cetuximab blocked the proliferation activity of UT5 cells. In combination with EBI, CHX-A''-DTPA-cetuximab increased the radiosensitivity of UT5 to a similar degree as control cetuximab did. In contrast, in SAS and HSF7 cells neither proliferation nor radiosensitivity was affected by either of the antibodies. Binding [ 90 Y]Y-CHX-A''-DTPA-cetuximab ( 90 Y-cetuximab) to EGFR in HNSCC cells occurred time dependently with a maximum binding at 24 h. Retention of 90 Y-cetuximab was similar in both HNSCC cell lines; 24 h after treatment, approximately 90% of bound activity remained in the cell layer. Competition assays, using cell membranes in the absence of an internalized fraction of cetuximab, showed that the cetuximab affinity is not lost as a result of conjugation with CHX-A''-DTPA. Cetuximab and CHX-A''-DTPA-cetuximab blocked EGF-induced Y1068 phosphorylation of EGFR. The lack of an effect of cetuximab on EGF-induced Akt and ERK1/2 phosphorylation and the inhibition of irradiation (IR)-induced Akt and ERK1/2 phosphorylation by cetuximab were not affected by DTPA conjugation. 90 Y-cetuximab in combination with EBI resulted in a pronounced inhibition of colony formation of HNSCC cells. Conclusions: Conjugation of CHX-A''-DTPA to cetuximab