POST-TRACER AND POST-THERAPY IMAGING USING A NEW SPECT-CT INTEGRATED SYSTEM FOR

使用新的 SPECT-CT 集成系统进行示踪剂后和治疗后成像

• 批准号: 7376642
• 负责人: YUNI K DEWARAJA
• 金额: $ 0.92万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-05 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376642
• 关键词: bone marrow; lymphoma; neoplasm /cancer; radionuclide therapy; tissues

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. I-131 labeled radioimmunotherapy (RIT) is showing great promise in the treatment of non-Hodgkin s lymphoma (NHL). To make advances towards individualized treatment planning in radionuclide therapy, it is necessary to establish reliable dose-response relationships for target tissue and dose-toxicity relationships for normal tissue. Thus far, most clinical I-131 radionuclide therapy studies have shown an absent or rather weak relationship between radiation absorbed dose and tumor response or critical organ toxicity. The lack of better correlation is possibly due to inaccuracies in absorbed dose estimation methods used thus far. This warrants the effort towards developing and evaluating highly accurate methods for imaging based dosimetry. This is a prospective pilot study evaluating the potential value of a new SPECT-CT integrated system for imaging based dosimetry in Non-Hodgkins lymphoma patients treated with I-131 tositumomab (Bexaar) radioimmunotherapy (RIT). We aim to determine the value of concurrent SPECT-CT imaging in precise anatomic localization of areas of abnormal radiotracer activity compared to planar scintigraphy and conventional SPECT. The SPECT-CT images will be used to carry out highly accurate patient specific 3-dimensional dosimetry in tumors and bone marrow using a computer algorithm recently implemented by our group. Five patients over 21 years of age of both genders and all ethnic and racial groups who are scheduled to undergo the Bexaar treatment will be asked to volunteer for between 3 to 6 scans on the new SPECT-CT system following the tracer and/or the therapy administration of Bexaar. The imaging is based on the radioactivity that is administered as part of the RIT treatment and the patient will not be injected with any additional radioactivity due to the research aspect of the proposed study. If the feasibility of using the new system for highly accurate dosimetry is established by the present project, it can be used in the future with a large number of subjects to establish dose-response and dose-toxicity relationships. Establishment of such relationships and the capability to carry out highly accurate imaging based dosimetry prospectively, will allow physicians in the future to tailor the treatment regimen on a patient-by-patient basis to deliver the optimum dose to the tumor while avoiding toxicity to critical organs. Highly accurate bone marrow dosimetry may also allow for the inclusion of additional patients who are presently excluded from this treatment because of the present criteria that they have < 25% bone marrow involvement.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。 I-131标记的放射免疫疗法（RIT）在治疗非霍奇金S淋巴瘤（NHL）方面表现出巨大的希望。为了在放射性核素治疗中迈向个性化的治疗计划，有必要建立可靠的剂量反应关系，以实现正常组织的靶组织和剂量毒性关系。到目前为止，大多数临床I-131放射性核素治疗研究都表明，辐射吸收剂量与肿瘤反应或临界器官毒性之间没有或较弱的关系。缺乏更好的相关性可能是由于迄今为止使用的吸收剂量估计方法的不准确性。这需要努力开发和评估基于成像的剂量法的高度准确方法。这是一项前瞻性试验研究，评估了在非霍奇金斯淋巴瘤患者中基于成像剂量测定的新SPECT-CT集成系统的潜在值，该系统接受了I-131 tositumomab（Bexaar）放射免疫疗法（RIT）治疗的患者。我们旨在确定与平面闪烁显像和常规SPECT相比，在异常的放射性示意剂活性区域的精确解剖学定位中，并发SPECT-CT成像的价值。 SPECT-CT图像将用于使用我们组最近实施的计算机算法在肿瘤和骨髓中进行高度准确的患者特异性三维剂量测定法。在示踪剂和/或Bexaar治疗后，将要求五名21岁以上的性别和所有种族和种族群体在新的Spect-CT系统上进行3至6次扫描。该成像基于作为RIT治疗的一部分进行的放射性，并且由于拟议研究的研究方面，不会给患者注射任何其他放射性。如果本项目建立了将新系统用于高度准确的剂量法的可行性，则将来可以使用大量受试者使用它来建立剂量反应和剂量刺激性关系。建立这种关系以及前瞻性地基于成像的剂量法进行高度准确的剂量法的能力，将来将允许医生在患者的逐个患者基础上调整治疗方案，以将最佳剂量送给肿瘤，同时避免对关键器官的毒性。高度准确的骨髓剂量法也可能允许包括其他患者，这些患者目前因目前的骨髓受累而被排除在这种治疗中。