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Dosimetric Impact of Prolonged [Y-86]-NM600 PET/CT Imaging for Immunomodulatory Molecular Radiotherapy with [Y-90]-NM600

I Marsh1*, R Hernandez1 , M Turek1 , J Grudzinski1 , J Weichert1 , Z Morris1 , D Vail1 , B Bednarz1 , (1) University of Wisconsin - Madison, Madison, WI


(Sunday, 7/14/2019) 4:30 PM - 5:00 PM

Room: Exhibit Hall | Forum 4

Purpose: The combination of low-dose molecular radiotherapy (MRT) and checkpoint blockade can potentially enhance the immune response against immunologically “cold� tumors. To this end, we are investigating the capability of a radiolabeled alkylphosphocholine (NM600) to deliver immunomodulatory dose to the tumor microenvironment without inducing systemic immunosuppression. This work considers the dosimetric impact of prolonged ��Y-NM600 PET/CT imaging for theranostic treatment planning in ��Y-NM600 MRT.

Methods: A companion dog presenting with widespread metastatic osteosarcoma was administered 178 MBq of ��Y-NM600, and longitudinal PET/CT scans were acquired at 2.5, 24, and 48 h post-injection. ��Y-NM600 PET/CT volumes were used in a Monte Carlo voxel-based dosimetry platform to calculate integral prescription doses (Gy/GBq) to ROIs by ��Y-NM600 MRT and ��Y-NM600. The prolonged uptake and retention of ��Y-NM600 can be more precisely characterized with >48 h imaging but requires considerably more tracer activity given the 14.7 h half-life. The dosimetric impact of achieving similar 48 h ��Y-NM600 activity concentrations at later timepoints was assessed in the context of ��Y-NM600 MRT delivering 2.0 Gy to the tumor.

Results: PET/CT imaging confirmed selective uptake and retention of ��Y-NM600 in tumors (3.4 SUV at 48 h) and hepatobiliary excretion of the tracer (4.0 SUV at 48 h). In the current protocol, ��Y-NM600 delivers only 5.8% of MRT to the tumor, but 14.5% of MRT to the red marrow. For prolonged imaging, tracer activity and imaging dose increases exponentially while tumor-specificity of the theranostic treatment decreases.

Conclusion: This work characterizes ��Y-NM600 tracer dosimetry and indicates the potential for imaging through 72-96 h. With modest compromises in image quality and scan duration at late timepoints, the requisite tracer activity for prolonged imaging can be reduced to limit any potential impact on tumor-specificity.


Targeted Radiotherapy, In Vivo Dosimetry, PET


IM/TH- Radiopharmaceutical therapy: General (most aspects)

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