SeHCAT retention measurements may be compromised by traces of 177 Lu/ 177m Lu more than 90 days after 177 Lu-DOTATATE was administered.

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-12-01 Epub Date: 2024-09-16 DOI:10.1097/MNM.0000000000001903
Tamar Willson, Richard Meades
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Abstract

[ 75 Se]tauroselcholic acid (SeHCAT) retention measurement provides a noninvasive test for bile acid diarrhea (BAD); however, it is sensitive to the presence of other radionuclides. Two SeHCAT patients at the Royal Free Hospital (RFH) had significant discrepancies between the lower photopeak (111-159 keV) and central photopeak (242-296 keV) windows, indicating contamination with a radionuclide other than 75 Selenium. These patients had received lutetium-177 oxodotreotide ( 177 Lu-DOTATATE) therapy 98 and 151 days before their SeHCAT tests. Traces of 177 Lu may be retained longer than typically modeled, along with the contaminant 177m Lu. This work includes a retrospective audit to examine the prevalence of SeHCAT tests being affected by 177 Lu and phantom measurements to investigate the potential impact. Of 579 patients who received 177 Lu-DOTATATE therapy at our center, 11 subsequently attended for a SeHCAT test. The two previously identified patients may have had compromised SeHCAT results; however, the other patients had longer intervals between their therapy and test, and their tests are believed to be valid. Spectra were acquired from a phantom containing either a SeHCAT capsule or a mixture of 177 Lu/ 177m Lu representative of a patient >90 days after their treatment. The SeHCAT spectrum was scaled to produce simulated day-7 spectra, and the SeHCAT retention that would have been calculated if 177 Lu/ 177m Lu were present was determined. All SeHCAT measurement windows are affected by the 177 Lu/ 177m Lu, producing clinically significant errors. Patients requiring SeHCAT testing should be asked whether they have ever received 177 Lu-DOTATATE. Patient-specific background measurements may be useful for checking for significant levels of other radionuclides.

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施用 177Lu-DOTATATE 超过 90 天后,177Lu/177mLu 残留可能会影响 SeHCAT 保留测量。
[75Se]牛磺胆硷酸(SeHCAT)潴留测定为胆汁酸腹泻(BAD)提供了一种无创检测方法;但它对其他放射性核素的存在很敏感。英国皇家自由医院(RFH)的两名 SeHCAT 患者的下部光峰(111-159 千伏)和中部光峰(242-296 千伏)窗口之间存在明显差异,表明他们受到了 75Selenium 以外的放射性核素污染。这些患者在接受 SeHCAT 检测的 98 天和 151 天前接受了镥-177 奥托曲肽(177Lu-DOTATATE)治疗。痕量 177Lu 与污染物 177mLu 一起保留的时间可能比通常的模型更长。这项工作包括一项回顾性审计,以检查 SeHCAT 检测受 177Lu 影响的普遍程度,并进行模拟测量以调查潜在的影响。在本中心接受177Lu-DOTATATE治疗的579名患者中,有11人随后接受了SeHCAT检测。之前发现的两名患者的 SeHCAT 检测结果可能受到了影响;但其他患者的治疗和检测之间的间隔时间较长,相信他们的检测结果是有效的。在患者接受治疗 90 天后,从一个含有 SeHCAT 胶囊或 177Lu/177mLu 混合物的模型中获取光谱。对 SeHCAT 光谱进行缩放,以生成模拟的第 7 天光谱,并确定在存在 177Lu/177mLu 的情况下计算出的 SeHCAT 保留度。所有 SeHCAT 测量窗口都会受到 177Lu/177mLu 的影响,从而产生明显的临床误差。应询问需要进行 SeHCAT 检测的患者是否曾接受过 177Lu-DOTATATE。患者的特定本底测量可能有助于检查其他放射性核素的显著水平。
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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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