{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:55:38Z","timestamp":1790931338052,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Munich Clinician Scientist Program","award":["Munich Clinician Scientist Program"],"award-info":[{"award-number":["Munich Clinician Scientist Program"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s00259-026-08030-x","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:38:19Z","timestamp":1782441499000},"page":"6849-6857","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metformin and renal dosimetry in patients undergoing [177Lu]Lu-PSMA therapy: reduced kidney absorbed dose without impact on tumor dosimetry"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3175-952X","authenticated-orcid":false,"given":"Sophie Carina","family":"Siegmund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Delker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Widjaja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Hornfeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muyu","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena M.","family":"Unterrainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz Josef","family":"Gildehaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"B\u00f6ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Ells","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"8030_CR1","doi-asserted-by":"publisher","unstructured":"Hartrampf PE, Weinzierl FX, Serfling SE, Pomper MG, Rowe SP, Higuchi T, Cancers, et al. (Basel). 2022;14. https:\/\/doi.org\/10.3390\/cancers14030647.","DOI":"10.3390\/cancers14030647"},{"key":"8030_CR2","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.remnie.2021.04.007","volume":"41","author":"B Nilica","year":"2022","unstructured":"Nilica B, Svirydenka A, Fritz J, Bayerschmidt S, Kroiss A, Gruber L, et al. Nephrotoxicity and hematotoxicity one year after four cycles of peptide receptor radionuclide therapy (PRRT) and its impact on future treatment planning - A retrospective analysis. Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022;41:138\u201345. https:\/\/doi.org\/10.1016\/j.remnie.2021.04.007.","journal-title":"Rev Esp Med Nucl Imagen Mol (Engl Ed)"},{"key":"8030_CR3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/0360-3016(91)90171-y","volume":"21","author":"B Emami","year":"1991","unstructured":"Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109\u201322. https:\/\/doi.org\/10.1016\/0360-3016(91)90171-y.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"8030_CR4","first-page":"134","volume":"48","author":"M Konijnenberg","year":"2007","unstructured":"Konijnenberg M, Melis M, Valkema R, Krenning E, de Jong M. Radiation dose distribution in human kidneys by octreotides in peptide receptor radionuclide therapy. J Nucl Med. 2007;48:134\u201342.","journal-title":"J Nucl Med"},{"key":"8030_CR5","doi-asserted-by":"publisher","first-page":"s23","DOI":"10.2967\/jnumed.121.262751","volume":"62","author":"RL Wahl","year":"2021","unstructured":"Wahl RL, Sgouros G, Iravani A, Jacene H, Pryma D, Saboury B, et al. Normal-tissue tolerance to radiopharmaceutical therapies, the knowns and the unknowns. J Nucl Med. 2021;62:s23\u201335. https:\/\/doi.org\/10.2967\/jnumed.121.262751.","journal-title":"J Nucl Med"},{"key":"8030_CR6","first-page":"123","volume":"1","author":"B Emami","year":"2013","unstructured":"Emami B. Tolerance of normal tissue to therapeutic radiation. Rep radiotherapy Oncol. 2013;1:123\u20137.","journal-title":"Rep radiotherapy Oncol"},{"key":"8030_CR7","doi-asserted-by":"publisher","unstructured":"Cohen EP, Robbins ME. Radiation nephropathy. Semin Nephrol. 2003;23(5):486\u201399. https:\/\/doi.org\/10.1016\/s0270-9295(03)00093-7","DOI":"10.1016\/s0270-9295(03)00093-7"},{"key":"8030_CR8","doi-asserted-by":"publisher","first-page":"596","DOI":"10.2967\/jnumed.106.036020","volume":"48","author":"M Gotthardt","year":"2007","unstructured":"Gotthardt M, van Eerd-Vismale J, Oyen WJ, de Jong M, Zhang H, Rolleman E, et al. Indication for different mechanisms of kidney uptake of radiolabeled peptides. J Nucl Med. 2007;48:596\u2013601. https:\/\/doi.org\/10.2967\/jnumed.106.036020.","journal-title":"J Nucl Med"},{"key":"8030_CR9","doi-asserted-by":"publisher","unstructured":"de Roode KE, Joosten L, Behe M. Towards the magic radioactive bullet: improving targeted radionuclide therapy by reducing the renal retention of radioligands. Pharmaceuticals (Basel). 2024;17. https:\/\/doi.org\/10.3390\/ph17020256.","DOI":"10.3390\/ph17020256"},{"key":"8030_CR10","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.2967\/jnumed.124.267452","volume":"65","author":"Z Ells","year":"2024","unstructured":"Ells Z, Grogan TR, Czernin J, Dahlbom M, Calais J. Dosimetry of [(177)Lu]Lu-PSMA-targeted radiopharmaceutical therapies in patients with prostate cancer: a comparative systematic review and metaanalysis. J Nucl Med. 2024;65:1264\u201371. https:\/\/doi.org\/10.2967\/jnumed.124.267452.","journal-title":"J Nucl Med"},{"key":"8030_CR11","unstructured":"Novartis. Fachinformation Lutathera."},{"key":"8030_CR12","doi-asserted-by":"publisher","unstructured":"Courault P, Deville A, Habouzit V, Gervais F, Bolot C, Bournaud C, et al. Amino acid solutions for (177)Lu-Oxodotreotide premedication: a tolerance study. Cancers (Basel). 2022;14. https:\/\/doi.org\/10.3390\/cancers14215212.","DOI":"10.3390\/cancers14215212"},{"key":"8030_CR13","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1021\/acs.molpharmaceut.8b01091","volume":"16","author":"C Xiong","year":"2019","unstructured":"Xiong C, Yin D, Li J, Huang Q, Ravoori MK, Kundra V, et al. Metformin reduces renal uptake of radiotracers and protects kidneys from radiation-induced damage. Mol Pharm. 2019;16:808\u201315. https:\/\/doi.org\/10.1021\/acs.molpharmaceut.8b01091.","journal-title":"Mol Pharm"},{"key":"8030_CR14","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1056\/NEJMoa012512","volume":"346","author":"WC Knowler","year":"2002","unstructured":"Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393\u2013403. https:\/\/doi.org\/10.1056\/NEJMoa012512.","journal-title":"N Engl J Med"},{"key":"8030_CR15","doi-asserted-by":"publisher","first-page":"241","DOI":"10.2147\/dmso.S43731","volume":"7","author":"KA Coughlan","year":"2014","unstructured":"Coughlan KA, Valentine RJ, Ruderman NB, Saha AK. AMPK activation: a therapeutic target for type 2 diabetes? Diabetes Metab Syndr Obes. 2014;7:241\u201353. https:\/\/doi.org\/10.2147\/dmso.S43731.","journal-title":"Diabetes Metab Syndr Obes"},{"key":"8030_CR16","first-page":"829","volume":"37","author":"TM Behr","year":"1996","unstructured":"Behr TM, Becker WS, Sharkey RM, Juweid ME, Dunn RM, Bair HJ, et al. Reduction of renal uptake of monoclonal antibody fragments by amino acid infusion. J Nucl Med. 1996;37:829\u201333.","journal-title":"J Nucl Med"},{"key":"8030_CR17","unstructured":"Information NCB. PubChem Compound Summary for CID 4091, Metformin. 2026."},{"key":"8030_CR18","doi-asserted-by":"publisher","first-page":"2830","DOI":"10.1007\/s00259-023-06255-8","volume":"50","author":"C Kratochwil","year":"2023","unstructured":"Kratochwil C, Fendler WP, Eiber M, Hofman MS, Emmett L, Calais J, et al. Joint EANM\/SNMMI procedure guideline for the use of (177)Lu-labeled PSMA-targeted radioligand-therapy ((177)Lu-PSMA-RLT). Eur J Nucl Med Mol Imaging. 2023;50:2830\u201345. https:\/\/doi.org\/10.1007\/s00259-023-06255-8.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"8030_CR19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40658-023-00529-8","volume":"10","author":"S Resch","year":"2023","unstructured":"Resch S, Takayama Fouladgar S, Zacherl M, Sheikh GT, Liubchenko G, Rumiantcev M, et al. Investigation of image-based lesion and kidney dosimetry protocols for (177)Lu-PSMA-I&T therapy with and without a late SPECT\/CT acquisition. EJNMMI Phys. 2023;10:11. https:\/\/doi.org\/10.1186\/s40658-023-00529-8.","journal-title":"EJNMMI Phys"},{"key":"8030_CR20","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s00259-015-3174-7","volume":"43","author":"A Delker","year":"2016","unstructured":"Delker A, Fendler WP, Kratochwil C, Brunegraf A, Gosewisch A, Gildehaus FJ, et al. Dosimetry for (177)Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:42\u201351. https:\/\/doi.org\/10.1007\/s00259-015-3174-7.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"8030_CR21","doi-asserted-by":"publisher","first-page":"N277","DOI":"10.1088\/0031-9155\/53\/14\/n02","volume":"53","author":"A Sohlberg","year":"2008","unstructured":"Sohlberg A, Watabe H, Iida H. Acceleration of Monte Carlo-based scatter compensation for cardiac SPECT. Phys Med Biol. 2008;53:N277\u201385. https:\/\/doi.org\/10.1088\/0031-9155\/53\/14\/n02.","journal-title":"Phys Med Biol"},{"key":"8030_CR22","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.2967\/jnumed.121.262305","volume":"63","author":"J O\u2019Donoghue","year":"2022","unstructured":"O\u2019Donoghue J, Zanzonico P, Humm J, Kesner A. Dosimetry in radiopharmaceutical therapy. J Nucl Med. 2022;63:1467\u201374. https:\/\/doi.org\/10.2967\/jnumed.121.262305.","journal-title":"J Nucl Med"},{"key":"8030_CR23","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.2967\/jnumed.123.266871","volume":"65","author":"S Resch","year":"2024","unstructured":"Resch S, Ziegler SI, Sheikh G, Unterrainer LM, Zacherl MJ, Bartenstein P, et al. Impact of the reference multiple-time-point dosimetry protocol on the validity of single-time-point dosimetry for [(177)Lu]Lu-PSMA-I&T therapy. J Nucl Med. 2024;65:1272\u20138. https:\/\/doi.org\/10.2967\/jnumed.123.266871.","journal-title":"J Nucl Med"},{"key":"8030_CR24","doi-asserted-by":"publisher","first-page":"767","DOI":"10.2967\/jnumed.122.264594","volume":"64","author":"J Brosch-Lenz","year":"2023","unstructured":"Brosch-Lenz J, Delker A, V\u00f6lter F, Unterrainer LM, Kaiser L, Bartenstein P, et al. Toward single-time-point image-based dosimetry of (177)Lu-PSMA-617 therapy. J Nucl Med. 2023;64:767\u201374. https:\/\/doi.org\/10.2967\/jnumed.122.264594.","journal-title":"J Nucl Med"},{"key":"8030_CR25","doi-asserted-by":"publisher","first-page":"75","DOI":"10.2967\/jnumed.117.193706","volume":"59","author":"H H\u00e4nscheid","year":"2018","unstructured":"H\u00e4nscheid H, Lapa C, Buck AK, Lassmann M, Werner RA. Dose mapping after endoradiotherapy with (177)Lu-DOTATATE\/DOTATOC by a single measurement after 4 days. J Nucl Med. 2018;59:75\u201381. https:\/\/doi.org\/10.2967\/jnumed.117.193706.","journal-title":"J Nucl Med"},{"key":"8030_CR26","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.2967\/jnumed.120.242057","volume":"61","author":"R Seifert","year":"2020","unstructured":"Seifert R, Herrmann K, Kleesiek J, Sch\u00e4fers M, Shah V, Xu Z, et al. Semiautomatically quantified tumor volume using (68)Ga-PSMA-11 PET as a biomarker for survival in patients with advanced prostate cancer. J Nucl Med. 2020;61:1786\u201392. https:\/\/doi.org\/10.2967\/jnumed.120.242057.","journal-title":"J Nucl Med"},{"key":"8030_CR27","doi-asserted-by":"publisher","first-page":"663631","DOI":"10.3389\/fonc.2021.663631","volume":"11","author":"LM Mittlmeier","year":"2021","unstructured":"Mittlmeier LM, Brendel M, Beyer L, Albert NL, Todica A, Zacherl MJ, et al. Feasibility of different tumor delineation approaches for (18)F-PSMA-1007 PET\/CT imaging in prostate cancer patients. Front Oncol. 2021;11:663631. https:\/\/doi.org\/10.3389\/fonc.2021.663631.","journal-title":"Front Oncol"},{"key":"8030_CR28","doi-asserted-by":"publisher","first-page":"226","DOI":"10.2967\/jnumed.121.261906","volume":"63","author":"A Gafita","year":"2022","unstructured":"Gafita A, Wang H, Robertson A, Armstrong WR, Zaum R, Weber M, et al. Tumor sink effect in (68)Ga-PSMA-11 PET: Myth or Reality? J Nucl Med. 2022;63:226\u201332. https:\/\/doi.org\/10.2967\/jnumed.121.261906.","journal-title":"J Nucl Med"},{"key":"8030_CR29","doi-asserted-by":"publisher","first-page":"559446","DOI":"10.3389\/fendo.2020.559446","volume":"11","author":"Y Hu","year":"2020","unstructured":"Hu Y, Lei M, Ke G, Huang X, Peng X, Zhong L, et al. Metformin Use and Risk of All-Cause Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease-A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2020;11:559446. https:\/\/doi.org\/10.3389\/fendo.2020.559446.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"8030_CR30","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1159\/000531432","volume":"148","author":"JZ Li","year":"2023","unstructured":"Li JZ, Li YR. Cardiovascular protection by metformin: latest advances in basic and clinical research. Cardiology. 2023;148:374\u201384. https:\/\/doi.org\/10.1159\/000531432.","journal-title":"Cardiology"},{"key":"8030_CR31","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.2337\/db14-1388","volume":"64","author":"T Dujic","year":"2015","unstructured":"Dujic T, Zhou K, Donnelly LA, Tavendale R, Palmer CN, Pearson ER. Association of organic cation transporter 1 with intolerance to metformin in type 2 diabetes: A GoDARTS study. Diabetes. 2015;64:1786\u201393. https:\/\/doi.org\/10.2337\/db14-1388.","journal-title":"Diabetes"},{"key":"8030_CR32","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1007\/s00259-011-1826-9","volume":"38","author":"G Giovacchini","year":"2011","unstructured":"Giovacchini G, Nicolas G, Freidank H, Mindt TL, Forrer F. Effect of amino acid infusion on potassium serum levels in neuroendocrine tumour patients treated with targeted radiopeptide therapy. Eur J Nucl Med Mol Imaging. 2011;38:1675\u201382. https:\/\/doi.org\/10.1007\/s00259-011-1826-9.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"8030_CR33","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s10928-019-09666-z","volume":"47","author":"CA Wesolowski","year":"2020","unstructured":"Wesolowski CA, Wanasundara SN, Babyn PS, Alcorn J. Comparison of the gamma-Pareto convolution with conventional methods of characterising metformin pharmacokinetics in dogs. J Pharmacokinet Pharmacodyn. 2020;47:19\u201345. https:\/\/doi.org\/10.1007\/s10928-019-09666-z.","journal-title":"J Pharmacokinet Pharmacodyn"},{"key":"8030_CR34","doi-asserted-by":"publisher","first-page":"170","DOI":"10.5604\/01.3001.0010.3801","volume":"71","author":"M Podhorecka","year":"2017","unstructured":"Podhorecka M, Ibanez B, Dmoszy\u0144ska A. Metformin - its potential anti-cancer and anti-aging effects. Postepy Hig Med Dosw (Online). 2017;71:170\u20135. https:\/\/doi.org\/10.5604\/01.3001.0010.3801.","journal-title":"Postepy Hig Med Dosw (Online)"},{"key":"8030_CR35","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1038\/s41574-023-00833-4","volume":"19","author":"M Foretz","year":"2023","unstructured":"Foretz M, Guigas B, Viollet B. Metformin: update on mechanisms of action and repurposing potential. Nat Rev Endocrinol. 2023;19:460\u201376. https:\/\/doi.org\/10.1038\/s41574-023-00833-4.","journal-title":"Nat Rev Endocrinol"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-08030-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-026-08030-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-08030-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:32:00Z","timestamp":1790929920000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-026-08030-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["8030"],"URL":"https:\/\/doi.org\/10.1007\/s00259-026-08030-x","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"29 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This analysis was performed in compliance with the principles of the Declaration of Helsinki and was approved by the institutional ethics board of the LMU Munich (IRB #25-0130-1).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RAW: speaker honoraria from and advisory board work for Novartis\/AAA. L.M.U.: speaker honoraria from Astellas Pharma Inc., Novartis Pharma \/ Radiopharmaceuticals, consultant work for Telix Pharmaceuticals.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work the author(s) used Google-Assisted AI for language editing. After using this tool\/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.","order":4,"name":"Ethics","label":"Generative AI and AI-assisted technologies in the writing process","group":{"name":"EthicsHeading","label":"Declarations"}}]}}