{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:27:01Z","timestamp":1793158021123,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Radboud Oncology Foundation"},{"name":"Dutch Prostate Cancer Foundation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["EJNMMI Phys"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Bone marrow toxicity in advanced prostate cancer patients who receive [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 is a well-known concern. In early stage patients; e.g. low volume metastatic hormone sensitive prostate cancer (mHSPC) patients, prevention of late bone marrow toxicity is even more crucial due to longer life expectancy. To date, bone marrow dosimetry is primarily performed using blood sampling. This method is time consuming and does not account for possible active bone marrow uptake. Therefore other methodologies are investigated. We calculated the bone marrow absorbed dose for [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 in mHSPC patients using SPECT\/CT imaging and compared it to the blood sampling method as reference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eight mHSPC patients underwent two cycles (3 and 6\u00a0GBq) of [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 therapy. After each cycle, five time point (1\u00a0h, 1\u00a0day, 2\u00a0days, 3\u00a0days, 7\u00a0days) SPECT\/CT was performed at kidney level. Bone marrow dosimetry was performed using commercial software by drawing ten 1.5\u00a0cm diameter spheres in the lowest ten vertebrae to determine the time-integrated activity. Simplified protocols using only 2 imaging time points and 3 vertebrae were also compared. Blood-based dosimetry was based on the blood sampling method according to the EANM guideline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean bone marrow absorbed dose was significantly different (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) for the imaging based method (25.4\u2009\u00b1\u20098.7\u00a0mGy\/GBq) and the blood based method (17.2\u2009\u00b1\u20093.4\u00a0mGy\/GBq), with an increasing absorbed dose ratio between both methods over time. Bland Altman analysis of both simplification steps showed that differences in absorbed dose were all within the 95% limits of agreement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study showed that bone marrow absorbed dose after [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 can be determined using an imaging-based method of the lower vertebrae, and simplified using 2 time points (1 and 7\u00a0days) and 3 vertebrae. An increasing absorbed dose ratio over time between the imaging-based method and blood-based method suggests that there might be specific bone marrow binding of [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40658-024-00636-0","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T06:01:38Z","timestamp":1712124098000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Bone marrow dosimetry in low volume mHSPC patients receiving Lu-177-PSMA therapy using SPECT\/CT"],"prefix":"10.1186","volume":"11","author":[{"given":"Dagmar","family":"Grob","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan M.","family":"Priv\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantijn H. 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This study was approved by the Medical Review Ethics Committee Region Arnhem-Nijmegen and was registered on clinicaltrials.gov (NCT03828838). All subjects provided written informed consent before study entry.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Patients signed informed consent regarding publishing their data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflicts of interest to declare that are relevant to the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}