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@ARTICLE{Moraitis:299833,
author = {A. Moraitis$^*$ and A. Prochnow$^*$ and T. D. Poeppel$^*$
and J. Schmitz$^*$ and C. Laschinsky$^*$ and K. Herrmann$^*$
and A. Bockisch$^*$ and P. Fragoso Costa$^*$ and D.
Kersting$^*$ and W. Jentzen$^*$},
title = {{T}umor {D}ose-{R}esponse {R}elationship of [131{I}]{MIBG}
{T}herapy in {P}atients with {N}eural {C}rest {T}umors by
{M}eans of [124{I}]{MIBG} {PET}.},
journal = {Journal of nuclear medicine},
volume = {66},
number = {4},
issn = {0097-9058},
address = {New York, NY},
publisher = {Soc.},
reportid = {DKFZ-2025-00570},
pages = {641–647},
year = {2025},
note = {66(4), pp. 641–647},
abstract = {[131I]Metaiodobenzylguanidine (MIBG) therapy in patients
with neural crest tumors has demonstrated sustained control
of catecholamine-associated hypertension and corresponding
partial response. Details on how neural crest tumors respond
to an absorbed dose delivered by [131I]MIBG-targeted
therapies is insufficiently known. The primary aim of this
retrospective study was to assess the tumor dose-response
relationship by means of quantitative analysis of [124I]MIBG
PET data. Methods: The tumor dose-response relationship was
studied in patients with advanced malignant
pheochromocytoma, neuroblastoma, or paraganglioma receiving
[131I]MIBG treatment, as well as pretherapeutic and
follow-up [124I]MIBG-based dosimetry. [124I]MIBG PET imaging
was performed around 4, 24, 48, and 120 h after injection.
Lesion uptake was projected to [131I]MIBG for every time
point, and respective time-integrated activity coefficients
(TIACs) for [131I]MIBG were calculated and used for
tumor-absorbed dose estimation. Functional response was
denoted for decrease of maximal lesion uptake or TIAC by at
least $30\%$ in the follow-up examination. In a consecutive
analysis, the predictive value of a single tumor-uptake
assessment from PET imaging at 24 h after administration was
investigated with respect to receiving the derived target
dose. Results: In total, 46 lesions from 9 patients were
available for dose-response analysis. The mean ± SD
tumor-absorbed dose coefficient was 13.4 ± 15.4 Gy/GBq
(median, 7.2 Gy/GBq; range, 1.1-64.7 Gy/GBq). A high
correlation (-0.60, P < 0.001) was found between uptake
decrease and tumor dose. In addition, a very high
correlation (0.91, P < 0.001) was found between uptake and
TIAC decrease. The estimated targeted tumor dose was 200 Gy,
that is, the dose at which the response rate exceeded the
$90\%$ threshold. A single 24-h uptake assessment showed
predictive value with respect to receiving the target dose.
Conclusion: This study demonstrated a clear correlation
between tumor-absorbed dose and functional response in
[131I]MIBG therapy and proposes a target dose for response
at the tumor level.},
keywords = {PET (Other) / [124I]MIBG (Other) / [131I]MIBG (Other) /
dose response (Other) / neural crest tumor (Other)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40081949},
doi = {10.2967/jnumed.124.269377},
url = {https://inrepo02.dkfz.de/record/299833},
}