Clinical evaluation of the radiolanthanide terbium-152: first-in-human PET/CT with 152Tb-DOTATOC

Dalton Trans. 2017 Oct 31;46(42):14638-14646. doi: 10.1039/c7dt01936j.

Abstract

The existence of theragnostic pairs of radionuclides allows the preparation of radiopharmaceuticals for diagnostic and therapeutic purposes. Radiolanthanides, such as 177Lu, are successfully used for therapeutic purposes; however, a perfect diagnostic match is currently not available for clinical use. A unique, multi-disciplinary study was performed using 152Tb (T1/2 = 17.5 h, Eβ+average = 1140 keV, Iβ+ = 20.3%), which resulted in the first-in-human PET/CT images with this promising radionuclide. For this purpose, 152Tb was produced via a spallation process followed by mass separation at ISOLDE, CERN. The chemical separation and quality control, performed at PSI, resulted in a pure product in sufficient yields. Clinical PET phantom studies revealed an increased image noise level, because of the smaller β+ branching ratio of 152Tb as compared to standard PET nuclides at matched activity concentrations; however, the expected recovery would be comparable at matched signal-to-noise ratios in clinical PET. 152Tb was used for labeling DOTATOC, at Zentralklinik Bad Berka, and administered to a patient for a first-in-human clinical study. PET scans were performed over a period of 24 h, allowing the visualization of even small metastases with increased tumor-to-background contrast over time. Based on the results obtained in this work, it can be deduced that PET/CT imaging with 152Tb-labeled targeting agents has promise for clinical application and may be particularly interesting for pre-therapeutic dosimetry.

MeSH terms

  • Aged
  • Humans
  • Isotope Labeling
  • Male
  • Neuroendocrine Tumors / diagnostic imaging
  • Octreotide / analogs & derivatives*
  • Octreotide / chemistry
  • Phantoms, Imaging
  • Positron Emission Tomography Computed Tomography / methods*
  • Radiochemistry
  • Radioisotopes / chemistry*
  • Terbium / chemistry*

Substances

  • Radioisotopes
  • Terbium-152
  • Terbium
  • Octreotide
  • Edotreotide