Para-[(123)I]iodo-L-phenylalanine in patients with pancreatic adenocarcinoma: tumour uptake, whole-body kinetics, dosimetry.
Recently, p-[(123)I]iodo-L-phenylalanine (IPA) was clinically validated for brain tumour imaging. Preclinical studies demonstrated uptake of IPA into pancreatic adenocarcinoma suggesting its diagnostic application in patients with pancreatic tumours. The aim was to study the tumour uptake of IPA in patients with pancreatic adenocarcinoma and to analyse its biodistribution and dosimetry to assess the radiation dose resulting from its diagnostic use.


METHODS
Seven patients with pancreatic adenocarcinoma underwent whole-body scintigraphies and SPECT up to 24 h after administration of 250 MBq of IPA. Tumour uptake of IPA was assessed visually. Time activity curves and the corresponding residence times were determined for whole-body, kidneys, liver, spleen, lung, heart content, brain, and testes. Mean absorbed doses for various organs and the effective dose were assessed based on the MIRD formalism using OLINDA/EXM.


RESULTS
IPA exhibited no accumulation in proven manifestations of pancreatic adenocarcinomas. IPA was exclusively eliminated by the urine and showed a delayed clearance from blood. Residence times were 0.26 +/- 0.09 h for kidneys, 0.38 +/- 0.19 h for liver, 0.15 +/- 0.07 h for spleen, 0.51 +/- 0.20 h for lungs, 0.22 +/- 0.07 h for heart content, 0.11 +/- 0.05 h for brain, 0.014 +/- 0.005 h for testes and 6.4 +/- 2.2 h for the remainder. The highest absorbed doses were determined in the urinary bladder wall and in the kidneys. According to the ICRP 60 the effective dose resulting from 250 MBq IPA was 3.6 +/- 0.7 mSv.


CONCLUSIONS
Para-[(123)I]iodo-L-phenylalanine can be used in diagnostic nuclear medicine with acceptable radiation doses. Besides its proven validity for brain tumour imaging, IPA does not appear to be suitable as tracer for pancreatic cancer.
Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany. Dirk.Hellwig@uks.eu
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Schaefer
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Samnick
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006207:Half-Life; D006801:Humans; D007457:Iodine Radioisotopes / Q000493:pharmacokinetics; D007700:Kinetics; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010649:Phenylalanine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon; D014916:Whole-Body Irradiation
D007457:Iodine Radioisotopes; D010649:Phenylalanine; C049181:4-iodophenylalanine