The impact of 177Lu-octreotide therapy on 99mTc-MAG3 clearance is not predictive for late nephropathy.
Peptide Receptor Radionuclide Therapy (PRRT) for the treatment of neuroendocrine tumors may lead to kidney deterioration. This study aimed to evaluate the suitability of 99mTc-mercaptoacetyltriglycine (99mTc--MAG3) clearance for the early detection of PRRT-induced changes on tubular extraction (TE). TE rate (TER) was measured prior to 128 PRRT cycles (7.6±0.4 GBq 177Lu-octreotate/octreotide each) in 32 patients. TER reduction during PRRT was corrected for age-related decrease and analyzed for the potential to predict loss of glomerular filtration (GF). The GF rate (GFR) as measure for renal function was derived from serum creatinine. The mean TER was 234 ± 53 ml/min/1.73 m² before PRRT (baseline) and 221 ± 45 ml/min/1.73 m² after a median follow-up of 370 days. The age-corrected decrease (mean: -3%, range: -27% to +19%) did not reach significance (p=0.09) but significantly correlated with the baseline TER (Spearman p=-0.62, p<0.001). Patients with low baseline TER showed an improved TER after PRRT, high decreases were only observed in individuals with high baseline TER. Pre-therapeutic TER data were inferior to plasma creatinine-derived GFR estimates in predicting late nephropathy. TER assessed by 99mTc-MAG3-clearance prior to and during PRRT is not suitable as early predictor of renal injury and an increased risk for late nephropathy.
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Rudolf A
RA
Werner
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Seval
S
Beykan
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Takahiro
T
Higuchi
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Katharina
K
Lückerath
Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany.
Alexander
A
Weich
Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany.
Michael
M
Scheurlen
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Christina
C
Bluemel
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
Ken
K
Herrmann
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Andreas K
AK
Buck
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Michael
M
Lassmann
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Constantin
C
Lapa
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Heribert
H
Hänscheid
D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate / Q000528:radiation effects*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology; D007684:Kidney Tubules / Q000378:metabolism* / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000378:metabolism / Q000532:radiotherapy; D015282:Octreotide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D011832:Radiation Injuries / Q000175:diagnosis*; D012189:Retrospective Studies; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D017263:Technetium Tc 99m Mertiatide / Q000493:pharmacokinetics*; D055815:Young Adult
C554548:177Lu-octreotate; D017263:Technetium Tc 99m Mertiatide; D015282:Octreotide
177Lu; MAG3; PRRT; neuroendocrine tumor; renal scintigraphy