PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy
Introduction: Xerostomia is a well-known complication after iodine-131 ( 131 I) therapy for thyroid carcinoma. It is currently insufficiently understood how the dose and biodistribution of 131 I relates to salivary gland toxicity, and whether this is consistent for all salivary glands within a singl...
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SAGE Publishing
2020-07-01
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| Series: | Molecular Imaging |
| Online Access: | https://doi.org/10.1177/1536012120934992 |
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| author | Vineet Mohan MSc Wouter V. Vogel MD, PhD Gerlof D. Valk MD, PhD Jan P. de Boer MD, PhD Marnix G. E. H. Lam MD, PhD Bart de Keizer MD, PhD |
| author_facet | Vineet Mohan MSc Wouter V. Vogel MD, PhD Gerlof D. Valk MD, PhD Jan P. de Boer MD, PhD Marnix G. E. H. Lam MD, PhD Bart de Keizer MD, PhD |
| author_sort | Vineet Mohan MSc |
| collection | DOAJ |
| description | Introduction: Xerostomia is a well-known complication after iodine-131 ( 131 I) therapy for thyroid carcinoma. It is currently insufficiently understood how the dose and biodistribution of 131 I relates to salivary gland toxicity, and whether this is consistent for all salivary glands within a single patient. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) was recently introduced as a new tool to evaluate the relative loss of vital acinar cells in individual salivary glands. We aimed to assess gland-specific salivary gland toxicity after 131 I-therapy using PSMA PET/CT. Methods: Five patients with differentiated thyroid cancer underwent [ 68 Ga]Ga-PSMA-11 PET/CT to evaluate their eligibility for peptide radioligand therapy with [ 177 Lu]Lu-PSMA-617. Uptake patterns in salivary glands were evaluated visually and quantitatively as an indicator of vital acinar cell loss after prior 131 I-therapy. Results: Four of 5 patients demonstrated significant lowered uptake in at least one salivary gland, after receiving at least 2 131 I-treatments. Asymmetric loss of vital acinar cells occurred by gland type (parotid/submandibular) and location (right/left). The other salivary glands in these patients and all salivary glands in the fifth patient showed normal uptake, demonstrating high intrapatient and interpatient variability. Conclusions: 131 I-therapy can induce salivary gland toxicity with high inter- but also high intrapatient variation among separate gland locations, which can be assessed with PSMA PET/CT. This new technique offers potential to guide further development and evaluation of protective measures in patients receiving 131 I-therapy. |
| format | Article |
| id | doaj-art-e7503d360be94e0d8e6f53cb3cf2281a |
| institution | Kabale University |
| issn | 1536-0121 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Molecular Imaging |
| spelling | doaj-art-e7503d360be94e0d8e6f53cb3cf2281a2025-02-03T10:07:57ZengSAGE PublishingMolecular Imaging1536-01212020-07-011910.1177/1536012120934992PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 TherapyVineet Mohan MSc0Wouter V. Vogel MD, PhD1Gerlof D. Valk MD, PhD2Jan P. de Boer MD, PhD3Marnix G. E. H. Lam MD, PhD4Bart de Keizer MD, PhD5 Department of Radiation Oncology, Antoni van Leeuwenhoek, The Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Radiation Oncology, Antoni van Leeuwenhoek, The Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, the Netherlands Department of Medical Oncology, Antoni van Leeuwenhoek, The Netherlands Cancer Institute, Amsterdam, the Netherlands Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Utrecht, the Netherlands Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Utrecht, the NetherlandsIntroduction: Xerostomia is a well-known complication after iodine-131 ( 131 I) therapy for thyroid carcinoma. It is currently insufficiently understood how the dose and biodistribution of 131 I relates to salivary gland toxicity, and whether this is consistent for all salivary glands within a single patient. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) was recently introduced as a new tool to evaluate the relative loss of vital acinar cells in individual salivary glands. We aimed to assess gland-specific salivary gland toxicity after 131 I-therapy using PSMA PET/CT. Methods: Five patients with differentiated thyroid cancer underwent [ 68 Ga]Ga-PSMA-11 PET/CT to evaluate their eligibility for peptide radioligand therapy with [ 177 Lu]Lu-PSMA-617. Uptake patterns in salivary glands were evaluated visually and quantitatively as an indicator of vital acinar cell loss after prior 131 I-therapy. Results: Four of 5 patients demonstrated significant lowered uptake in at least one salivary gland, after receiving at least 2 131 I-treatments. Asymmetric loss of vital acinar cells occurred by gland type (parotid/submandibular) and location (right/left). The other salivary glands in these patients and all salivary glands in the fifth patient showed normal uptake, demonstrating high intrapatient and interpatient variability. Conclusions: 131 I-therapy can induce salivary gland toxicity with high inter- but also high intrapatient variation among separate gland locations, which can be assessed with PSMA PET/CT. This new technique offers potential to guide further development and evaluation of protective measures in patients receiving 131 I-therapy.https://doi.org/10.1177/1536012120934992 |
| spellingShingle | Vineet Mohan MSc Wouter V. Vogel MD, PhD Gerlof D. Valk MD, PhD Jan P. de Boer MD, PhD Marnix G. E. H. Lam MD, PhD Bart de Keizer MD, PhD PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy Molecular Imaging |
| title | PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy |
| title_full | PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy |
| title_fullStr | PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy |
| title_full_unstemmed | PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy |
| title_short | PSMA PET/CT Identifies Intrapatient Variation in Salivary Gland Toxicity From Iodine-131 Therapy |
| title_sort | psma pet ct identifies intrapatient variation in salivary gland toxicity from iodine 131 therapy |
| url | https://doi.org/10.1177/1536012120934992 |
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