Research ArticleContinuing Education

177Lu-PSMA Therapy

Ephraim E. Parent, Bital Savir-Baruch, Isis W. Gayed, Frankis Almaguel, Bennett B. Chin, Austin R. Pantel, Evan Armstrong, Amanda Morley, Robin C. Ippisch and Robert R. Flavell
Journal of Nuclear Medicine Technology September 2022, 50 (3) 205-212; DOI: https://doi.org/10.2967/jnmt.122.263814

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Previously published image demonstrating discordant hypermetabolic right inguinal metastatic deposit with high 18F-FDG PET uptake and little to no PSMA accumulation. (Reprinted from (13).)

  • FIGURE 2.
    FIGURE 2.

    Gravity-method 177Lu-PSMA-617 delivery system with inflow and outflow needles (A) and acrylic glass shielding to reduce radiation dose to nuclear technologist while maintaining validation of adequate flow. Radiation survey meter is used during 177Lu-PSMA-617 infusion to verify systemic administration (B).

  • FIGURE 3.
    FIGURE 3.

    Previously published data showing 6 individual subjects with good serum PSA response. Paired 68Ga PSMA-11 PET maximum-intensity projections are shown before (left) and 3 mo after (right) 177Lu-PSMA therapy. Highlighted in red are lesions that have SUVmax over 3. Serum PSA values before and after 177Lu-PSMA therapy serum are shown below each image and demonstrate good response to treatment. (Reprinted from (29).)

  • FIGURE 4.
    FIGURE 4.

    Previously published image providing examples of maximum-intensity projections of PSMA PET for each tumor load group. PSMA-positive tumor segmentation is highlighted in red. (Reprinted from (34).)

  • FIGURE 5.
    FIGURE 5.

    Previously published region-of-interest measurements on 177Lu-PSMA-617 uptake (anterior [A]; posterior [B]) in both parotid glands and cranium in patient on whom right-sided ice pack was used during posttreatment SPECT/CT. No differences in radioligand uptake were observed between cooled (right) and noncooled (left) sides, with region of interest or volume of interest on images shown. (Reprinted from (44).)

Tables

  • TABLE 1.

    Typical Specifications for Quality Control Tests

    TestSpecification
    Radiochemical purity (HPLC)>95%
    Radiochemical identity (HPLC)tR ± 5% reference standard
    Appearance (visual inspection)Clear, colorless, particulate-free
    pH4.0–7.0
    Endotoxin content (USP <85>)<175 EU/injected dose
    Filter integrity (bubble point)According to filter manufacturer
    SterilitySterile after 14 d

    • EU = endotoxin units; HPLC = high-performance liquid chromatography; tR = retention time; USP = U.S. Pharmacopeia.

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