SPECT/CT Quantification for Theranostics
With more than 1,600 publications referencing theranostics in 20191, there is clear momentum in this fast-growing area of medicine. Combining diagnostics and therapy brings new opportunities for delivering the right treatment at the right time to each patient. But having reliable patient-specific data is essential for achieving this.
When establishing a theranostics practice, differentiating between technologies can be challenging. To better understand why all SPECT/CTs are not created equal, three points quickly rise to the top of the list:
Dependably image medium- and high-energy isotopes.
System design is critical for reliably imaging medium- and high-energy isotopes. With sodium iodide crystals, the only SPECT crystal technology clinically proven to manage all SPECT energies, and the flexibility to easily change and use collimators specifically designed for each isotope, Symbia Intevo™ SPECT/CTs provide the technology foundation required for a theranostics program. And with TrueCalc™ high count rate detector technology, there is peace of mind in having consistent quantitative accuracy across the therapy cycle and multiple time points.
Easily implement quantification into a workflow.
Conventional quantification calibration workflows can take as many as 14 manual, time-intensive steps—increasing the potential for error. xSPECT Quant™ provides an automated calibration solution that is fast, accurate, and easily implemented into your department’s workflow. With xSPECT Quant, you no longer need to rely on a medical physicist to complete the calibration. Calibration can be easily performed by a technologist, thus allowing for more flexibility within the department.
Reliably produce accurate quantitative values.
Precise and reproducible to within 5%2,3, xSPECT Quant provides the degree of standardized SPECT/CT quantification you rely on for theranostics and radionuclide therapy. Using a patented NIST-traceable calibration source, xSPECT Quant is unrivaled in its level of accuracy4, and is your basis for optimal therapy planning and management. xSPECT Quant is available for multiple isotopes, including 177Lu and 131I4.
What experts say
Ken Herrmann, MD
Chair, Department of Nuclear Medicine
Universitätsklinikum Essen, Germany
“As a guest editor for The Journal of Nuclear Medicine, I had the chance to create a dedicated issue on theranostics. Bringing together and sharing our knowledge will only help propel its use. In my opinion, this is nuclear medicine‘s most exciting development since the introduction of PET and PET/CT.”
The Journal of Nuclear Medicine: Theranostics Supplement (2017)
A collection of 15 articles highlighting the experiences and impressions of researchers and clinicians working in the field.
Defining the Clinical Value of Quantitative SPECT/CT
Use of Quantitative SPECT in Dosimetry
Case 1 – Metastatic Neuroendocrine Tumor
- 49-year-old male
- Metastatic neuroendocrine tumor with extensive liver involvement
- Underwent peptide receptor radionuclide therapy (PRRT) with 7.5 GBq of 177Lu DOTATATE
Case 2 – Three-time-point study post-therapy
- 70-year-old female
- Liver metastases from neuroendocrine tumor
- Underwent peptide receptor radionuclide therapy (PRRT) with 6.3 GBq of 177Lu DOTATATE
Case 3 – Single-time-point study
- 49-year-old patient
- Advanced pancreatic neuroendocrine tumor
- Initial staging cT4 cNx cM1(HEP) was referred for a fourth cycle of peptide receptor radionuclide therapy (PRRT) with 4.1 GBq 177Lu-somatostatin-receptor (SSTR)-targeting ligand
Sequential quantitative SPECT/CT following therapeutic administration of 177Lu DOTATATE in a patient with liver metastases from neuroendocrine tumor
Data courtesy of Ludwig Maximillians University, Munich, Germany
Evaluation of absorbed dose using sequential quantitative SPECT/CT following 177Lu DOTATATE metastatic neuroendocrine tumor therapy
Data courtesy of Royal North Shore Hospital & University of Sydney, Sydney, Australia
Accurate, reproducible, and standardized quantification
Written by A. Hans Vija, PhD, Carl von Gall, MD, and Partha Ghosh, MD
Siemens Healthineers Molecular Imaging
1Results of pubmed.gov search for “Theranostics” or “Theragnostics” accessed February 24, 2020. Data on file.
2Accuracy of Bq/ml quantification measured per NEMA NU1-2018 using a uniform cylinder phantom. Calibration method: NIST-traceable source.
3For xSPECT 99mTc and xSPECT 177Lu for large uniform objects with volumes larger than 3000 mL.
4xSPECT Quant 131I is pending 510(k) clearance, and not yet commercially available in the United States and other countries. Due to regulatory reasons, its future availability cannot be guaranteed. Please contact your local Siemens organization for further details.
The statements by Siemens Healthineers customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.