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This month’s Editor’s favorite is Minczeles and colleagues “Dose-Limiting Bone Marrow Toxicities After Peptide Receptor Radionuclide Therapy Are More Prevalent in Women Than in Men?”. The authors pose that peptide receptor radionuclide therapy (PRRT) can cause dose limiting toxicities (DLTs) of the bone marrow, liver, and kidneys. They asked the question whether women and men are equally at risk of these DLTs. They retrospectively studied their 971 patients with NET treated with 177Lu-DOTATATE between 2000 and 2015 with data collected from their phase II trial. For all DLTs, the highest Common Terminology Criteria for Adverse Events (version 4.03) grades that occurred from the start of PRRT until 3 months after the last cycle were scored.
At baseline, women (n = 439) had a significantly lower body mass index, Karnofsky Performance Score, hemoglobin level, and creatinine clearance and a significantly higher platelet level than men (n = 534). Both groups received a median activity of 29.6 GBq (800 mCi). After the start of PRRT, women more frequently developed grade ≥2 thrombocytopenia compared with men (25% vs 18%, P = 0.004) due to a significant increase in grade ≥3 thrombocytopenia (11% vs 6%, P = 0.008). Furthermore, the incidence of grade ≥3 anemia was higher in women (7% vs 3%, P = 0.002). In the multivariable regression model, female sex (odds ratio, 2.50; 95% confidence interval, 1.67–3.74) was confirmed to be an independent risk factor for grade ≥2 thrombocytopenia, among baseline platelet count, bone metastases, uptake on 111In-DTPA-octreotide scan, Karnofsky Performance Score, alkaline phosphatase, lymphocytes, albumin, and renal function.
The authors concluded that female patients with neuroendocrine tumor more often experienced PRRT-induced toxicities of platelets and hemoglobin than males, but this did not require lower cumulative activity.​

Current Issue

PET With 11C-Methyl-l-Methionine as a Predictor of Consequential Outcomes at the Time of Discontinuing Temozolomide-Adjuvant Chemotherapy in Patients With Residual IDH-Mutant Lower-Grade Glioma

Beppu, Takaaki; Iwaya, Takeshi; Sato, Yuichi; More

Clinical Nuclear Medicine. 47(7):569-574, July 2022.

18F-FDG PET/CT During Neoadjuvant Targeted Therapy in Prior Unresectable Stage III Melanoma Patients: Can (Early) Metabolic Imaging Predict Histopathologic Response or Recurrence?

van der Hiel, Bernies; Blankenstein, Stephanie A.; Aalbersberg, Else A.; More

Clinical Nuclear Medicine. 47(7):583-589, July 2022.

Decentralized Distributed Multi-institutional PET Image Segmentation Using a Federated Deep Learning Framework

Shiri, Isaac; Vafaei Sadr, Alireza; Amini, Mehdi; More

Clinical Nuclear Medicine. 47(7):606-617, July 2022.

Sentinel Node Biopsy Imaging in Breast Cancer: Scatter Reduction Using 3-Dimensionally Printed Lead Shields

Cañete-Sánchez, Francisco M.; Boulvard-Chollet, Xavier L. E.; Chamorro, Xabier; More

Clinical Nuclear Medicine. 47(7):618-624, July 2022.

Visualization of Tumor Heterogeneity in Advanced Medullary Thyroid Carcinoma by Dual-Tracer Molecular Imaging: Revealing the Theranostic Potential of SSTR- and PSMA-Directed Endoradiotherapy

Hasenauer, Natalie; Higuchi, Takahiro; Deschler-Baier, Barbara; More

Clinical Nuclear Medicine. 47(7):651-652, July 2022.