Figure 8, page 34 of the thesis. The segmented bone marrow biopsy shows the three components of spongiosa, red marrow, yellow marrow, and trabecular bone together with three tumors with the sizes of 10, 100, and 10,000 cells.

Linn Hagmarker: Image-based method for bone marrow dosimetry

Published

13 May 2024

at

Neuroendocrine tumors are frequently metastatic and can be treated with targeted radionuclide therapy. Linn Hagmarker has developed a new method for calculating bone marrow absorbed dose during 177Lu-DOTATATE treatment, aiding in personalized treatment to enhance efficacy and minimize side effects.

Linn Hagmarker, a medical physicist at Sahlgrenska University Hospital and a doctoral student at the Institute of Clinical Sciences.

LINN HAGMARKER
Dissertation defense: 4 June 2024 (click for details)
Doctoral thesis: Development of a hybrid image-based method for bone marrow dosimetry during ¹⁷⁷Lu-DOTATATE treatment
Research area: Medical Radiation Sciences
Sahlgrenska Academy, The Institute of Clinical Sciences

Patients with neuroendocrine tumors often have a metastasized disease requiring targeted treatment. Radionuclide therapy with ¹⁷⁷Lu-DOTATATE is an option for patients with tumor cells that overexpress somatostatin receptors.

DOTATATE is a molecule that binds to somatostatin receptors, and the radioactive isotope lutetium-177 (abbreviated ¹⁷⁷Lu) provides local radiation therapy.

“Usually, the treatment only has mild side effects, but the radiation dose to the kidneys and bone marrow can cause both short-term and long-term side effects. Dosimetry, or the measurement of radiation dose, can be used to personalize treatment. This allows for increasing the dose to the tumor and reducing the risk of toxicity.,” says Linn Hagmarker, a doctoral student in Medical Radiation Science, also working as a medical physicist in Nuclear Medicine at Sahlgrenska University Hospital.

Cover image of the thesis. Location of spheric volume of interests in vertebrae in a patient with bone metastases.

Developed a new method

What is your doctoral thesis about in brief?
“My research has focused on developing a method for calculating the radiation dose to the bone marrow during treatment with ¹⁷⁷Lu-DOTATATE. By using repeated imaging with a gamma camera, we can determine the kinetics of the radioactive drug, revealing how the drug moves through the body over time and how long it remains. And with the help of our models, we can calculate the radiation dose to the bone marrow.”

What are the most important research findings?
“With the method we have developed, we have been able to calculate the radiation dose to the bone marrow and we have been able to show that it affects hematological response. We have also developed a model to calculate the dose for patients with skeletal metastases.”

Figure 3, page 27 in the thesis. The high uptake compartment (HUC), marked with blue, increases with increasing nNUF value. A whole-body VOI is created. Highest uptake foci in (A), all high-uptake organs in (B), the number of foci escalates in (C).

“Fun to Collaborate”

What has been enjoyable and rewarding about your doctoral project?
“Developing new methods has been very enjoyable. It has also been fun to collaborate with colleagues from different professions in the various projects. There has been a large patient material and a lot of data to handle, which has been challenging.”

Text: Jakob Lundberg

Area

Health and medicine