view.
Fixed areas (unchanged with time) of uptake in the normal bowel greater than uptake in the liver.
In less than 0.5% of patients receiving In-111 Zeva lin, prominent bone marrow uptake was observed, characterized by clear visualization of the long bones and ribs.
Consider bone marrow involvement by lymphoma, increased marrow activity due to recent hematopoietic growth factor administration, and increased reticuloendothelial uptake in patients with HAMA and HACA, as possible causes of prominent bone marrow uptake. Re-assess biodistribution after correction of underlying factors.
2.6 Radiation Dosimetry
Estimations of radiation-absorbed doses for In-111 Zeva lin and Y-90 Zeva lin were performed using sequential whole body images and the MIRDOSE 3 software program. The estimated radiation absorbed doses to organs and marrow from a course of the Zeva lin therapeutic regimen are summarized in Table 1. Absorbed dose estimates for the lower large intestine, upper large intestine, and small intestine have been modified from the standard MIRDOSE 3 output to account for the assumption that activity is within the intestine wall rather than the intestine contents.
Table 1. Estimated Radiation Absorbed Doses from Y-90 Zeva lin and In-111 Zeva lin *
Organ region of interest
Sacrum region of interest
Whole body region of interest
Organ Y-90 Zeva lin cGy /mCi (mGy/MBq) In-111 Zeva lin cGy/mCi (mGy/MBq)
Median Range Median Range
Spleen* 34.78 (9.4) 6.66 - 74.00 (1.8 - 20.0) 3.33 (0.9) 0.74 - 6.66 (0.2 - 1.8)
Liver* 17.76 (4.8) 10.73 - 29.97 (2.9 - 8.1) 2.59 (0.7) 1.48 - 4.07 (0.4 - 1.1)
Lower Large Intestinal Wall* 17.39 (4.7) 11.47 - 30.34 (3.1 - 8.2) 1.48 (0.4) 0.74 - 2.22 (0.2 -0.6)
Upper Large Intestinal Wall* 13.32 (3.6) 7.40 - 24.79 (2.0 - 6.7) 1.11 (0.3) 0.74 - 2.22 (0.2 - 0.6)
Heart Wall* 10.73 (2.9) 5.55 - 11.84 (1.5 - 3.2) 1.48 (0.4) 0.74 - 1.85 (0.2 - 0.5)
Lungs* 7.4 (2) 4.44 - 12.58 (1.2 -3.4) 0.74 (0.2) 0.74 - 1.48 (0.2 - 0.4)
Testes* 5.55 (1.5) 3.70 - 15.91 (1.0 - 4.3) 0.37 (0.1) 0.37 - 1.11 (0.1 - 0.3)
Small Intestine* 5.18 (1.4) 2.96 - 7.77 (0.8 - 2.1) 0.74 (0.2) 0.74 - 1.11 (0.2 - 0.3)
Red Marrow 4.81 (1.3) 2.22 - 6.66 (0.6 - 1.8) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
Urinary Bladder Wall‡ 3.33 (0.9) 2.59 - 4.81 (0.7 - 1.3) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
Bone Surfaces† 3.33 (0.9) 1.85 - 4.44 (0.5 - 1.2) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
Total Body 1.85 (0.5) 1.48 - 2.59 (0.4 - 0.7) 0.37 (0.1) 0.37 - 0.74 (0.1 - 0.2)
Ovaries 1.48 (0.4) 1.11 - 1.85 (0.3 - 0.5) 0.74 (0.2) 0.74 - 0.74 (0.2 - 0.2)
Uterus 1.48 (0.4) 1.11 - 1.85 (0.3 - 0.5) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
Adrenals 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.74 (0.2) 0.74 - 1.11 (0.2 - 0.3)
Brain 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.00 - 0.37 (0.0 - 0.1)
Breasts 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.37 - 0.37 (0.1 - 0.1)
Gallbladder Wall‡ 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 1.11 (0.3) 0.74 - 1.48 (0.2 - 0.4)
Muscle 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.37 - 0.37 (0.1 - 0.1)
Pancreas 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.74 (0.2) 0.74 - 1.11 (0.2 - 0.3)
Skin‡ 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.00 - 0.37 (0.0 - 0.1)
Stomach 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
Thymus 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.37 - 0.74 (0.1 - 0.2)
Thyroid 1.11 (0.3) 0.74 - 1.85 (0.2 - 0.5) 0.37 (0.1) 0.00 - 0.37 (0.0 - 0.1)
Kidneys* 0.37 (0.1) 0.00 - 1.11 (0.0 - 0.3) 0.74 (0.2) 0.37 - 0.74 (0.1 - 0.2)
3 DOSAGE FORMS AND STRENGTHS
|
