The radiation dosimetry of Re-186 HEDP

Patients suffering from metastatic bone cancer may be offered some relief of bone pain by several palliative agents currently under study. One such agent is Re-186 HEDP (etidronate). We gathered biodistribution data from 27 patients receiving this agent for palliation of bone pain. Skeletal activity was estimated as that portion of administered activity not recovered in urine or measured in kidneys or extracellular fluid (ECF) space. Activity in kidneys was estimated through scintigraphic imaging. Activity in urine and blood were estimated by direct counting of samples; activity in ECF was approximated as blood activity divided by the plasmacrit, multiplied by 0.2 times body weight. All retention data were fit to a sum of exponentials for estimation of residence times. Activity in the urinary bladder contents was estimated from the urinary excretion data using the dynamic bladder model of Cloutier et al. Estimated residence times were kidneys 0.538 hr, bone 33.3 hr (divided evenly between cortical and trabecular bone for dosimetry purposes), urinary bladder contents 1.18 hr, and remainder of body 6.52hr. Radiation dose estimates were developed, using the MIRDOSE 3 software. Radiation dose estimates for bone surfaces and red marrow are 1.9 and 0.82 mGy/MBq, respectively. The estimate for themore » urinary bladder wall is 0.57 mGy/MBq. Most other organs` estimates were around 0.02 mGy/MBq. The new marrow dose model presented in MIRDOSE 3 was used to look at the distribution of marrow dose in different bones, and to develop a dose-volume histogram. These data should be used as the basis for the radiation dosimetry of this agent.« less