Intraarterial Administration Boosts <sup>177</sup>Lu-HA-DOTATATE Accumulation in Salvage Meningioma Patients.

Vonken, Evert-Jan P A; Bruijnen, Rutger C G; Snijders, Tom J; Seute, Tatjana; Lam, Marnix G E H; Keizer, Bart de; Braat, Arthur J A T · J Nucl Med · 2022

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Abstract

Intravenous <sup>177</sup>Lu-high-affinity (HA)-DOTATATE has shown promising results for the treatment of surgery- and radiotherapy-refractory meningiomas. We aimed to investigate the added value of intraarterial administration. <b>Methods:</b> Patients underwent at least 1 intravenous <sup>177</sup>Lu-HA-DOTATATE treatment first and subsequent intraarterial cycles. Inpatient and intrapatient comparison was based on posttreatment <sup>177</sup>Lu-HA-DOTATATE imaging 24 h after injection. The technical success rate and adverse events were recorded. <b>Results:</b> Four patients provided informed consent. The technical success rate was 100%, and no angiography-related or unexpected adverse events occurred. Intrapatient comparison showed an increased target lesion accumulation on both planar imaging (mean, +220%) and SPECT/CT (mean, +398%) after intraarterial administration, compared with intravenous administration. No unexpected adverse events occurred during follow-up. <b>Conclusion:</b> Intraarterial peptide receptor radionuclide therapy significantly increases tracer accumulation and is a safe and promising improvement for salvage meningioma patients. Future prospective studies on intraarterial peptide receptor radionuclide therapy are needed to determine the gain in efficacy and survival.

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