Evaluation of safe use of 188Re-HEDP comparing urine data and whole body counting in gamma camera

Cancer is the second more frequent cause of death, after cardiovascular disease, in developing countries. Most of adult patients with neoplasms will develop skeletal metastases that can lead to progressive pain. 188Re emits both beta particles suitable for therapy and a gamma ray (155 keV), adequate for diagnostic imaging in order to verify localization in the pain areas associated to metastatic process. The aim of this work was to correlate 188Re-HEDP dose estimations using biological samples and direct measures. All the patients had breast or prostate cancer, with bone metastases. Each patient received a tracer dose of 185 MBq of radiopharmaceutical. Urine samples were collected at 0-1, 1-2, 2-4 and, 4-6 hours post administration, and measured in dose calibrator. Whole body counts were acquired using a camera without collimator, window centered at 155 KeV, matrix 256 x 256, during 60 seconds. Data were obtained at 1 and 6 hours post administration with the patient in sitting position at 2 meter from the detector. Percentage of injected dose was calculated both for urine samples and image for each patient. The number of disintegrations was determined for organs in which higher concentration of activity was observed: those involved in the excretion, red marrow and the reminder of the body. Total doses were estimated using OLINDA/EXM software. Conclusions: Data showed that the organs chosen as more compromised during the tracer dose procedure received very low effective doses. A good correlation between calculations performed both for image and urine samples was obtained. Safety of the radiopharmaceutical was also verified using this method. (author)