Biomedical subjects

Sven-Erik Strand

Publications and source records attributed to Sven-Erik Strand.

22 records · Page 2Linked to original sources

PubMed2002

131I-labelled anti-CD22 MAb (LL2) in patients with B-cell lymphomas failing chemotherapy. Treatment outcome, haematological toxicity and bone marrow absorbed dose estimates.

The experience with radioimmunotherapy in B-cell lymphomas using the rapidly internalizing antibody, anti-CD22 (LL2), is limited. In this study we investigated the efficacy and toxicity of 131I-labelled-LL2 for radioimmunotherapy in patients with B-cell lymphomas that failed one or two cytostatic regimens. Eleven patients were treated with one or repeated cycles of 131I-anti-CD22 antibody, 1330 MBq/m2 (36 mCi/m2). Six of the 11 treated patients demonstrated an objective response, three of them with complete remission. All follicular (3 patients) and transformed lymphomas (2 patients) responded compared to one of four diffuse large B-cell lymphomas. Two out of six responders exhibited event-free survival (EFS), which was comparable with or longer than the EFS following primary anthracycline-containing chemotherapy. Non-haematological toxicity was mild. Haematological toxicity was associated with pretreatment clinical characteristics but not with estimated absorbed bone marrow doses. Objective remission following treatment with 131I-anti-CD22 can be achieved in patients with various subtypes of B-cell lymphomas, failing standard chemotherapy. Follicular or transformed lymphomas seem particularly responsive. Haematological toxicity seems to be dependent on the functional status of the bone marrow before radioimmunotherapy.

Adult↗

PubMed2002

An activity quantification method based on registration of CT and whole-body scintillation camera images, with application to 131I.

UNLABELLED: This article presents a new method for conjugate view activity quantification for 131I-labeled monoclonal antibody distribution. METHODS: The method is based on the combined use of images from 3 modalities: whole-body (WB) scintillation camera scanning, WB transmission scanning using 57Co, and CT. All images are coaligned using a recently developed program for the registration of WB images. Corrections for attenuation, scatter, and septal penetration are performed in image space. Compensation for scatter and septal penetration is performed by deconvolution, using point-response functions determined from Monte Carlo simulations. Attenuation correction is performed by applying a patient-specific 364-keV narrow-beam attenuation map obtained by combining information from the CT and the transmission scan. A relationship is presented for the conversion of the CT numbers to mass density. The attenuation- and scatter-compensated image is converted from counts to activity using a sensitivity value that was determined for 364-keV photons in air. This activity projection image is then analyzed for the activity of volumes of interest (VOI) using 2-dimensional regions of interest (ROIs) that are determined from the CT study. The CT is first resliced into coronal slices, and a maximum-extension ROI is outlined that encloses the VOI. Compensation for background activity and overlapping organs is performed on the basis of total patient thickness in the projection line, and on precalculated organ- background thickness fractions. RESULTS: Method evaluation was performed using data from both experimental measurements and Monte Carlo simulations. The use of an attenuation map derived directly from the CT study was also evaluated. For organ activity quantification, an accuracy of > or =10% was obtained. For small-diameter tumors, deviations were larger because of lack of correction for the background-dependent partial-volume effect. CONCLUSION: Registration of CT and WB scintillation camera images was successfully applied to improve activity quantification by the conjugate view method.

Antibodies, Monoclonal↗

PubMed2002

A 3-dimensional absorbed dose calculation method based on quantitative SPECT for radionuclide therapy: evaluation for (131)I using monte carlo simulation.

UNLABELLED: A general method is presented for patient-specific 3-dimensional absorbed dose calculations based on quantitative SPECT activity measurements. METHODS: The computational scheme includes a method for registration of the CT image to the SPECT image and position-dependent compensation for attenuation, scatter, and collimator detector response performed as part of an iterative reconstruction method. A method for conversion of the measured activity distribution to a 3-dimensional absorbed dose distribution, based on the EGS4 (electron-gamma shower, version 4) Monte Carlo code, is also included. The accuracy of the activity quantification and the absorbed dose calculation is evaluated on the basis of realistic Monte Carlo-simulated SPECT data, using the SIMIND (simulation of imaging nuclear detectors) program and a voxel-based computer phantom. CT images are obtained from the computer phantom, and realistic patient movements are added relative to the SPECT image. The SPECT-based activity concentration and absorbed dose distributions are compared with the true ones. RESULTS: Correction could be made for object scatter, photon attenuation, and scatter penetration in the collimator. However, inaccuracies were imposed by the limited spatial resolution of the SPECT system, for which the collimator response correction did not fully compensate. CONCLUSION: The presented method includes compensation for most parameters degrading the quantitative image information. The compensation methods are based on physical models and therefore are generally applicable to other radionuclides. The proposed evaluation methodology may be used as a basis for future intercomparison of different methods.

Humans↗

PubMed2002

A dosimetry model for the small intestine incorporating intestinal wall activity and cross-doses.

UNLABELLED: Current internal radiation dosimetry models for the small intestine, and for most walled organs, lack the ability to account for the activity uptake in the intestinal wall. In existing models the cross-dose from nearby loops of the small intestine is not taken into consideration. The aim of this investigation was to develop a general model for calculating the absorbed dose to the radiation-sensitive cells in the small intestinal mucosa from radionuclides located in the small intestinal wall or contents. METHODS: A model was developed for calculation of the self-dose and cross-dose from activity in the intestinal wall or contents. The small intestine was modeled as a cylinder with 2 different wall thicknesses and with an infinite length. Calculations were performed for various mucus thicknesses. S values were calculated using the EGS4 Monte Carlo simulation package with the PRESTA algorithm and the simulation results were integrated over the depth of the radiosensitive cells. The cross-organ dose was calculated by summing the dose contributions from other intestinal segments. Calculations of S values for self-dose and cross-dose were made for monoenergetic electrons, 0.050-10 MeV, and for the radionuclides (99m)Tc, (111)In, (131)I, (67)Ga, (90)Y, and (211)At. RESULTS: The self-dose S value from activity located in the small intestinal wall is considerably greater than the S values for self-dose from the contents and the cross-dose from wall and contents except for high electron energies. For all radionuclides investigated and for electrons 0.10-0.20 MeV and 8-10 MeV in energy, the cross-dose from activity in the contents is higher than the self-dose from the contents. The mucus thickness affects the S value when the activity is located in the contents. CONCLUSION: A dosimetric model for the small intestine was developed that takes into consideration the localization of the radiopharmaceutical in the intestinal wall or in the contents. It also calculates the contribution from self-dose and cross-dose. With this model, more accurate calculations of absorbed dose to radiation-sensitive cells in the intestine are possible.

Electrons↗