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Title	Clinical evaluation of the radiolanthanide terbium-152: first-in-human PET/CT with $^152$Tb-DOTATOC
Related title	Clinical evaluation of the radiolanthanide terbium-152: first-in-human PET/CT with 152Tb-DOTATOC
Author(s)	Baum, Richard P (Zentralklinik, Bad Berka) ; Singh, Aviral (Zerntralklinik, Bad Berka) ; Benešová, Martina (PSI, Villigen ; ETH, Zurich (main)) ; Vermeulen, Christiaan (PSI, Villigen) ; Gnesin, Silvano (Lausanne U. Hospital, Lausanne) ; Köster, Ulli (Laue-Langevin Inst.) ; Johnston, Karl (CERN) ; Müller, Dirk (Zentralklinik, Bad Berka) ; Senftleben, Stefan (Zentralklinik, Bad Berka) ; Kulkarni, Harshad R (Zentralklinik, Bad Berka) ; Türler, Andreas (PSI, Villigen ; U. Bern (main)) ; Schibli, Roger (PSI, Villigen ; ETH, Zurich (main)) ; Prior, John O (Lausanne U. Hospital, Lausanne) ; van der Meulen, Nicholas P (PSI, Villigen) ; Müller, Cristina (PSI, Villigen ; ETH, Zurich (main))
Publication	2017
Number of pages	9
In:	Dalton Trans. 46 (2017) 14638-14646
DOI	10.1039/c7dt01936j
Subject category	Other
Abstract	The existence of theragnostic pairs of radionuclides allows the preparation of radiopharmaceuticals for diagnostic and therapeutic purposes. Radiolanthanides, such as $^{177}$Lu, are successfully used for therapeutic purposes; however, a perfect diagnostic match is currently not available for clinical use. A unique, multi-disciplinary study was performed using $^{152}$Tb ($T_{1/2}$ = 17.5 h, E$\beta ^+_{average}$ = 1140 keV, I$β^+$ = 20.3%), which resulted in the first-in-human PET/CT images with this promising radionuclide. For this purpose, $^{152}$Tb was produced via a spallation process followed by mass separation at ISOLDE, CERN. The chemical separation and quality control, performed at PSI, resulted in a pure product in sufficient yields. Clinical PET phantom studies revealed an increased image noise level, because of the smaller $\beta^+$ branching ratio of $^{152}$Tb as compared to standard PET nuclides at matched activity concentrations; however, the expected recovery would be comparable at matched signal-to-noise ratios in clinical PET. $^{152}$Tb was used for labeling DOTATOC, at Zentralklinik Bad Berka, and administered to a patient for a first-in-human clinical study. PET scans were performed over a period of 24 h, allowing the visualization of even small metastases with increased tumor-to-background contrast over time. Based on the results obtained in this work, it can be deduced that PET/CT imaging with $^{152}$Tb-labeled targeting agents has promise for clinical application and may be particularly interesting for pre-therapeutic dosimetry.
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