Radiation Dosimetry in Non-Hodgkin’s B-Cell Lymphoma Patients Treated with 131I-Rituximab Radioimmunotherapy

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Wirote Changmuang
Arpakorn Kositwattanarerk
Kittipong Thongklam
Kanokon Poonak
Putthiporn Charoenphun
Thanete Doungta


Objective: The aim of this study was to calculate a therapeutic dose of 131I-Rituximab after a tracer patient-specific dosimetry based on whole body absorbed dose of 0.75 Gy.

Methods: Eight patients (mean ± S.D. age, 59.0 ± 11.6 years) were given initial tracer activity of 131I-Rituximab intravenously. Whole body images at 10 minutes, 3 days and 6 days were used to generate the Time-activity curve (TAC). TAC was fitted by plotting Log10 of the percentage administered activity remaining with time of scan and was used for calculation of the effective half-life, residence time and therapeutic dose. The organs dose was calculated by MIRDOSE 3.1 software.

Results: The mean effective half-life was 145.7 ± 13.4 hours, whereas the residence time was 210.3 ± 19.4 hours. The mean therapeutic dose was 1.16 ± 0.16 GBq. The mean absorbed dose to liver, lungs, ovaries, red marrow, testes and total body was 0.58 ± 0.05, 0.54 ± 0.05, 0.63 ± 0.06, 0.56 ± 0.05, 0.53 ± 0.05 and 0.54 ± 0.06 mGy/MBq, respectively.

Conclusions: The whole body radiation dose using a patient-specific tracer dose calculation based on whole body absorbed dose of 0.75 Gy was appropriate for therapeutic dose calculation in Radioimmunotherapy (RIT) patient.


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Changmuang, W., Kositwattanarerk, A., Thongklam, K., Poonak, K., Charoenphun, P., & Doungta, T. (2017). Radiation Dosimetry in Non-Hodgkin’s B-Cell Lymphoma Patients Treated with 131I-Rituximab Radioimmunotherapy. Ramathibodi Medical Journal, 40(2), 8-15. Retrieved from https://he02.tci-thaijo.org/index.php/ramajournal/article/view/87519
Original Articles


1. Juweid ME. Radioimmunotherapy of B Cell Non-Hodgkin's Lymphoma-From Clinical Trials to Clinical Preactice. J Nucl Med. 2002;43(11):1507-1529.

2. Jacene HA, Filice R, Kasecamp W, Wahl RL. Comparison of 90Y-ibritumomab tiuxetan and 131I-tositumomab in clinical practice. J Nucl Med. 2007;48(11):1767-1776.

3. Leahy MF, Turner JH. Radioimmunotherapy of relapsed indolent non-Hodgkin lymphoma with 131I-rituximab in routine clinical practice: 10-year single-institution experience of 142 consecutive patients. Blood. 2011;117(1):45-52. doi:10.1182/blood-2010-02-269753.

4. Gopal AK, Rajendran JG, Gooley TA, et al. High-dose [131I] tositumomab (anti-CD20) radioimmunotherapy and autologous hematopoietic stem-cell transplantation for adults > or = 60 years old with relapsed or refractory B-cell lymphoma. J Nucl Med. 2007;25(11):1396-1402.

5. Leahy MF, Seymour JF, Hicks RJ, Turner JH. Multicenter phase II clinical study of iodine-131-rituximab radioimmunotherapy in relapsed or refractory indolent non-Hodgkin's lymphoma. J Clin Oncol. 2006;24(27):4418-4425.

6. Bishton MJ, Leahy MF, Hicks RJ, Turner JH, McQuillan AD, Seymour JF. Repeat treatment with iodine-131-rituximab is safe and effective in patients with relapsed indolent B-cell non-Hodgkin's lymphoma who had previously responded to iodine-131-rituximab. Ann Oncol. 2008;19(9):1629-1633. doi:10.1093/annonc/mdn172.

7. Lymphomation.org. Comparing Properties of Bexxar and Zevalin. https://www.lymphomation.org/compare-bexxar-zevalin.htm. Updated August 16, 2013. Accessed Apirl 20, 2016.

8. Turner JH, Martindale AA, Boucek J, Claringbold PG, Leahy MF. 131I-Anti CD20 radioimmunotherapy of relapsed or refractory non-Hodgkins lymphoma: a phase II clinical trial of a nonmyeloablative dose regimen of chimeric rituximab radiolabeled in a hospital. Cancer Biother Radiopharm. 2003;18(4):513-524.

9. Mihailovic J. Current concepts of 131I therapy in oncology: Indications, methods and follow up. Archive of oncology. 2006;14(1-2):45-51. doi:10.2298/AOO0602045M.

10. Siegel JA, Yeldell D, Goldenberg DM, et al. Red marrow radiation dose adjustment using plasma FLT3-L cytokine levels: improved correlations between hematologic toxicity and bone marrow dose for radioimmunotherapy patients. J Nucl Med. 2003;44(1):67-76.

11. Changmuang W, Chotipanich C, Tuntawiroon M, Chuamsaamarkkee K, Jumpee C, Wittayachokkitikhun S. First experience for internal dosimetry calculation of red marrow in Thai-neuroendocrine tumor patients treated with 131I-MIBG. J Nucl Med. 2009;50(Suppl 2):2131.

12. Calais PJ, Turner JH. Standard Operating Procedure for Prospective Individualised Dosimetry for ([131]) I-rituximab Radioimmunotherapy of Non-Hodgkin's Lymphoma. World J Nucl Med. 2012;11(3):110-116. doi:10.4103/1450-1147.103409.

13. Kaminski MS, Fig LM, Zasadny KR, et al. Imaging, dosimetry, and radioimmunotherapy with iodine 131-labeled anti-CD37 antibody in B-cell lymphoma. J Clin Oncol. 1992;10(11):1696-711.

14. Wahl RL, Kroll S, Zasadny KR. Patient-specific whole-body dosimetry: principles and a simplified method for clinical implementation. J Nucl Med. 1998;39(8 Suppl):14S-20S.

15. Stabin MG, Sparks RB, Crowe E. OLINDA/EXM: the second-generation personal computer software for internal dose assessment in nuclear medicine. J Nucl Med. 2005;46(6):1023-7.

16. Stabin MG, Siegel JA, Sparks RB, Eckerman KF, Breitz HB. Contribution to red marrow absorbed dose from total body activity: a correction to the MIRD method. J Nucl Med. 2001;42(3):492-8.

17. Calais PJ, Turner JH. Outpatient 131I-rituximab radioimmunotherapy for non-Hodgkin lymphoma: a study in safety. Clin Nucl Med. 2012;37(8):732-7. doi:10.1097/RLU.0b013e31825ae6f6.

18. Kositwattanarerk A, Changmuang W, Sangsuriyan J, et al. 131I-rituximab treatment in patient with relapsed non-Hodgkin's lymphoma: the first case report in Thailand. J Med Assoc Thai. 2013;96(6):756-60.

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