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Prostate Cancer Treatment with Actinium-225 PSMA (program ID: 447923)

University Hospital Carl Gustav Carus Dresden

location_on Dresden, Germany
9.1/10 from 23 Votes
Specialized hospital
Jörg Kotzerke

Head Physician
Prof. Dr. med.

Jörg Kotzerke

Specialized in: nuclear medicine

Department of Nuclear Medicine

Program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • general physical examination
  • laboratory tests:
    • complete blood count
    • biochemical analysis of blood
    • urinalysis
    • TSH-basal, fT3, fT4
    • PSA blood level
    • tests for urogenital infections
    • indicators of inflammation
    • indicators of blood coagulation
  • ultrasound scan of the urogenital system
  • renal scintigraphy
  • PSMA PET-CT
  • PSMA treatment with Actinium-225
  • full body scintigraphy after 24 hours
  • full body scintigraphy after 48 hours
  • symptomatic treatment
  • cost of essential medicines
  • nursing services
  • elaboration of further recommendations
  • stay in the hospital with full board 
  • accommodation in 2-bedded room 

How program is carried out

During the first visit, the doctor will carry out a general physical examination and go through the results of previous laboratory and instrumental tests. After that, you will undergo the necessary additional tests such as the assessment of liver and kidney function, scintigraphy of the skeleton and salivary glands, PSMA PET / CT. This will allow the doctor to assess how effective PSMA therapy with Actinium-225 will be and how well you will tolerate it. Also, the doctor will calculate your individual dosage of the radionuclide.

PSMA therapy with Actinium-225 is carried out via intravenous administration of a solution with the radioactive isotope Actinium-225. The solution is injected through a catheter. This is a short procedure, as the infusion usually takes no more than 20 minutes.

During the procedure, you will need to apply cooling bags to the salivary glands, as Actinium-225 partially accumulates in the salivary glands, affecting their function and causing dry mouth. You will also receive intravenous saline solutions to protect your kidneys.

After the infusion of Actinium-225, you will stay in a specially equipped (radiation-shielded) ward for 48 hours. The drug is quickly excreted by the kidneys, and after 48 hours you will no longer be dangerous to others. During these 48 hours, you can read, use a mobile phone, tablet or computer – all these devices will not be a source of radiation in the future.

Follow-up examinations include whole-body scintigraphy or computed tomography in 24 hours and 48 hours after the procedure. Based on the results of the examination, the doctor will determine whether one procedure is enough for you, or whether you will need to visit the hospital again. As a rule, 1-2 procedures are required for achieving a stable positive result. Procedures are carried out with an interval of 8 weeks.

Required documents

  • Medical records
  • PSA blood test
  • MRI/CT scan (not older than 3 months)
  • Bone scintigraphy (if available)
  • Biopsy results (if available)
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About the department

The Department of Nuclear Medicine at the University Hospital Carl Gustav Carus Dresden offers the full range of diagnostics and treatment with therapeutic radionuclides. The department has been successful in conducting clinical activities for more than 60 years, and therefore has an extensive experience and outstanding achievements. The department is equipped with the state-of-the-art medical equipment, which allows its specialists to provide the optimal medical services in accordance with the highest international standards. The Chief Physician of the department is Prof. Dr. med. Jörg Kotzerke.

Special focus is on treatment of benign and malignant thyroid diseases. In addition, over the past two decades, the department’s range of treatment has been significantly expanded. Today, the department’s focus is on interventional radionuclide therapy for neuroendocrine tumors. Radioimmunotherapy is used to treat malignant lymphomas.

In order to ensure an accurate diagnostics, the department has at its disposal all the cutting-edge diagnostic techniques, including gamma camera, PET-CT and PET-MRI. The most frequently used examinations are scintigraphy of the thyroid and parathyroid glands, lungs, brain, heart and kidneys.

The department’s diagnostic and therapeutic service range:

  • Diagnostics
    • Brain perfusion scintigraphy 
    • Thyroid scintigraphy
    • Conventional skeletal scintigraphy
    • Skeletal scintigraphy using PET
    • Myocardial scintigraphy
    • Pulmonary ventilation scintigraphy
    • Pulmonary perfusion scintigraphy
    • Gastrointestinal scintigraphy (for example, esophagus, stomach, including the search for the source of gastrointestinal bleeding)
    • Salivary gland scintigraphy
    • Liver scintigraphy
    • Spleen scintigraphy
    • Kidney scintigraphy
    • Lymph node scintigraphy
    • Conventional scintigraphy for the detection of tumors and inflammatory processes
      • Bone marrow scintigraphy
      • Adrenal medulla scintigraphy
      • Adrenal cortex scintigraphy
    • Oncological diagnostics using PET, PET-CT and PET-MRI
      • Tumor diagnostics with PET using fluorodeoxyglucose
      • Somatostatin receptor scintigraphy
      • Skeletal scintigraphy using PET
      • PET with acetate (for example, for the diagnostics of prostate cancer)
      • PET using Ga-PSMA for prostate cancer
      • PET with F-DOPA (for example, for the detection of insulinoma)
  • Therapy
    • Radioiodine therapy for benign thyroid tumors 
    • Radioiodine therapy for malignant thyroid tumors 
    • Radiosynoviorthesis (RDF) in joint inflammatory diseases 
    • Receptor radiotherapy for neuroendocrine tumors
    • Radioimmunotherapy for malignant lymphomas
    • Palliative pain therapy for bone metastases
    • Selective internal radiation therapy for liver tumors and metastases
    • Radioisotope MIBG therapy
    • PSMA therapy
    • Other diagnostic and therapeutic options

Curriculum vitae

Education and Clinical Career

  • 1977 - 1983 Study of Human Medicine at the Hannover Medical School.
  • 1984 - 1988 Assistant Physician, Department of Nuclear Medicine and Special Biophysics, Hannover Medical School.
  • 1985 Doctorate, Hannover Medical School (Prof. Dr. med. Heinz Hundeshagen).
  • 1988 Board certification in Nuclear Medicine.
  • 1989 - 1995 Senior Physician, Department of Nuclear Medicine and Special Biophysics, Hannover Medical School.
  • 1991 Habilitation and Venia legendi (Nuclear Medicine), Hannover Medical School.
  • 1995 - 2002 Associate Professor of Cardiovascular Nuclear Medicine, Department of Nuclear Medicine, University of Ulm.
  • 2000 - 2002 Managing Senior Physician of the Department of Radiology, University Hospital Ulm.
  • Since 2002, Professor of Nuclear Medicine at the Carl Gustav Carus Faculty of Medicine, TU Dresden, and Medical Director of Positron Emission Tomography Center, Research Center Dresden-Rossendorf.
  • Since 2002, Head of the Department of Nuclear Medicine at the University Hospital Carl Gustav Carus Dresden.

Clinical Focuses

  • Tumor diagnostics with PET.
  • Radionuclide therapy.

Memberships

  • German Society for Nuclear Medicine (DGN).
  • German Roentgen Society (DRG).
  • European Association of Nuclear Medicine (EANM).
  • Society of Nuclear Medicine (SNM).
  • German Cancer Society (DKG).

Photo: (c) depositphotos 


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