Prostate Cancer Treatment with Actinium-225 PSMA (program ID: 447944)
Charite University Hospital Berlin
Holger AmthauerSpecialized in: nuclear medicine
Department of Nuclear Medicine
- Initial presentation in the clinic
- clinical history taking
- general physical examination
- laboratory tests:
- complete blood count
- biochemical analysis of blood
- 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.
- 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 Charite University Hospital Berlin offers the full range of radioisotope diagnostics and treatment using radionuclides. Of particular interest to the department's specialists are the diagnostics and therapy of cancers, diseases of the nervous system, heart, musculoskeletal system, ENT pathologies, surgical diseases, disorders of the urological and gynecological sphere. The department's doctors carry out outpatient diagnostics, inpatient and outpatient treatment in accordance with the guidelines of professional societies. The department is headed by Prof. Dr. med. Holger Amthauer.
The department is equipped with all the innovative equipment available in nuclear medicine. For example, the department performs all types of scintigraphy (including whole body scintigraphy), SPECT, advanced hybrid examinations (SPECT-CT, PET-CT, PET-MR). In addition, the department has several radiochemical modules, including cyclotron for the synthesis of radioactive isotopes for SPECT and PET, as well as for the creation of radioisotope drugs.
The service range of the department includes:
- Outpatient diagnostics
- Brain examinations
- Dopamine D2 receptor scintigraphy
- Dopamine transporter scintigraphy
- Benzodiazepine receptor scintigraphy
- Cerebrospinal fluid scintigraphy
- Cardiovascular examinations
- Radionuclide ventriculography
- Myocardial perfusion scintigraphy
- Lung examinations
- Perfusion scintigraphy
- Ventilation scintigraphy
- Inhalation scintigraphy
- Kidney examination
- Perfusion/functional scintigraphy
- Glomerular and tubular clearance
- Static scintigraphy
- Abdominal/gastrointestinal examinations
- Hepatobiliary functional scintigraphy
- Selective spleen scintigraphy
- Radioactive blood pool scintigraphy
- Search for bleeding source
- Gastric mucosal examinations
- Esophageal scintigraphy
- Scintigraphy for the determination of gastric emptying degree
- Salivary gland scintigraphy
- Skeletal examinations
- Skeletal scintigraphy
- Bone marrow scintigraphy
- Scintigraphy for the detection of inflammatory processes
- Scintigraphy for the detection of benign and malignant neoplasms
- Endocrine examinations
- Thyroid scintigraphy
- Parathyroid scintigraphy
- Adrenal gland scintigraphy
- Examinations of the hematopoietic system
- Examinations of the lymphatic system
- Sentinel lymph node scintigraphy
- Scintigraphy in lymphedema
- Brain examinations
- PET-CT and PET-MRI
- Diagnostics of inflammations and neoplasms
- Diagnostics of brain function
- Skeletal diagnostics
- Prostate cancer diagnostics
- Diagnostics of brain tumors
- Diagnostics of neuroendocrine tumors
- Outpatient treatment
- Pain therapy in bone metastases
- Radiosynoviorthesis in joint pain
- Cevalin therapy
- Inpatient treatment
- Radioiodine therapy in thyroid diseases
- Peptide receptor radionuclide therapy in neuroendocrine tumors
- Selective intra-arterial radiation therapy in multiple liver metastases
- MIBG therapy in neuroblastomas
- Other medical services
- 1986 - 1993 Study of Human Medicine in Budapest, Giessen and Munich (Technical University).
- 1998 Doctoral thesis defense with honors, Institute of Pathology, University Hospital Rechts der Isar Munich. Topic: "Areas of nucleation in neuroendocrine tumors of the gastrointestinal tract and pancreas: correlation with histopathological and clinical data".
- 13.11.2006 Habilitation and Venia legendi in Nuclear Medicine.
- Medical Specialist in Nuclear Medicine.
- Theoretical basics of the specialty in Diagnostic Radiology.
- Theoretical basics of the specialty in Radiation Protection.
- Comprehensive imaging using SPECT-CT and PET-CT in oncology.
- Development of new algorithms in the diagnostics of malignant diseases in childhood and adolescence.
- Diagnostics and treatment of neuroendocrine tumors using nuclear medicine techniques.
- Use of innovative radiopharmaceuticals in the diagnostics of neurodegenerative diseases and in neuro-oncology.
- Creation of a Molecular Imaging Center.
- Integration of outpatient and inpatient care.
- Creation of new treatment methods in the field of nuclear medicine (radioreceptor therapy, radioimmunotherapy, minimally invasive radionuclide therapy).
- Diagnostics of neurodegenerative and neuro-oncological diseases.
Photo of the doctor: (c) Charité – Universitätsmedizin Berlin