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Prostate Cancer Treatment with Actinium-225 PSMA (program ID: 447917)

University Hospital Erlangen

location_on Erlangen, Germany
9.1/10 from 51 Votes
Specialized hospital
Torsten Kuwert

Head Physician
Prof. Dr. med.

Torsten Kuwert

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 Erlangen offers the full range of diagnostic and therapeutic services in its specialization. Of particular interest are PET/CT, SPECT/CT, as well as innovative therapeutic methods of nuclear medicine, such as peptide radioreceptor therapy for neuroendocrine tumors, radioembolization of liver tumors and treatment of prostate cancer with radioligands targeting a prostate specific membrane antigen (PSMA therapy). The highly qualified world-renowned doctors take care of the patients. The department is headed by Prof. Dr. med. Torsten Kuwert.

The department has a specialized outpatient clinic for the diagnostics and treatment of all benign and malignant thyroid diseases. The diagnostic capabilities include ultrasound examinations of various modifications (three modern high-resolution ultrasound machines), thyroid scintigraphy and SPECT/CT, which is rarely required. The tests to determine thyroid hormones and antibody levels are carried out in the in-house laboratory. Further laboratory tests are carried out in the central laboratory of the university hospital. The doctors of the outpatient clinic are experienced experts in the field of radioiodine therapy and always inform patients about the details of the course of therapy and the indications for it before its start. The clinical cases of patients with thyroid malignancies are considered at the interdisciplinary consultations, after which the optimal treatment tactics is selected.

The service range of the department includes:

  • Diagnostic options
    • PET, PET/CT and PET/MR
      • Brain tumors (gliomas)
      • Recurrent prostate cancer
      • Neuroendocrine tumors
      • Inflammatory processes
      • Diagnostics of myocardial condition
    • Scintigraphy and SPECT/CT
      • Endocrinology
        • Thyroid scintigraphy using sodium pertechnetate 99mTc or MIBI Tc-99m
        • Parathyroid scintigraphy
      • Gastroenterology and pulmonology
        • Perfusion lung scintigraphy
        • Salivary gland scintigraphy
        • Scintigraphy to assess the dynamics of gastric emptying
        • Scintigraphy in case of suspected Meckel's diverticulum
        • Search for the source of bleeding using Tc-99m-labeled red blood cells
        • Spleen scintigraphy
      • Oncology
        • Bone scintigraphy
        • Scintigraphy to determine the expression of somatostatin receptors using Tc-99m-Tectreotyd
        • I-123 MIBG scintigraphy
        • Scintigraphy to determine the expression of PSMA (prostate specific membrane antigen) with Tc-99m MIP1404
      • Cardiology
        • Myocardial perfusion scintigraphy
        • Myocardial viability assessment
        • Assessment of sympathetic innervation using I-123-MIBG
      • Nephrology and urology
        • Dynamic kidney scintigraphy using TER-MAG-3 (Tc-99m-MAG-3)
        • Static kidney scintigraphy (Tc-99m-DMSA)
      • Neurology
        • Perfusion brain scintigraphy
        • Diagnostics of Parkinson's disease using FP-CIT-SPECT (dopamine-amino transporter scintigraphy) and IBZM-SPECT (dopamine receptor-2 scintigraphy)
      • Orthopedics and traumatology
        • Bone scintigraphy
        • Diagnostics of inflammatory processes using granulocyte antibody scintigraphy
  • Therapy
    • Radioiodine therapy for benign and malignant thyroid diseases
    • Peptide radioreceptor therapy (PRRT) for neuroendocrine tumors
    • Lutetium-177-PSMA therapy for metastatic prostate cancer
    • Selective internal radiation therapy for primary malignant neoplasms of the liver and liver metastases
    • Xofigo® therapy (radium-223-dichloride) for the treatment of bone metastases in prostate cancer
    • Radiosynoviorthesis (RSO) in chronic inflammatory joint diseases
    • Zevalin therapy
  • Other diagnostic and therapeutic services

Curriculum vitae

Education

  • 1986 Master of Engineering, Rhine-Westphalian Technical Aachen University, Germany.

Professional Career

  • 1986 - 1992 Assistant, Institute of Microelectronics/Children with Food Allergies, Juelich, Germany.
  • 1992 - 1994 Associate Professor, Institute of Microelectronics/Children with Food Allergies, Juelich, Germany.
  • 1994 - 1997 Associate Professor, Department of Nuclear Medicine, University of Muenster, Germany.
  • 1997 Head and Professor, Department of Nuclear Medicine, Institute for Nuclear Medicine, Bad Oeynhausen, Germany.
  • Head of the Department of Nuclear Medicine at the University Hospital Erlangen.

Photo of the doctor: (c) Universitätsklinikum Erlangen 


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