Evidence mapPaperPMID 42350617Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

Metformin and renal dosimetry in patients undergoing [

Sophie Carina Siegmund, Astrid Delker, Liam Widjaja, Johannes Hornfeck, Muyu Wu, Lena M Unterrainer, Franz Josef Gildehaus, Guido Böning, Rudolf A Werner, Zachary Ells

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sophie Carina SiegmundDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany. sophie.siegmund@med.uni-muenchen.de.ORCID http://orcid.org/0009-0003-3175-952X
Astrid DelkerDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Liam WidjajaDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Johannes HornfeckDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Muyu WuDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Lena M UnterrainerDepartment of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany.
Franz Josef GildehausDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Guido BöningDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Rudolf A WernerDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
Zachary EllsDepartment of Nuclear Medicine, LMU University Hospital, LMU Medizin, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.

Funding

Munich Clinician Scientist Program Munich Clinician Scientist Program
6 · The paper itself

Abstract

purposeProstate-specific membrane antigen (PSMA)-targeted radiopharmaceutical therapy (RPT) is an established treatment for advanced prostate cancer, but renal radiation exposure remains a major safety concern, as no clinically established nephroprotective strategy exists. Preclinical data suggest metformin to reduce renal radiopharmaceutical retention by interfering with tubular reabsorption. This study aimed to investigate the effect of metformin on renal and tumor dosimetry in PSMA RPT patients.

methods57 patients undergoing PSMA RPT were retrospectively analyzed (n=15 with metformin; n=42 without metformin). The mean kidney absorbed dose (AD) and mean tumor AD (up to three randomly selected osseous metastases per patient) were assessed by post-RPT dosimetry. Total tumor volume (TTV) was evaluated as a potential confounder.

resultsPatients on metformin showed a significantly lower mean kidney AD compared to patients without metformin (median 0.290 vs. 0.367 Gy/GBq; p=0.046). In multiple linear regression analysis, metformin use was independently associated with reduced mean kidney AD, whereas TTV was not a significant predictor. No significant difference in mean tumor AD was observed between groups (0.739 vs. 0.997 Gy/GBq; p=0.215), indicating preserved tumor targeting. No association between tumor burden and mean kidney AD was detected, suggesting independence from tumor sink effect.

conclusionMetformin use was associated with a reduced mean kidney AD in patients undergoing PSMA RPT without affecting tumor ADs. Thus, metformin may represent a promising and widely available strategy to reduce renal radiation exposure and improve the therapeutic index of PSMA-targeted RPT. Prospective studies are warranted to validate these findings and define optimal treatment regimens.

Indexed as

DosimetryKidney absorbed doseMetforminPSMA radiopharamceutical therapyTumor dose

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.