ABSTRACT
The usage of European Medicines Agency and United States Food and Drug Administration approved Lu-177 DOTATATE for the peptide receptor radionuclide therapies especially for the patients with Neuroendocrine tumors are accelarating continuously in the past years. Since the optimal treatment schedule concerning the Lu-177 DOTATATE PRRT was not standardized yet, it is a hot topic in research area. In this manuscript, the main aim is to summarize the current status of the requlations regarding to the patient-specific dosimetry in the Lu-177 DOTATATE PRRT including the results of the related studies. In addition, dosimetry approaches for the Lu-177 DOTATATE PRRT as well as their limitations were reviewed briefly.
Keywords:
Lu-177 dosimetry, why dosimetry, regulations for dozimetry, patient-specific dosimetry
References
1
Kesner AL, Bodei L. Modern Radiopharmaceutical Dosimetry Should Include Robust Biodistribution Reporting. J Nucl Med 2018;59:1507-1509.
2
Konijnenberg M, Herrmann K, Kobe C, et al. EANM position paper on article 56 of the Council Directive 2013/59/Euratom (basic safety standards) for nuclear medicine therapy. Eur J Nucl Med Mol Imaging 2021;48:67-72.
3
European Society of R. Summary of the European Directive 2013/59/Euratom: essentials for health professionals in radiology. Insights Imaging 2015;6:411-417.
4
Flux G, Buscombe J, Officers, Council of the British Nuclear Medicine S. BNMS position statement on molecular radiotherapy. Nucl Med Commun 2021.
5
Bodei L, Cremonesi M, Ferrari M, et al. Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors. Eur J Nucl Med Mol Imaging 2008;35:1847-1856.
6
Kwekkeboom DJ, de Herder WW, Kam BL, et al. Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0,Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol 2008;26:2124-2130.
7
Pettinato C, Sarnelli A, Di Donna M, et al. Ga-68 DOTANOC: biodistribution and dosimetry in patients affected by neuroendocrine tumors. Eur J Nucl Med Mol Imaging 2008;35:72-79.
8
Bodei L, Mueller-Brand J, Baum RP, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2013;40:800-816.
9
Cremonesi M, Ferrari M, Bodei L, Tosi G, Paganelli G. Dosimetry in Peptide radionuclide receptor therapy: a review. J Nucl Med 2006;47:1467-1475.
10
Eberlein U, Cremonesi M, Lassmann M. Individualized Dosimetry for Theranostics: Necessary, Nice to Have, or Counterproductive? J Nucl Med 2017;58:97S-103S.
11
Strigari L, Benassi M, Chiesa C, Cremonesi M, Bodei L, D’Andrea M. Dosimetry in nuclear medicine therapy: radiobiology application and results. Q J Nucl Med Mol Imaging 2011;55:205-221.
12
Stokke C, Gabina PM, Solny P, et al. Dosimetry-based treatment planning for molecular radiotherapy: a summary of the 2017 report from the Internal Dosimetry Task Force. EJNMMI Phys 2017;4:27.
13
Ljungberg M, Celler A, Konijnenberg MW, et al. MIRD Pamphlet No. 26: Joint EANM/MIRD Guidelines for Quantitative 177Lu SPECT Applied for Dosimetry of Radiopharmaceutical Therapy. J Nucl Med 2016;57:151-162.
14
Imhof A, Brunner P, Marincek N, et al. Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers. J Clin Oncol 2011;29:2416-2423.
15
Barone R, Borson-Chazot F, Valkema R, et al. Patient-specific dosimetry in predicting renal toxicity with (90)Y-DOTATOC: relevance of kidney volume and dose rate in finding a dose-effect relationship. J Nucl Med 2005;46 Suppl 1:99S-106S.
16
Menda Y, Madsen MT, O’Dorisio TM, et al. (90)Y-DOTATOC Dosimetry-Based Personalized Peptide Receptor Radionuclide Therapy. J Nucl Med 2018;59:1692-1698.
17
Sundlov A, Sjogreen-Gleisner K, Svensson J, et al. Individualised (177)Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry. Eur J Nucl Med Mol Imaging 2017;44:1480-1489.
18
Garske-Roman U, Sändstrom M, Fross Baron K, et al. Prospective observational study of 177Lu-DOTA-octreotate therapy in 200 patients with advanced metastasized neuroendocrine tumours (NETs): feasibility and impact of a dosimetry-guided study protocol on outcome and toxicity. Eur J Nucl Med Mol Imaging 2018;45:970-988.
19
Del Prete M, Buteau FA, Arsenault F, et al. Personalized 177Lu-octreotate peptide receptor radionuclide therapy of neuroendocrine tumours: initial results from the P-PRRT trial. Eur J Nucl Med Mol Imaging 2019;46:728-742.
20
Huizing DMV, de Wit-van der Veen BJ, Verheij M, Stokkel MPM. Dosimetry methods and clinical applications in peptide receptor radionuclide therapy for neuroendocrine tumours: a literature review. EJNMMI research 2018;8:89.
21
Lassmann M, Chiesa C, Flux G, Bardies M, Committee ED. EANM Dosimetry Committee guidance document: good practice of clinical dosimetry reporting. Eur J Nucl Med Mol Imaging 2011;38:192-200.
22
Hanscheid H, Schirbel A, Hartrampf P, et al. Biokinetics and Dosimetry of [(177)Lu]Lu-Pentixather. J Nucl Med 2021.
23
Haug AR. PRRT of neuroendocrine tumors: individualized dosimetry or fixed dose scheme? EJNMMI research 2020;10:35.
24
Lassmann M, Eberlein U. Radiation Dosimetry Aspects of 177Lu. Curr Radiopharm 2015;8:139-144.
25
Rinscheid A, Kletting P, Eiber M, Beer AJ, Glatting G. Technical Note: Optimal sampling schedules for kidney dosimetry based on the hybrid planar/SPECT method in 177Lu-PSMA therapy. Medical physics 2019;46:5861-5866.
26
Belli ML, Mezzenga E, Di Iorio V, et al. A Whole Body Dosimetry Protocol for Peptide-Receptor Radionuclide Therapy (PRRT): 2D Planar Image and Hybrid 2D+3D SPECT/CT Image Methods. J Vis Exp 2020.
27
Hanscheid H, Lapa C, Buck AK, Lassmann M, Werner RA. Dose Mapping After Endoradiotherapy with 177Lu-DOTATATE/DOTATOC by a Single Measurement After 4 Days. J Nucl Med 2018;59:75-81.
28
Siegel JA, Thomas SR, Stubbs JB, et al. MIRD pamphlet no. 16: Techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates. J Nucl Med 1999;40:37S-61S.
29
Hindorf C, Glatting G, Chiesa C, Linden O, Flux G, Committee ED. EANM Dosimetry Committee guidelines for bone marrow and whole-body dosimetry. Eur J Nucl Med Mol Imaging 2010;37:1238-1250.
30
Hagmarker L, Svensson J, Ryden T, et al. Bone marrow absorbed doses and correlations with hematological response during 177Lu-DOTATATE treatments are influenced by image-based dosimetry method and presence of skeletal metastases. J Nucl Med 2019.
