ABSTRACT
Peptide receptor radionuclide therapy (PRRT) have been successfully used for the past 20 years to target metastatic or inoperable neuroendocrine tumors expressing the somatostatin receptors. Both prospective and retrospective studies indicate that patients receiving PRRT show significantly high objective responses, leading to longer survival and improved quality of life. PRRT is generally well tolerated, with acceptable hematological toxicity profiles. Nephrotoxicity is dose-limiting with Y-90 labelled peptides and not with Lu-177. The majority of centers use standard protocols based on fixed activities, at most modulating the activity or the number of administrations based on the patient clinical scenario and risk factors. This guidance covers the rationale, indications and contraindications for PRRNT, assessment of treatment response and patient follow-up. This practical guidance is aimed at guiding nuclear medicine specialists in delivering the treatment in a safe and effective manner.
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