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Review
. 2024 Jul 18;11(1):65.
doi: 10.1186/s40658-024-00658-8.

A review of 177Lu dosimetry workflows: how to reduce the imaging workloads?

Affiliations
Review

A review of 177Lu dosimetry workflows: how to reduce the imaging workloads?

Laure Vergnaud et al. EJNMMI Phys. .

Abstract

177 Lu radiopharmaceutical therapy is a standardized systemic treatment, with a typical dose of 7.4 GBq per injection, but its response varies from patient to patient. Dosimetry provides the opportunity to personalize treatment, but it requires multiple post-injection images to monitor the radiopharmaceutical's biodistribution over time. This imposes an additional imaging burden on centers with limited resources. This review explores methods to lessen this burden by optimizing acquisition types and minimizing the number and duration of imaging sessions. After summarizing the different steps of dosimetry and providing examples of dosimetric workflows for 177 Lu -DOTATATE and 177 Lu -PSMA, we examine dosimetric workflows based on a reduced number of acquisitions, or even just one. We provide a non-exhaustive description of simplified methods and their assumptions, as well as their limitations. Next, we detail the specificities of each normal tissue and tumors, before reviewing dose-response relationships in the literature. In conclusion, we will discuss the current limitations of dosimetric workflows and propose avenues for improvement.

Keywords: 177 Lu ; Dosimetry; Review; Single time-point.

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Conflict of interest statement

The authors declare that they have no Conflict of interest.

References

    1. Strosberg, J., El-Haddad, G., Wolin, E., Hendifar, A., Yao, J., Chasen, B., Mittra, E., Kunz, P.L., Kulke, M.H., Jacene, H., Bushnell, D., O’Dorisio, T.M., Baum, R.P., Kulkarni, H.R., Caplin, M., Lebtahi, R., Hobday, T., Delpassand, E., Van Cutsem, E., Benson, A., Srirajaskanthan, R., Pavel, M., Mora, J., Berlin, J., Grande, E., Reed, N., Seregni, E., öberg, K., Sierra, M.L., Santoro, P., Thevenet, T., Erion, J.L., Ruszniewski, P., Kwekkeboom, D., Krenning, E (2017) Phase 3 trial of 177lu-dotatate for midgut neuroendocrine tumors. New England Journal of Medicine 376(2), 125–135 - PMC - PubMed
    1. Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A, Mittra E, Wolin EM, Yao JC, Pavel ME, Grande E, Van Cutsem E, Seregni E, Duarte H, Gericke G, Bartalotta A, Mariani MF, Demange A, Mutevelic S, Krenning EP. 177lu-dotatate plus long-acting octreotide versus high-dose long-acting octreotide in patients with midgut neuroendocrine tumours (netter-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial. Lancet Oncol. 2021;22(12):1752–63. - PubMed
    1. Sartor O, Bono JD, Chi KN, Fizazi K, Herrmann K, Rahbar K, Tagawa ST, Nordquist LT, Vaishampayan N, Haddad GE, Park CH, Beer TM, Armour A, Contreras WJP, Desilvio M, Kpamegan E, Gericke G, Messmann RA, Morris MJ, Krause BJ, Investigators V. Lutetium-177-psma-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385(12):1091–103. - PMC - PubMed
    1. Eberlein U, Cremonesi M, Lassmann M. Individualized dosimetry for theranostics: necessary, nice to have, or counterproductive? J Nucl Med. 2017;58(9):97–103. - PubMed
    1. Garin E, Tselikas L, Guiu B, Chalaye J, Edeline J, De Baere T, Assenat E, Tacher V, Robert C, Terroir-Cassou-Mounat M, Mariano-Goulart D, Amaddeo G, Palard X, Hollebecque A, Kafrouni M, Regnault H, Boudjema K, Grimaldi S, Fourcade M, Kobeiter H, Vibert E, Le Sourd S, Piron L, Sommacale D, Laffont S, Campillo-Gimenez B, Rolland Y, Robert CR, Pracht M, Ardisson V, Lenoir L, Deschamps F, Ducreux M, Gelli M, Cassinotto C, Allimant C, Bonnot-Lours S, Marie M, Itti E, Lerman L, Abulizi M, Luciani A, Costentin CE, Milliner M. Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (dosisphere-01): a randomised, multicentre, open-label phase 2 trial. Lancet Gastroenterol Hepatol. 2021;6(1):17–29. - PubMed

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