Dosimetric evaluation of NET treatment with somatostatin analogs labeled with ¹⁷⁷Lu

• Autorzy: Cichoński Adam , Ćwikła Jarosław

Identyfikatory

DOI

10.2478/pjmpe-2025-0010

• Języki publikacji: EN

Abstrakty

EN

Introduction: A reliable dosimetric assessment in internal radiotherapy is a key element in ensuring the effectiveness and safety of the treatment. The aim of the presented work was to perform model dosimetric calculations in patients undergoing treatment with a somatostatin analog labeled with radioactive lutetium-177, [¹⁷⁷Lu]Lu-DOTA-TOC, for GEP-NET. Material and Methods: Dosimetric modeling was performed for 17 patients (11 women, 6 men, aged 32–77). Each patient received 2-4 injections of the radiopharmaceutical [¹⁷⁷Lu]Lu-DOTA-TOC during treatment, with an activity range of 2–8 GBq. Subsequently, patients underwent SPECT-CT scanning. The obtained images were segmented and quantitatively analyzed using the GE Dosimetry Toolkit software package. VOIs were delineated for the liver, kidneys, spleen, heart, and areas of pathological radiopharmaceutical accumulation. Model TAC were determined for these areas. Dosimetric calculations were performed using the OLINDA/EXM version 2.1 software. Results: The average absorbed dose values in a single therapeutic cycle were 2.5 Gy for the liver, 3.8 Gy for the kidneys, 2.9 Gy for the spleen, and 28 mGy for the heart. The calculated absorbed dose from these organs for the bone marrow averaged 11.6 mGy. The average cumulative absorbed dose values for these organs were: 6.9 Gy, 10.6 Gy, 7.8 Gy, and 72.3 mGy, respectively. Areas of localized, non-physiological accumulation of [¹⁷⁷Lu]Lu-DOTA-TOC received an average absorbed dose of 16.2 Gy in a single therapy cycle and 48 Gy in total over the entire treatment process. Conclusion: The results of internal dosimetry in the studied group of patients are characterized by high variability. The kidneys were the organs most exposed to high radiation doses, and their function was monitored during treatment using biochemical markers. The good tolerance of high absorbed doses may be due to the microscopic characteristics of the dose distribution from the ¹⁷⁷Lu radionuclide radiation. The highest absorbed doses were observed in areas of pathological radiopharmaceutical accumulation.

Słowa kluczowe

EN

dosimetry; PRRT; radiotherapy; NET

• Wydawca: Polskie Towarzystwo Fizyki Medycznej
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2025
• Tom: Vol. 31, Iss. 2
• Strony: 99--103
• Opis fizyczny: Bibliogr. 7 poz., rys., tab.

Twórcy

autor

Cichoński Adam

• The Children's Memorial Health Institute, Warsaw, Poland

autor

Ćwikła Jarosław

• University of Warmia and Mazury in Olsztyn, Olsztyn, Poland

Bibliografia

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• 2. Taniyama Y, Suzuki T, Mikami Y, Moriya T, Satomi S, Sasano H. Systemic Distribution of Somatostatin Receptor Subtypes in Human: An Immunohistochemical Study. Endocr J. 2005;52(5):605-611. https://doi.org/10.1507/endocrj.52.605
• 3. Deepa S, Vijay Sai K, Gowrishankar R, Rao D, Venkataramaniah K. Precision electron–gamma spectroscopic measurements in the decay of 177Lu. Applied Radiation and Isotopes. 2011;69(6):869-874. https://doi.org/10.1016/j.apradiso.2011.02.012
• 4. Capala J, Graves SA, Scott A, et al. Dosimetry for Radiopharmaceutical Therapy: Current Practices and Commercial Resources. J Nucl Med. 2021;62(Supplement 3):3S-11S. https://doi.org/10.2967/jnumed.121.262749
• 5. Staanum PF, Frellsen AF, Olesen ML, Iversen P, Arveschoug AK. Practical kidney dosimetry in peptide receptor radionuclide therapy using [177Lu]Lu-DOTATOC and [177Lu]Lu-DOTATATE with focus on uncertainty estimates. EJNMMI Phys. 2021;8(1). https://doi.org/10.1186/s40658-021-00422-2
• 6. Grassi E, Fioroni F, Berenato S, et al. Effect of image registration on 3D absorbed dose calculations in 177 Lu-DOTATOC peptide receptor radionuclide therapy. Physica Medica. 2018;45:177-185. https://doi.org/10.1016/j.ejmp.2017.11.021
• 7. Goetz ThI, Lang EW, Prante O, et al. Three-dimensional Monte Carlo-based voxel-wise tumor dosimetry in patients with neuroendocrine tumors who underwent 177Lu-DOTATOC therapy. Ann Nucl Med. 2020;34(4):244-253. https://doi.org/10.1007/s12149-020-01440-3