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1 Polish Journal of Medical Physics and Engineering

1 2025

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

Cichoński Adam, Ćwikła Jarosław

Polish Journal of Medical Physics and Engineering

2025

Vol. 31, Iss. 2

99--103

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.