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Kidney dosimetry during (177)Lu-DOTATATE therapy in patients with neuroendocrine tumors: aspects on calculation and tolerance.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
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2017 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, 1-6 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Fractionated therapy with (177)Lu-DOTATATE has been reported to be an effective treatment for patients with metastasized neuroendocrine tumors. To optimize the treatment, absorbed doses to risk organs are calculated for the individual patient. For each organ, absorbed dose due to activity in the organ itself (self-dose) and that originating from other organs (cross-dose) are calculated from serial measurements to obtain the activity distribution following treatment. The main aim of the present work were to calculate the cross-dose contribution to the total absorbed kidney dose.

METHODS: Five hundred patients with neuroendocrine tumors undergoing therapy with (177)Lu-DOTATATE were included. Scintigraphic planar whole body images and single photon emission computed tomography/computed tomography (SPECT/CT) over the abdomen were acquired at 1, 4 and 7 days after treatment. Kidney self-dose was calculated based on radioactivity distribution obtained from SPECT/CT. Cross-dose to kidneys was estimated using organ-based analysis of planar whole body images and cross-fire dose factors from Olinda/EXM 1.1.

RESULTS: Cross-dose to kidneys in the majority of patients were less than 2% and almost all cross-doses were less than 10%. Cross-dose exceeded 10% only in rare cases of patients with high tumor burden and low absorbed doses to kidneys.

CONCLUSIONS: The absorbed dose from (177)Lu-octreotate to solid organs due to cross-fire is generally low and can usually be neglected.

Place, publisher, year, edition, pages
2017. 1-6 p.
National Category
Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-329755DOI: 10.1080/0284186X.2017.1378431PubMedID: 28920501OAI: oai:DiVA.org:uu-329755DiVA: diva2:1142895
Available from: 2017-09-20 Created: 2017-09-20 Last updated: 2017-09-20

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