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Absorbed dose to the kidneys after treatment with 177Lu-octreotate

Conference paper
Authors Maria Larsson
Peter Bernhardt
Eva Forssell-Aronsson
Published in European Journal of Nuclear Medicine & Molecular Imaging
Publication year 2011
Published at Institute of Clinical Sciences, Department of Radiation Physics
Language en
Subject categories Radiological physics

Abstract

177Lu-DOTA-octreotate (177Lu-octreotate) is used for therapy of patients with neuroendocrine (NE), somatostatin-receptor-expressing tumours. After administration 177Lu is mainly secreted via the kidneys with reabsorption and accumulation in the kidney cortex. One of the limiting factors in this type of treatment is kidney toxicity. The aim of this study was to estimate the absorbed dose to the kidneys after fractionated therapy, and examine how which time-points that are necessary for more accurate determination of the biokinetics and cumulated activity of 177Lu. Methods: Totally, 33 patients with NE tumours received 3.5-8 GBq 177Lu-octreotate, up to five times, combined with amino acid infusion to block the kidney uptake. Whole body planar gamma camera images were taken at day 0, 1, 2 and 7. The conjugate-view method was used to determine the 177Lu activity in the kidneys, and the absorbed dose to the kidneys was determined. Then, activity data from one time-point at a time was excluded, and the resulting absorbed dose was compared with that based on all time-points. Results: Large variations were found in the patterns of the time-activity curves, and in kidneys between patients: 0.34-2.43 Gy/GBq, also. Large variations were also seen in the absorbed dose to the kidneys between fractions for an individual patient. Excluding data for day 7 resulted in a deviation in the absorbed dose to the kidneys up to a factor of 2.3. Conclusion: A large variation in the absorbed dose to the kidneys per administered activity was found after therapy with 177Lu-octreotate. The results clearly show that treatment planning and treatment follow-up is necessary for each patient for individual optimisation of the treatment.

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