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Patient-specific dosimetry in peptide receptor radionuclide therapy: a clinical review

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Abstract

Neuroendocrine tumours (NETs) belong to a relatively rare class of neoplasms. Nonetheless, their prevalence has increased significantly during the last decades. Peptide receptor radionuclide therapy (PRRT) is a relatively new treatment approach for inoperable or metastasised NETs. The therapeutic effect is based on the binding of radiolabelled somatostatin analogue peptides with NETs’ somatostatin receptors, resulting in internal irradiation of tumours. Pre-therapeutic patient-specific dosimetry is essential to ensure that a treatment course has high levels of safety and efficacy. This paper reviews the methods applied for PRRT dosimetry, as well as the dosimetric results presented in the literature. Focus is given on data concerning the therapeutic somatostatin analogue radiopeptides 111In-[DTPA0,D-Phe1]-octreotide (111In-DTPA-octreotide), 90Y-[DOTA0,Tyr3]-octreotide (90Y-DOTATOC) and 177Lu-[DOTA0,Tyr3,Thr8]-octreotide (177Lu-DOTATATE). Following the Medical Internal Radiation Dose (MIRD) Committee formalism, dosimetric analysis demonstrates large interpatient variability in tumour and organ uptake, with kidneys and bone marrow being the critical organs. The results are dependent on the image acquisition and processing protocol, as well as the dosimetric imaging radiopharmaceutical.

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Authors and Affiliations

  1. University General Hospital of Athens “Attikon”, 1, Rimini Street, Chaidari, 12462, Athens, Greece

    M. T. Chalkia, A. P. Stefanoyiannis, S. N. Chatziioannou & E. P. Efstathopoulos

  2. School of Engineering, University of Waikato, Hillcrest Road, Hamilton, 3240, New Zealand

    W. H. Round

  3. Department of Medical Physics, School of Medicine, University of Patras, 26504, Rion, Greece

    G. C. Nikiforidis

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  1. M. T. Chalkia
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  2. A. P. Stefanoyiannis
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  3. S. N. Chatziioannou
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  4. W. H. Round
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  5. E. P. Efstathopoulos
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  6. G. C. Nikiforidis
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Correspondence to A. P. Stefanoyiannis.

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Chalkia, M.T., Stefanoyiannis, A.P., Chatziioannou, S.N. et al. Patient-specific dosimetry in peptide receptor radionuclide therapy: a clinical review. Australas Phys Eng Sci Med 38, 7–22 (2015). https://doi.org/10.1007/s13246-014-0312-7

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  • DOI: https://doi.org/10.1007/s13246-014-0312-7

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