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Radiation and Environmental Biophysics

, Volume 57, Issue 1, pp 55–61 | Cite as

Blood clearance and occupational exposure for 177Lu-DOTATATE compared to 177Lu-PSMA radionuclide therapy

  • Mohammad AbuqbeitahEmail author
  • Mustafa Demir
  • Lebriz Uslu-Beşli
  • Nami Yeyin
  • Kerim Sönmezoğlu
Original Article

Abstract

The main target of this work is to examine blood clearance and external exposure for 177Lu-DOTATATE compared with new emerging 177Lu-PSMA therapy. Blood clearance and radiation exposure of 31 patients treated with 5.5 ± 1.1 GBq 177Lu-DOTATATE were compared to those of 23 patients treated with 7.4 GBq 177Lu-PSMA. Dose rates were measured at several distances and time points up to 120 h after treatment. Blood samples were collected conjunctively after infusion. Caregiver’s cumulative dose was measured by means of an OSL (optically stimulated luminescence) dosimeter for 4–5 days and medical staff’s dose was also estimated using electronic personal dosimeters. Finger dose was determined via ring TLD (Thermoluminescence Dosimeter) for radiopharmacists and nurses. Dose rates due to 177Lu-DOTATATE at a distance of 1 m, 4 h and 6 h after infusion, were 3.0 ± 2.8 and 2 ± 1.9 µSv/(h GBq), respectively, while those due to 177Lu-PSMA were 3.1 ± 0.8 and 2.2 ± 0.9 µSv/(h GBq). Total effective dose of 17 caregivers was 100–200 µSv for 177Lu-DOTATATE therapy. Mean effective doses to nurses and radiopharmacists were 5 and 4 µSv per patient, respectively, while those for physicists and physicians were 2 µSv per patient. For 177Lu-DOTATATE, effective half-life in blood and early elimination phase were 0.31 ± 0.13 and 4.5 ± 1 h, while they were found as 0.4 ± 0.1 and 5 ± 1 h, respectively, for 177Lu-PSMA. The first micturition time following 177Lu-DOTATATE infusion was noted after 36 ± 14 min, while the second and third voiding times were after 74 ± 9 and 128 ± 41 min, respectively. It is concluded that blood clearance and radiation exposure for 177Lu-DOTATATE are very similar to those for 177Lu-PSMA, and both treatment modalities are reasonably reliable for outpatient treatment, since the mean dose rate [2.1 µSv/(h GBq)] decreased below the dose rate that allows release of the patient from the hospital (20 µSv/h) after 6 h at 1 m distance.

Keywords

177Lu-DOTATATE 177Lu-PSMA Radiation exposure Dose rate Blood clearance 

Notes

Acknowledgements

The authors would like to express their sincere gratitude to the Head of Nuclear Medicine Department in Cerrahpaşa Medical Faculty for his cordial support, and to all colleagues who provided insight and professional advice to achieve this work.

Compliance with ethical standards

Conflict of interest

All authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by Istanbul University Cerrahpaşa Medical Faculty Clinical Research Ethics Committee (document number: 83045809/604/5855).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Mohammad Abuqbeitah
    • 1
    Email author
  • Mustafa Demir
    • 1
  • Lebriz Uslu-Beşli
    • 1
  • Nami Yeyin
    • 1
  • Kerim Sönmezoğlu
    • 1
  1. 1.Department of Nuclear Medicine, Cerrahpasa Faculty of MedicineIstanbul UniversityIstanbulTurkey

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