Abstract
IntroductionThe kidney is considered as a critical dose-limiting organ with 177Lu-Dotatate. Renal dosimetry could play a role in optimizing treatment. We present a feedback on the implementation of renal dosimetry in our medical center. Material and methodThe renal dosimetry of the 1st administration of 177Lu-Dotatate (approximately 7.4 GBq) has been performed for seven patients. The reference dosimetry strategy included 4 post-therapeutic SPECT/CT at 6h, 24h, 72h and 168h and anatomical renal volume delineation (VOI). Alternative dosimetric strategies consisted of 72h or 168h time point eviction (time sampling A or B) and delimitation of 1 or 3 spherical VOIs (3mL each) per kidney (“1 sVOI” or “3 sVOI” methods). The quantitative scintigraphic processing was performed by 4 operators using Dosimetry Toolkit®. The renal dose was calculated with OLINDA/EXM® 2.0. ResultsThe calculated mean absorbed renal dose was 3.68±0.68Gy with the reference method, with no significant impact of interoperator variability (P=0.41). It was in satisfactory agreement with time sampling A or B. The “1 sVOI” and “3 sVOI” methods overestimated the renal dose (5.01±0.94Gy and 4.91±0.79Gy respectively), with a significant impact on interoperator variability (P<0.05), despite a reduction in processing time. ConclusionThe main logistic constraint of 177Lu-Dotatate renal dosimetry in our center is the time-consumption due to SPECT/CT acquisitions. A possible approach supported by our preliminary results is a reduction in the number of scintigraphic acquisitions.
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