Dosimetry to Estimate the Effect of Gelofusine® on the Renal Absorbed Dose of Lutetium 177-DOTA-octreotate.
Introduction: Lutetium-177 DOTA-octreotate (LuTate), a radiolabelled somatostatin analogue, delivers targeted radiation to neuroendocrine tumours and metastases. Healthy tissues also receive significant irradiation. Charged amino acids are routinely co-infused to block renal proximal tubular LuTate reabsorption. Gelofusine® (a succinylated bovine gelatin molecule), proposed to interact with the megalin/cubulin receptor-mediated transporter system, has been shown to reduce renal uptake of indium-111 octreotide. Routine Gelofusine® administration is limited by risk of allergic reaction.
Aim(s): To utilise personalised dosimetry to assess renal radiation risk from LuTate therapy and the additional effect of Gelofusine® on renal absorbed dose of LuTate.
Materials and methods: Quantitative SPECT images are routinely acquired following the first therapy cycle to estimate accumulated radiation doses delivered to kidneys. Five patients demonstrated a higher than threshold renal radiation dose and received additional renal protection with Gelofusine® for future cycles of LuTate, with repeat dosimetry.
Conference: 13th Annual ENETSConcerence (2016)
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