Lu-177 Dotatate External Dosimetry- An Update from 2013 by Mushref Algarni in Novel Approaches in Cancer Study
London health sciences center is a frequent user of Lu-177 Dotatate
for the treatment of neuroendocrine disease. We began using this
radionuclidetherapy as an in-patient procedure, where patients were released at 20
hours’ post therapy administration with minimal restrictions. Over the
course
of 2013, we worked to transform this therapy into an outpatient
procedure, where patients were released at 4-6 hours’ post therapy
administration
with major restrictions. The previous methods and data we presented in December 17, 2013 [1]
were based on dose rates derived from cumulated doses measured over
approximately 16 hours, and an assumption of Lu-177 clearance based on
radioactive decay only. Since 2013, our hospital has gained more experience with Lu-177
Dotatate, enabling us to develop a better understanding of dosimetry. We
describe
new dose measurements, a new model we developed to describe our
observations, and a revised schedule of patient release and restriction
duration. Compared against previous measurements from 2013, our new
measurements are of instantaneous (not cumulative) dose rates, and we
now
consider Lu-177 clearance to proceed both by physical decay and biologic
excretion. Our new proposed model combines our experimental results
with
results from literature. The model will state the dose rate from time of
discharge can be modeled as a decaying double exponential function.
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