Dosimetric rénale du~(177)Lu-Dotatate : mise en place au sein du Groupement hospitalier Est des Hospices Civils de Lyon

摘要

Introduction. - The kidney is considered as a critical dose-limiting organ with Lu-177-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 method. - The renal dosimetry of the 1st administration of Lu-177-Dotatate (approximately 7.4 GBq) has been performed for seven patients. The reference dosimetry strategy included 4 post-therapeutic SPECT/CT at 6 h, 24 h, 72 h and 168 h and anatomical renal volume delineation (vol). Alternative dosimetric strategies consisted of 72 h or 168 h time point eviction (time sampling A or B) and delimitation of 1 or 3 spherical VOls (3 mL each) per kidney ("1 sVOI" or "3 sVOI" methods). The quantitative scintigraphic processing was performed by 4 operators using Dosimetry Toolkit (R). The renal dose was calculated with OLINDA/EXM (R) 2.0.Results. - The calculated mean absorbed renal dose was 3.68 +/- 0.68 Gy 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 +/- 0.94 Gy and 4.91 +/- 0.79 Gy respectively), with a significant impact on interoperator variability (P 0.05), despite a reduction in processing time.Conclusion. - The main logistic constraint of Lu-177-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. (C) 2020 Elsevier Masson SAS. All rights reserved.