Lu-177 Labeled Somatostatin Receptors and PSMA Dosimetry

This dosimetry guideline has been prepared based on the guidelines of the European Association of Nuclear Medicine, aiming to provide recommendations and guidance to scientists and clinicians on patient-specific dosimetry. Radiopharmaceuticals labeled with Lutetium-177 (Lu-177), particularly ligands for somatostatin receptors and small-molecule prostate specific membrane antigen (PSMA)-targeted ligands, are increasingly used for therapeutic applications in the treatment of metastatic neuroendocrine tumors and prostate adenocarcinoma. This guideline provides an overview of the reported dosimetry data for these therapies and summarizes the current knowledge on radiation-induced side effects in normal tissues and dose-response relationships in tumors. Dosimetry methods and data are summarized for the kidneys, bone marrow, salivary glands, lacrimal glands, pituitary gland and tumors.Where appropriate, guidance is provided considering the current state of the field and the latest evidence in the literature. The goal of these recommendations is to promote the implementation of patient-specific dosimetry in therapies involving Lu-177-labeled compounds. The proposed methods should fall within the scope of centers offering therapy with ligands for somatostatin receptors or small-molecule Lu-177 PSMA-targeted ligands.