Theranostic Applications of Lutetium-177 in Radionuclide Therapy

Curr Radiopharm. 2016;9(1):94-101. doi: 10.2174/1874471008666150313114644.

Abstract

Lutetium-177 has been widely discussed as a radioisotope of choice for targeted radionuclide therapy. The simultaneous emission of imageable gamma photons [208 keV (11%) and 113 keV (6.4%)] along with particulate β(-) emission [β(max) = 497 keV] makes it a theranostically desirable radioisotope. In the present article, the possibility of using two 177Lu-based agents viz. 177Lu-EDTMP and 177Lu-DOTATATE for theranostic applications in metastatic bone pain palliation (MBPP) and peptide receptor radionuclide therapy (PRRT), have been explored. In the case of 177Lu-EDTMP, the whole-body images obtained are compared with those recorded using 99mTc-MDP in the same patient. On the other hand, pre-therapy images acquired with 177Lu-DOTA-TATE are compared with similar images obtained with standard agents, such as 99mTc-HYNIC-TOC (SPECT) and 68Ga-DOTA-TOC (PET) in the same patient. The advantage of the long physical half-life (T1/2) of 177Lu has been utilized in mapping the pharmacokinetics of two additional agents, 177Lu-labeled hydroxyapatite (HA) in radiation synovectomy of knee joints and 177Lu-HA for therapy of hepatocellular carcinoma. Results of these multiple studies conclusively document the potential of 177Lu as a theranostic radioisotope.

Publication types

  • Comparative Study

MeSH terms

  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary
  • Durapatite / administration & dosage
  • Half-Life
  • Humans
  • Octreotide / administration & dosage
  • Octreotide / analogs & derivatives*
  • Octreotide / pharmacokinetics
  • Organometallic Compounds / administration & dosage*
  • Organometallic Compounds / pharmacokinetics
  • Organophosphorus Compounds / administration & dosage*
  • Organophosphorus Compounds / pharmacokinetics
  • Pain / etiology
  • Pain / radiotherapy
  • Radioisotopes / administration & dosage*
  • Radioisotopes / pharmacokinetics
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / pharmacokinetics
  • Receptors, Peptide / metabolism
  • Theranostic Nanomedicine / methods*

Substances

  • Organometallic Compounds
  • Organophosphorus Compounds
  • Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Peptide
  • lutetium ethylenediaminetetramethylene phosphonic acid
  • Durapatite
  • lutetium Lu 177 dotatate
  • Octreotide