NANETS/SNMMI Procedure Standard for Somatostatin Receptor-Based Peptide Receptor Radionuclide Therapy with 177 Lu-DOTATATE

J Nucl Med. 2019 Jul;60(7):937-943. doi: 10.2967/jnumed.118.230607.

Abstract

With the recent approval of 177Lu-DOTATATE for use in gastroenteropancreatic neuroendocrine tumors, access to peptide receptor radionuclide therapy is increasing. Representatives from the North American Neuroendocrine Tumor Society and the Society of Nuclear Medicine and Molecular Imaging collaborated to develop a practical consensus guideline for the administration of 177Lu-DOTATATE. In this paper, we discuss patient screening, maintenance somatostatin analog therapy requirements, treatment location and room preparation, drug administration, and patient release as well as strategies for radiation safety, toxicity monitoring, management of potential complications, and follow-up. Controversies regarding the role of radiation dosimetry are discussed as well. This document is designed to provide practical guidance on how to safely treat patients with this therapy.

MeSH terms

  • Bone Marrow / radiation effects
  • Humans
  • Kidney / radiation effects
  • Neuroendocrine Tumors / radiotherapy*
  • Nuclear Medicine*
  • Octreotide / administration & dosage
  • Octreotide / adverse effects
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / therapeutic use*
  • Organs at Risk / radiation effects
  • Radiometry
  • Receptors, Somatostatin / metabolism*
  • Reference Standards
  • Safety
  • Societies, Medical / standards*

Substances

  • Organometallic Compounds
  • Receptors, Somatostatin
  • lutetium Lu 177 dotatate
  • Octreotide