Radiation Safety Assessment of 177Lu-DOTATATE Intra-arterial Peptide Receptor Therapy (PRRT)

¹⁷⁷Lu-DOTATATE peptide receptor therapy (PRRT) is an established treatment for patients suffering from neuroendocrine tumors. In the last few years, intra-arterial PRRT is being considered for patients having liver metastatic disease predominantly. The aim of our study is to measure the radiation doses received by the treating intervention radiologists involved in intra-arterial PRRT treatment using ¹⁷⁷Lu-DOTATATE.

Radiation safety-related data of 31 patients who underwent 177Lu-DOTATATE intra-arterial PRRT treatment were used for this study. The exposure rate was measured at the hand and eye and chest level of treating intervention radiologists continuously from the beginning to the end of the administration. Exposure from the patient at the body surface (at the level of liver, thigh, and extremities) and 1 m from the body surface was measured just after the administration. The mean radiation exposure from the patient at the body surface and 1 m from the body was also calculated.

The mean administered activity was found to be 194 (±17) mCi. The mean radiation exposure at the surface at the level of the liver, thigh, and feet and at 1 m from the surface was found to be 100 (±25.11), 9 (±1.27), 5.6 (±0.52), and 5.3± (0.50) μSv/hr, respectively. The mean administration time was found to be 23 ± 5.6 min. The mean radiation dose to the hands, and eyes, of the treating intervention radiologist per procedure, was found to be 6.425 ± 2.75 μSv, 5.43 ± 1.76 μSv and 1-m exposure from the patient was found to be 5.3 ± 0.246 μSv, respectively.

Our result shows that the radiation exposure from the patient postadministration is below the permissible limit of discharge. The radiation exposure to the intervention radiologist is also suggestive of a safe procedure to be performed by maintaining the radiation dose well within the permissible limit for radiation professionals.