# EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands

Source: https://nuclide.cc/key-papers/paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022/  
Nuclide record `paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

European nuclear medicine physicists set out a detailed, agreed method for measuring exactly how much radiation dose a patient's kidneys and tumours actually receive during lutetium-177 treatments, so that dosing can eventually be tailored to the individual rather than fixed for everyone.

## Summary

This EANM Dosimetry Committee document provides detailed, practical recommendations for performing patient-specific dosimetry during therapy with 177Lu-labelled somatostatin-receptor ligands (for neuroendocrine tumours) and 177Lu-PSMA ligands (for prostate cancer). It specifies imaging protocols (typically three well-separated SPECT/CT time points per cycle for kidney and tumour dosimetry), segmentation and recovery-correction methods, and reports the underlying pharmacokinetic and dosimetric literature: mean kidney absorbed doses of roughly 0.54-1.00 Gy/GBq for 177Lu-somatostatin-receptor ligands and 0.4-0.8 Gy/GBq for 177Lu-PSMA, and tumour absorbed doses typically 1-8 Gy/GBq, with inter-patient variability up to ninefold for 177Lu-PSMA.

The guideline notes that because 177Lu-PSMA-617 (Pluvicto) is approved for use at a fixed activity per cycle (7.4 GBq every 6 weeks), patient-specific dosimetry is not mandatory for on-label use, but the committee encourages its practice to build the evidence base for eventually personalising dose - an approach already used for decades in dosimetry-led PRRT centres.

This document, alongside the companion joint EANM/SNMMI 177Lu-PSMA-RLT procedure guideline, is the reference clinical physicists and nuclear medicine physicians use to standardise dosimetry methodology across centres, a prerequisite for any future trial of dosimetry-personalised versus fixed-activity radioligand therapy.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: guideline; dosimetry; lutetium-177
- Journal: European Journal of Nuclear Medicine and Molecular Imaging
- Year: 2022
- DOI: 10.1007/s00259-022-05727-7
- Authors: Sjögreen Gleisner K, Chouin N, Gabina PM, Cicone F, Gnesin S, et al.
- Findings: Recommends kidney dosimetry using SPECT/CT at three well-separated time points between day 1 and day 7 after each therapy cycle.; Reports mean absorbed kidney doses of roughly 0.54-1.00 Gy/GBq for 177Lu-somatostatin-receptor ligands and 0.4-0.8 Gy/GBq for 177Lu-PSMA.; Reports mean tumour absorbed doses of approximately 1-8 Gy/GBq, with up to ninefold inter-patient variability for 177Lu-PSMA (range 0.09-0.84 Gy/GBq in one cited series).; Notes that patient-specific dosimetry is not mandatory for on-label 177Lu-PSMA-617 use, since it is approved at a fixed per-cycle activity.
- What it means: This document standardises how hospitals measure the actual radiation dose reaching a patient's kidneys and tumours during lutetium-177 treatment, laying the groundwork for shifting from a one-dose-fits-all schedule to treatment doses tailored to each patient's biology.
- Caveats: Journal metadata note: the article was published in the European Journal of Nuclear Medicine and Molecular Imaging (2022;49(6):1778-1809); recorded here under Journal of Nuclear Medicine as the nearest catalogued match, so the DOI and PMID should be treated as authoritative for sourcing.; Recommendations are methodological guidance, not a mandate; dosimetry uptake still varies widely between centres and countries.; Absorbed-dose ranges cited are drawn from the pooled literature the committee reviewed, not from a single new dataset.

## Sources

- EANM: dosimetry guidelines overview: https://eanm.org/publications/guidelines/overview/dosimetry/
- PMC: full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC9015994/

## Connected records

- technologies: [Lutetium-177 radioligand therapy](https://nuclide.cc/technologies/lu177-radioligand-therapy/), [Peptide receptor radionuclide therapy (PRRT)](https://nuclide.cc/technologies/prrt/), [Radioligand dosimetry](https://nuclide.cc/technologies/radioligand-dosimetry/)
- terms: [Dosimetry](https://nuclide.cc/terms/dosimetry/), [Gray unit (Gy)](https://nuclide.cc/terms/gray-unit/)
- drugs: [Lutetium-177 vipivotide tetraxetan](https://nuclide.cc/drugs/pluvicto/)
- institutions: [European Association of Nuclear Medicine](https://nuclide.cc/institutions/eanm/)
- isotopes: [Lutetium-177](https://nuclide.cc/isotopes/lu-177/)

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