{"entity":{"id":"paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022","kind":"paper","name":"EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands","aka":[],"tldr":"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.\n\nThe 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.\n\nThis 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.","asOf":"2026-09-22","links":[{"label":"EANM: dosimetry guidelines overview","url":"https://eanm.org/publications/guidelines/overview/dosimetry/"},{"label":"PMC: full text","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9015994/"}],"tags":["guideline","dosimetry","lutetium-177"],"related":["radioligand-dosimetry","dosimetry","prrt","lu177-radioligand-therapy","pluvicto","eanm","gray-unit","lu-177"],"indications":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"European Journal of Nuclear Medicine and Molecular Imaging","year":2022,"doi":"10.1007/s00259-022-05727-7","pmid":"35284969","authors":"Sjögreen Gleisner K, Chouin N, Gabina PM, Cicone F, Gnesin S, et al.","paperType":"guideline","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."],"whatItMeans":"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."],"changedPractice":true},"route":"/key-papers/paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022/","neighbours":{"technology":[{"id":"lu177-radioligand-therapy","kind":"technology","name":"Lutetium-177 radioligand therapy","route":"/technologies/lu177-radioligand-therapy/"},{"id":"prrt","kind":"technology","name":"Peptide receptor radionuclide therapy (PRRT)","route":"/technologies/prrt/"},{"id":"radioligand-dosimetry","kind":"technology","name":"Radioligand dosimetry","route":"/technologies/radioligand-dosimetry/"}],"term":[{"id":"dosimetry","kind":"term","name":"Dosimetry","route":"/terms/dosimetry/"},{"id":"gray-unit","kind":"term","name":"Gray unit (Gy)","route":"/terms/gray-unit/"}],"drug":[{"id":"pluvicto","kind":"drug","name":"Lutetium-177 vipivotide tetraxetan","route":"/drugs/pluvicto/"}],"institution":[{"id":"eanm","kind":"institution","name":"European Association of Nuclear Medicine","route":"/institutions/eanm/"}],"isotope":[{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"}]}}