(177)Lu-Dotatate therapy for the treatment of metastatic neuroendocrine tumours in a patient on haemodialysis—dosimetric considerations

We report on a case of a 68-year-old female, currently a dialysis-dependant patient with disseminated metastatic neuroendocrine tumour, treated with (177)Lu-Dotatate. As (177)Lu-Dotatate is cleared predominantly by the kidneys, there are concerns regarding the treatment plan strategy to avoid increased radiation exposure compared with patients with normal renal function. For this purpose, personalized dosimetry was used to calculate the safe administered activity using whole-body scans. Employing this strategy allowed us to adjust the administered activity for the third fraction. The whole-body doses calculated were not significantly different from those received by patients with normal renal function. The radiological follow-up showed a stable disease, suggesting effective treatment. We found negligible radiation protection problems involved with this procedure.