Abstract The purpose of the EANM Dosimetry Committee is to provide recommendations and guidance to scientists and clinicians on patient-specific dosimetry. Radiopharmaceuticals labelled with lutetium-177 (177Lu) are increasingly used for therapeutic applications, in particular for the treatment of metastatic neuroendocrine tumours using ligands for somatostatin receptors and prostate adenocarcinoma with small-molecule PSMA-targeting ligands. This paper provides an overview of reported dosimetry data for these therapies and summarises current knowledge about radiation-induced side effects on normal tissues and dose-effect relationships for tumours. Dosimetry methods and data are summarised for kidneys, bone marrow, salivary glands, lacrimal glands, pituitary glands, tumours, and the skin in case of radiopharmaceutical extravasation. Where applicable, taking into account the present status of the field and recent evidence in the literature, guidance is provided. The purpose of these recommendations is to encourage the practice of patient-specific dosimetry in therapy with 177Lu-labelled compounds. The proposed methods should be within the scope of centres offering therapy with 177Lu-labelled ligands for somatostatin receptors or small-molecule PSMA. 

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

This document presents the ICRP's updated vision on “Areas of Research to Support the System of Radiological Protection”, which have been previously published in 2017. It aims to complement the research priorities promoted by other relevant international organisations, with the specificity of placing them in the perspective of the evolution of the System of Radiological Protection. This document contributes to the process launched by ICRP to review and revise the System of Radiological Protection that will update the 2007 General Recommendations in ICRP Publication 103.

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Areas of research to support the system of radiological protection.

Male Wistar rats were expo\ed, nose-onlv, to a ""Pu nitrate aerosol generated from 0.27 N nitric acid solution. The initial lung burden was 78 f I X nCi ""Pu. Twenty days later, and at five subsequent weekly intervals. the rats were similarly exposed to Ca-DTPA aerosols ( 3 mg Ca-DTPA/rat/expo\ure, o r t o sham ('a-DTPA. Group\ of animals were sacrificed at 30, 60, 100 and 150 days after Pu inhalation to determine possible effects of Ca-DTPA therapy. and Pu retention and distribution kinetics for dosimetric purposes. Appropriate control animal\ exposed to nitric acid aerosols. nitric acid in cornbination with Ca-DTPA or sham Ca-DTPA. and non-treated controls, completed the study. Delayed inhaled chelation therapy had little effect on Pu clearance from the lung. However, eventual deposition in skeleton and liver was decreased by 20% (significance level = 0.05). Treatment with C'a-DTPA had no significant effect on weight gain or survival or on the incidence of lung and bone tumors induced by plutonium inhalation. It is noteworthy that one rat exposed only to Ca-DTPA aerosols, and one rat exposed to nitric acid prior to Ca-DTPA aerosols, developed lung tumors. Additional rats exposed only to nitric acid or to nitric acid and Ca-DTPA developed osteosarcomas of the skeleton. Radiation dose-tumor response data are presented which illustrate the wide range in accumulated radiation dose in these animals due to variations in initial lung burden and life-span subsequent to Pu inhalation.

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Influence of inhaled Ca-DTPA on the long-term effects of inhaled Pu nitrate

Occupational Intakes of Radionuclides: Part 5

Purpose: In recent years, radionuclides like 177Lu have been considered promising material for the creation of therapeutic radiopharmaceuticals. With the therapeutic use of radiopharmaceuticals, th...

Comparative studies on the potential use of 177Lu-based radiopharmaceuticals for the palliative therapy of bone metastases

The 2007 Recommendations (ICRP, 2007) introduced changes that affect the calculation of effective dose, and implied a revision of the dose coefficients for internal exposure, published previously in the Publication 30 series (ICRP, 1979a,b, 1980a, 1981, 1988) and Publication 68 (ICRP, 1994b). In addition, new data are now available that support an update of the radionuclide-specific information given in Publications 54 and 78 (ICRP, 1989a, 1997) for the design of monitoring programmes and retrospective assessment of occupational internal doses. Provision of new biokinetic models, dose coefficients, monitoring methods, and bioassay data was performed by Committee 2 and its task groups. A new series, the Occupational Intakes of Radionuclides (OIR) series, will replace the Publication 30 series and Publications 54, 68, and 78. OIR Part 1 (ICRP, 2015) describes the assessment of internal occupational exposure to radionuclides, biokinetic and dosimetric models, methods of individual and workplace monitoring, and general aspects of retrospective dose assessment. OIR Part 2 (ICRP, 2016), OIR Part 3 (ICRP, 2017), this current publication, and the final publication in the OIR series (OIR Part 5) provide data on individual elements and their radioisotopes, including information on chemical forms encountered in the workplace; a list of principal radioisotopes and their physical half-lives and decay modes; the parameter values of the reference biokinetic models; and data on monitoring techniques for the radioisotopes most commonly encountered in workplaces. Reviews of data on inhalation, ingestion, and systemic biokinetics are also provided for most of the elements. Dosimetric data provided in the printed publications of the OIR series include tables of committed effective dose per intake (Sv per Bq intake) for inhalation and ingestion, tables of committed effective dose per content (Sv per Bq measurement) for inhalation, and graphs of retention and excretion data per Bq intake for inhalation. These data are provided for all absorption types and for the most common isotope(s) of each element. The online electronic files that accompany the OIR series of publications contains a comprehensive set of committed effective and equivalent dose coefficients, committed effective dose per content functions, and reference bioassay functions. Data are provided for inhalation, ingestion, and direct input to blood. This fourth publication in the OIR series provides the above data for the following elements: lanthanum (La), cerium (Ce), praseodymium (Pr), neodymium (Nd), promethium (Pm), samarium (Sm), europium (Eu), gadolinium (Gd), terbium (Tb), dysprosium (Dy), holmium (Ho), erbium (Er), thulium (Tm), ytterbium (Yb), lutetium (Lu), actinium (Ac), protactinium (Pa), neptunium (Np), plutonium (Pu), americium (Am), curium (Cm), berkelium (Bk), californium (Cf), einsteinium (Es), and fermium (Fm).

V. Berkovski

Papers

ICRP Publication 141: Occupational Intakes of Radionuclides: Part 4.