INTERESTING IMAGE
Feasibility of 177Lu Therapy Monitoring Using Fast Whole-Body
SPECT Recordings Provided by a High-Speed 360° CZT Camera
Elodie Chevalier, MD,* Caroline Boursier, MD,* Marine Claudin, MD,*
Pierre-Yves Marie, MD, PhD,*†‡ and Laetitia Imbert, PhD*†§
Abstract: The whole-body absolute quantification of 177Lu-DOTATATE
Downloaded from https://journals.lww.com/nuclearmed by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3z484KQalTVH9P4/hxcgbR9gmzkNpSsvGzbzOBYN8gGE= on 07/09/2020
therapy was achieved using a high-speed 360° CZT SPECT/CT system.
Twelve high-resolution swelling detectors may be positioned close to pa-
tients, providing a high-count sensitivity that is particularly advantageous
for the low-count rate conditions of 177Lu imaging. After initially validating
177
Lu quantification on phantom, serial whole-body SPECT/CT acquisi-
tions of only 20 minutes were obtained for a 70-year-old woman treated
by 177Lu-DOTATATE injections for a metastatic recurrence of a pancreatic
neuroendocrine tumor. The progressive decrease in tumor uptake between
the consecutive 177Lu-DOTATATE injections could be quantified, and
thereby the corresponding dosimetry changes could be estimated.
Key Words: 177Lu, absolute quantification, CZT camera, neuroendocrine,
PRRT, SUV
(Clin Nucl Med 2020;00: 00–00)
Received for publication March 7, 2020; revision accepted May 9, 2020.
From the *Nuclear Medicine Department and †Nancyclotep Imaging Platform,
CHRU-Nancy, ‡INSERM, UMR-1116, and §INSERM, UMR-1254,
Université de Lorraine, Nancy, France.
Informed consent was obtained from the participant included in this study.
Conflicts of interest and sources of funding: none declared.
Correspondence to: Laetitia Imbert, PhD, Médecine Nucléaire, Hôpital de Brabois,
CHRU-Nancy, Allée du Morvan, 54500 Vandœuvre-lès-Nancy, France.
E-mail: l.imbert@chru-nancy.fr.
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
ISSN: 0363-9762/20/0000–0000
DOI: 10.1097/RLU.0000000000003169
Clinical Nuclear Medicine • Volume 00, Number 00, Month 2020
Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
This paper can be cited using the date of access and the unique DOI number which can be found in the footnotes.
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Chevalier et al Clinical Nuclear Medicine • Volume 00, Number 00, Month 2020

FIGURE 1. After initially validating the absolute quantification of 177Lu on an International Electrotechnical Commission
phantom (<10% error for the activities of spheres ranging 17- to 37-mm diameter), SPECT/CT images were obtained with the
Veriton CZT-SPECT/CT system (Spectrum Dynamics Medical, Caesarea, Israel)1,2 for a 70-year-old woman with metastatic
recurrence of a pancreatic neuroendocrine tumor who was treated with 3 LUTATHERA injections of 7.4 GBq at consecutive
2-month intervals.3–5 Whole-body acquisitions of less than 20 minutes (6 bed positions of 3 minutes each) were obtained 24 to
48 hours after each LUTATHERA injection, with SPECT images acquired on the 113-keV energy peak and reconstructed with
implementation of CT-based attenuation correction, scatter correction, and resolution recovery.6–8 Subclavian nodes and
hepatic and bone lesions could be easily detected on the whole-body SPECT images (A), and the absolute quantification of
these lesions demonstrated gradual decreases in SUV max values (B), leading to a global mean decrease of 58% ± 30% and thus
giving evidence of marked decreases in lesion dosimetry.9,10

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Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
This paper can be cited using the date of access and the unique DOI number which can be found in the footnotes.