Current practice in reporting internal dosimetry for [177Lu]Lu-DOTATATE therapy: a systematic review

Initiatives have been taken to standardize the reporting of dosimetry results in image-derived radiation absorbed dose in radiopharmaceutical therapies. EANM Dosimetry Committee guidance summarizes the minimum information required to aid reproducibility of work. EFOMP’s SIG_FRID Focus Group on Time-Activity Data Fitting reviewed a selection of published papers on [¹⁷⁷Lu]Lu-DOTATATE therapy to evaluate whether sufficient data are provided to reproduce methodologies presented. A systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines. Articles available on PubMed to December 31, 2024, focusing on [¹⁷⁷Lu]Lu-DOTATATE therapy were identified. Studies were evaluated using a checklist of dosimetry reporting derived from EANM Dosimetry Reporting Guidance and additional fields reflecting recent methodological developments. Compliance with dosimetry reporting guidance was assessed and trends in reporting quality identified. 144 articles were identified, with 57 meeting the inclusion criteria. Many parameters showed good compliance (e.g., 83% reported imaging equipment, 82% image processing and 100% absorbed dose). Some parameters were poorly reported (e.g., 59% reported phantom and calibration measurements, 18% radionuclide calibrator information, 29% listed time-integrated activity coefficients). 25% of papers fully complied with EANM guidance. EANM guidelines for clinical dosimetry reporting are not fully implemented in the examined articles on [¹⁷⁷Lu]Lu-DOTATATE. Data acquisition and imaging information are generally well documented, yet key details related to dosimetric calculations remain incompletely reported. To establish reproducible and comparable dosimetry studies, appropriate quality criteria for dosimetry reporting should be further developed.