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CC BY 4.0 · World J Nucl Med
DOI: 10.1055/s-0045-1812305
Original Article

Individualized Dosimetry to Guide LuTATE Therapy in Pediatric Neuroblastoma

Authors

  • Kevin London 

    1   Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia
    2   Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
    3   Alfred Nuclear Medicine and Ultrasound, Royal Prince Alfred Hospital Medical Centre, Newtown, Sydney, NSW, Australia

  • Justine Trpezanovski 

    1   Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia

  • Toby Trahair

    4   Kids Cancer Centre, Sydney Children's Hospital, Sydney Children's Hospitals Network, Randwick, Sydney, NSW, Australia
    5   Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia
    6   Discipline of Pediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia

  • Geoff McCowage

    7   Department of Oncology, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia
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Abstract

Neuroblastoma is the most common extracranial solid tumor in children. Tumor heterogeneity is a hallmark of neuroblastoma and prognosis can be dismal in the presence of high-risk factors such as N-myc gene amplification, aneuploidy, genetic rearrangement, and age at presentation. I-131 MIBG therapy has traditionally been the radionuclide therapy agent used in pediatric neuroblastoma and is incorporated in many treatment protocols. The high cost and limited availability of I-131 MIBG and the required radiation safety measures are barriers to its widespread use. LuTATE has emerged as a more practical radionuclide therapy agent requiring less stringent radiation safety measures and coupled with GaTATE PET/CT forms a potentially useful theranostic pairing for children with neuroblastoma. LuTATE therapy in adults with neuroendocrine tumors uses an empiric dosing schedule with good results. However, a previous study using empiric dosing of LuTATE in pediatric neuroblastoma was not shown to be effective. We present our use of individualized patient dosimetry to optimize the dose of LuTATE in three children with relapsed/resistant neuroblastoma.

Keywords

dosimetry - LuTATE - neuroblastoma - pediatric - theranostics

Authors' Contributions

K.L. and J.T. drafted the manuscript after clarifying the clinical details of each case. K.L. created the figures. J.T., T.T., and G.M. reviewed and edited the manuscript and contributed to the discussion points and revisions.


Ethical Approval

Ethical approval was provided by the Human Research Ethics Committee, The Children's Hospital at Westmead.




Publication History

Article published online:
09 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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