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Abstract
Lutetium-177 has been widely discussed as a radioisotope of choice for targeted radionuclide
therapy. The simultaneous emission of imageable gamma photons [208 keV (11%) and 113
keV (6.4%)] along with particulate β(-) emission [β(max) = 497 keV] makes it a theranostically
desirable radioisotope. In the present article, the possibility of using two 177Lu-based
agents viz. 177Lu-EDTMP and 177Lu-DOTATATE for theranostic applications in metastatic
bone pain palliation (MBPP) and peptide receptor radionuclide therapy (PRRT), have
been explored. In the case of 177Lu-EDTMP, the whole-body images obtained are compared
with those recorded using 99mTc-MDP in the same patient. On the other hand, pre-therapy
images acquired with 177Lu-DOTA-TATE are compared with similar images obtained with
standard agents, such as 99mTc-HYNIC-TOC (SPECT) and 68Ga-DOTA-TOC (PET) in the same
patient. The advantage of the long physical half-life (T1/2) of 177Lu has been utilized
in mapping the pharmacokinetics of two additional agents, 177Lu-labeled hydroxyapatite
(HA) in radiation synovectomy of knee joints and 177Lu-HA for therapy of hepatocellular
carcinoma. Results of these multiple studies conclusively document the potential of
177Lu as a theranostic radioisotope.