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Neuroendocrine Tumors (NETs) Treatment with Lutetium-177-DOTATATE (program ID: 642508)

University Hospital of Ludwig Maximilian University of Munich

location_on Munich, Germany
10/10 from 40 Votes
Specialized hospital
Peter Bartenstein

Head Physician
Prof. Dr. med.

Peter Bartenstein

Specialized in: nuclear medicine

Department of Nuclear Medicine

The program includes:

  • Initial presentation in the hospital
  • Clinical history taking
  • Physical examination
  • Laboratory tests:
    • complete blood count
    • biochemical analysis of blood
    • TSH, free T3, free T4
    • indicators of inflammation
    • coagulation tests
  • Renal scintigraphy
  • Ga-68 DOTATATE PET/CT (if indicated)
  • Lutetium-177-DOTATATE treatment
  • Full body scintigraphy after 24 hours
  • Full body scintigraphy after 48 hours
  • Symptomatic treatment
  • Cost of essential medicines
  • Nursing services
  • Stay in the hospital with full board
  • Accommodation in 2-bedded room
  • Elaboration of further recommendations

How program is carried out

During the first visit, the doctor will carry out a general physical examination and go through the results of previous laboratory and instrumental tests. After that, you will undergo the necessary additional tests such as the assessment of liver and kidney function, scintigraphy of the skeleton and salivary glands, somatostatin receptor imaging with Ga-68 DOTATATE PET/CT. This will allow the doctor to assess how effective the radionuclide therapy with Lutetium-177-DOTATATE will be and how well you will tolerate it. Also, the doctor will calculate your individual dosage of the radionuclide.

Radionuclide therapy with Lutetium-177-DOTATATE is carried out via intravenous administration of a solution with the radioactive isotope Lutetium-177-DOTATATE. The solution is injected through a catheter. This is a short procedure, as the infusion usually takes no more than 20 minutes.

During the procedure, you will need to apply cooling bags to the salivary glands, as Lutetium-177-DOTATATE partially accumulates in the salivary glands, affecting their function and causing dry mouth. You will also receive intravenous saline solutions and amino acid solutions to protect your kidneys.

After the infusion of Lutetium-177-DOTATATE, you will stay in a specially equipped (radiation-shielded) ward for 48 hours. The drug is quickly excreted by the kidneys, and after 48 hours you will no longer be dangerous to others. During these 48 hours, you can read, use a mobile phone, tablet or computer – all these devices will not be a source of radiation in the future.

Follow-up examinations include whole-body scintigraphy or computed tomography in 24 hours and 48 hours after the procedure. Based on the results of the examination, the doctor will determine whether one procedure is enough for you, or whether you will need to visit the hospital again. As a rule, 1-2 procedures are required for achieving a stable positive result. Procedures are carried out with an interval of 8 weeks.

Required documents:

  • Medical records
  • Complete blood count
  • PSA blood test
  • MRI/CT scan (not older than 3 months)
  • PSMA PET/CT (if available)
  • Bone scintigraphy (if available)
  • Biopsy results (if available)
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About the department

The Department of Nuclear Medicine at the University Hospital of the Ludwig Maximilian University of Munich, offers a full range of diagnostic and therapeutic services in modern nuclear medicine, for both outpatients and inpatients. Their focus is on the detection and treatment of oncological, neurological, and cardiac diseases. The department is the largest institution of this kind in Germany. The international recognition is approved by ISO 9001: 2015 certification. The Chief Physician of the department is Prof. Dr. med. Peter Bartenstein.

The department specializes in diagnostic and therapeutic procedures in oncology (for example, the detection and treatment of malignant diseases, diagnostics of sentinel lymph nodes, pain therapy in bone metastases), neurology (for example, diagnostics and therapy of brain diseases, Parkinson’s disease, Alzheimer's disease), and cardiology (for example, the assessment of the state of cardiac vessels and heart attack diagnostics).

Since August 2013, the department has had a new center for the production of radiopharmaceuticals, which is equipped with a cyclotron and allows for the production of radioactive drugs in compliance with the GMP standard, according to the current requirements for radiation protection and drug prescription. Therefore, the department receives the necessary diagnostic markers and radiopharmaceuticals for the individualized treatment of patients in a shorter time. They are distinguished by higher quality and improved safety. Thus, the doctors provide patients with the best possible treatment.

The diagnostic options of the department include:

  • Conventional radioisotope diagnostics (scintigraphy)
    • Detection of the hemorrhage source 
    • Scintigraphy for the detection of inflammatory processes
    • Brain scintigraphy
    • Testicular scintigraphy
    • Bone marrow scintigraphy
    • Liver scintigraphy
  • Positron emission tomography (PET)
    • PET/CT within the oncological diagnostics
    • PET in neurological / neuro-oncological diagnostics
    • PET and PET/CT for other diagnostic issues (for example, in the field of cardiology, etc.)
  • SPECT-CT
  • Other diagnostic options

Radiopharmaceuticals are successfully used for therapeutic purposes. Along with the treatment of benign and malignant thyroid diseases, the Department of Nuclear Medicine provides pain therapy in skeletal metastases, joint therapy (radiosynoviorthesis, for example, in rheumatic diseases), and neuroendocrine tumor treatment, in particular, SIRT in liver metastases. At the same time, these treatment programs are often developed in collaboration with doctors from other medical specialties (oncologists, endocrinologists, gynecologists, surgeons, orthopedists), for example, within the framework of the Comprehensive Cancer Center (CCC) or Breast Center.

The spectrum of radioisotope therapy: 

  • Treatment of benign and malignant thyroid diseases
    • Radioiodine therapy 
  • Treatment of malignant prostate diseases
    • Lu-177-PSMA-DKFZ-617 therapy 
    • Ra-223 therapy in bone metastases
  • Treatment of neuroendocrine tumors 
  • Radiopeptide therapy
  • MIBG therapy
  • Selective internal radiation therapy (SIRT)
  • Treatment of skeletal metastases
  • Radiosynoviorthesis (RSO)
  • Other treatment methods

Curriculum vitae

Education and Professional Career

  • 1978 - 1984 Medical School, Universities of Bochum and Bonn.
  • 1981 - 1984 Research work in the Department of Hematology and Oncology, University of Bonn.
  • 1984 - 1985 Clinical Internship in the Departments of Radiology, Internal Medicine, and Surgery at the District Hospital Waldbröl.
  • 1985 State Medical Examination, graded "very good" (A+).
  • 1985 - 1986 Military service as a Medical Officer in Andernach.
  • 1985 Dr. med., University of Bonn, graded "very good" (magna cum laude).
  • 1986 - 1990 Assistant Physician in the Department of Nuclear Medicine, University of Muenster.
  • 1990 Professional Board Certification in Nuclear Medicine.
  • 1990 - 1991 Research Fellowship (German Research Foundation) in the PET-Group of the Medical Research Council Cyclotron Unit, Hammersmith Hospital in London.
  • 1991 - 1994 Senior Physician in the Department of Nuclear Medicine, University of Muenster.
  • 1994 Habilitation.
  • 1994 - 1999 Senior Physician in the Department of Nuclear Medicine, Technical University of Munich, and Head of the Group on Neuroimaging.
  • 1999 - 2006 Chairman of the Department of Nuclear Medicine, Johannes Gutenberg University Mainz.
  • 2002 - 2006 Head of the University Neuroscience Center.
  • Since 2006, Chief Physician of the Department of Nuclear Medicine at the University Hospital of Ludwig Maximilian University of Munich.

Photo of the doctor: (c) LMU Klinikum 


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