DOSIMETRI PASIEN-SPESIFIK TERAPI LUTETIUM-177 PADA KANKER PAYUDARA: SYSTEMATIC LITERATURE REVIEW
DOI:
https://doi.org/10.37478/optika.v10i1.7945Abstract
Penelitian ini bertujuan mensintesis bukti ilmiah tentang strategi optimasi protokol dosimetri pasien-spesifik pada terapi radionuklida ¹??Lu. Penelitian juga memberi rekomendasi protokol yang akurat. Metode yang digunakan yaitu systematic literature review (SLR) mengikuti protokol PRISMA. Pencarian literatur dilakukan pada database PubMed, Scopus, dan Google Scholar dengan kata kunci "Lutetium-177", "dosimetry", "PSMA", "HER2", dan "protocol optimization" untuk periode 2015-2026. Kriteria inklusi meliputi artikel original, review, dan pedoman klinis tentang dosimetri ¹??Lu. Hasil review menunjukkan bahwa simplifikasi protokol menggunakan single-time-point SPECT pada 168 jam pasca injeksi memberikan estimasi dosis serap (terutama untuk lesi) dengan ketidakpastian 20%, sementara dua time point (24 dan 168 jam) menurunkan ketidakpastian menjadi 13%. Variabilitas antar parameter dalam satu workflow dosimetri mencapai 84%, hal ini menekankan perlunya sebuah standardisasi. Dosis serap organ at risk: ginjal berkisar 0,35-1,42 mGy/MBq, hati 0,03-1,07 mGy/MBq, dan sumsum tulang 0,005-0,15 mGy/MBq. Kontribusi penelitian ini terhadap pengembangan ilmu pengetahuan di bidang fisika medis dan kedokteran nuklir adalah tersusunnya rekomendasi protokol dosimetri ¹??Lu yang praktis, akurat, dan terstandardisasi untuk institusi pendidikan dan pelayanan kesehatan di Indonesia. Disimpulkan bahwa optimasi protokol dosimetri memerlukan standardisasi metode akuisisi SPECT/CT, kalibrasi kamera gamma, dan koreksi partial volume, dengan protokol simplifikasi satu atau dua time point layak untuk implementasi klinis rutin.
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