Radiation Dose to Medical Staff from Administering<sup>177</sup>Lu-PSMA-DKFZ-617 Therapy

Mahmoudi, Elahe; Pirayesh, Elahe; Deevband, Mohammad Reza; Amoui, Mahasti; Rad, Mohammadali Ghodsi; Rad, Mehrdad Ghorbani; Ghorbani, Mahdi

doi:10.2967/jnmt.121.263135

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Other studies also show similar values (0.36 ± 0.16 µSv/GBq (26) and 0.24 ± 0.05 µSv/GBq ( 14)), although no information is given on the use of aprons. A study involving administration of 177 Lu-PSMA-617 obtained 0.60 ± 0.05 µSv/GBq for physicians behind a lead shield (45). On the other hand, in a previous study on effective doses during manipulation of 68 Ga-DOTATOC (46) it was concluded that electronic dosemeters could underestimate the dose due to the non-linear response of the Geiger-Müller detector at the 68 Ga photon energies (1077 keV) and the pure beta eld.…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Riveira-Martin

Struelens

Iglesias³

et al. 2023

Preprint

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Background The use of lutetium-177 (177Lu)-based radiopharmaceuticals in peptide receptor nuclear therapy is increasing, but so is the number of nuclear medicine workers exposed to higher levels of radiation. In recent years, [177Lu]Lu-DOTA-TATE has begun to be widely used for the treatment of neuroendocrine tumours. However, there are few studies evaluating the occupational radiation exposure during its administration, and there are still some challenges that can result in higher doses to the staff, such as a lack of trained personnel or fully standardised procedures. In response, this study aims to provide a comprehensive analysis of occupational doses to the staff involved in the administration of [177Lu]Lu-DOTA-TATE. Results A total of 32 administrations of [177Lu]Lu-DOTA-TATE (7.4 GBq/session) carried out by a physician and a nurse, were studied. In total, two physicians and four nurses were independently monitored with cumulative (passive) and/or real-time (active) dosemeters. Extremity, eye lens and whole-body doses were evaluated in terms of the dosimetric quantities Hp(0.07), Hp(3) and Hp(10), respectively. It was obtained that lead aprons reduced dose rates and effective doses by 71% and 69% for the physician, respectively, and by 56% and 68% for the nurse. On average, normalised Hp(10) showed lower values with active (0.65 ± 0.18 µSv/GBq) than with passive (11.6 ± 2.9 µSv/GBq) dosemeters, so further measurements are needed. For physicians, the median of the maximum normalised Hp(0.07) values was 41.5 µSv/GBq on the non-dominant hand and 45.2 µSv/GBq on the dominant hand. For nurses 15.4 µSv/GBq on the non-dominant and 13.9 µSv/GBq on the dominant hand. The ratio between the maximum dose measured on the hand and the dose measured on the base of the middle/ring finger of the non-dominant hand resulted in a factor of 5/6 for the physicians and 3/4 for the nurses. Finally, maximum normalised Hp(3) doses resulted in 2.02 µSv/GBq for physicians and 1.76 µSv/GBq for nurses. Conclusions If appropriate safety measures are taken, the administration of [177Lu]Lu-DOTA-TATE is a safe procedure for workers. However, regular monitoring is recommended to ensure that the annual dose limits are not exceeded.

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Section: Discussionmentioning

confidence: 99%

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Riveira-Martin

Struelens

Iglesias³

et al. 2023

Preprint

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“…In recent years, many studies have been conducted to investigate the extracorporeal radiation levels of patients undergoing 177 Lu-PSMA therapy through field measurements (Demir et al 2016, Abuqbeitah et al 2018, Kurth et al 2018, Mair et al 2018, Rantala et al 2018, Mahmoudi et al 2023, Parlak et al 2023, and the dose rate limits have also been proposed for the patient's release in Europe and other countries (Bakker et al 2006, IAEA 2009, 2014, ICRP 2012, Turner 2012, Calais and Turner 2014, Lawal et al 2019. Nevertheless, all the limits were set at the distance of 1 m from the patient, the dose rates at other distances are still not clear.…”

Section: Introductionmentioning

confidence: 99%

Radiation levels outside a patient undergoing ¹⁷⁷Lu-PSMA radioligand therapy

Li,

Liu,

Zhang

et al. 2024

J. Radiol. Prot.

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Understanding the spatial distribution of radiation levels outside of a patient undergoing 177Lu radioligand therapy is not only helpful for conducting correct tests for patient release, but also useful for estimation of its potential exposure to healthcare workers, caregivers, family members, and the general public. In this study, by mimicking the 177Lu-PSMA radioligand therapy for prostate cancers in an adult male, the spatial distribution of radiation levels outside of the phantom was simulated based on the Monte Carlo software of PHITS, and verified by a series of measurements. Moreover, the normalized dose rates were further formulized on the three transverse planes representing the heights of pelvis, abdomen and chest. The results showed that the distributions of radiation levels were quite complex. Multi-directional and multi-height measurements are needed to ensure the external dose rate to meet the release criteria. In general, the radiation level was higher at the horizontal plane where the source was located, and the levels in front and behind of the body were higher than those of the left and right sides at the same height. The ratio of simulated dose rates to measured ones ranged from 0.82 to 1.19 within 1 m away from the body surface in all directions. Based on the established functions, the relative root mean square deviation (RRMSD) between the calculated and simulated values were 0.21, 0.25 and 0.23 within a radius of 1 m on the pelvis, abdomen and chest transverse planes, respectively. It is expected that the results of this study would be helpful for guiding the test of extracorporeal radiation to determine the patient’s release, and of benefit to estimate the radiation exposure to others.

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Radiation exposure assessment of nuclear medicine staff administering [177Lu]Lu-DOTA-TATE with active and passive dosimetry

Riveira-Martin,

Struelens,

Muñoz Iglesias

et al. 2023

EJNMMI Phys

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Background The use of lutetium-177 (177Lu)-based radiopharmaceuticals in peptide receptor nuclear therapy is increasing, but so is the number of nuclear medicine workers exposed to higher levels of radiation. In recent years, [177Lu]Lu-DOTA-TATE has begun to be widely used for the treatment of neuroendocrine tumours. However, there are few studies evaluating the occupational radiation exposure during its administration, and there are still some challenges that can result in higher doses to the staff, such as a lack of trained personnel or fully standardised procedures. In response, this study aims to provide a comprehensive analysis of occupational doses to the staff involved in the administration of [177Lu]Lu-DOTA-TATE. Results A total of 32 administrations of [177Lu]Lu-DOTA-TATE (7.4 GBq/session) carried out by a physician and a nurse, were studied. In total, two physicians and four nurses were independently monitored with cumulative (passive) and/or real-time (active) dosemeters. Extremity, eye lens and whole-body doses were evaluated in terms of the dosimetric quantities Hp(0.07), Hp(3) and Hp(10), respectively. It was obtained that lead aprons reduced dose rates and whole-body doses by 71% and 69% for the physicians, respectively, and by 56% and 68% for the nurses. On average, normalised Hp(10) values of 0.65 ± 0.18 µSv/GBq were obtained with active dosimetry, which is generally consistent with passive dosemeters. For physicians, the median of the maximum normalised Hp(0.07) values was 41.5 µSv/GBq on the non-dominant hand and 45.2 µSv/GBq on the dominant hand. For nurses 15.4 µSv/GBq on the non-dominant and 13.9 µSv/GBq on the dominant hand. The ratio or correction factor between the maximum dose measured on the hand and the dose measured on the base of the middle/ring finger of the non-dominant hand resulted in a factor of 5/6 for the physicians and 3/4 for the nurses. Finally, maximum normalised Hp(3) doses resulted in 2.02 µSv/GBq for physicians and 1.76 µSv/GBq for nurses. Conclusions If appropriate safety measures are taken, the administration of [177Lu]Lu-DOTA-TATE is a safe procedure for workers. However, regular monitoring is recommended to ensure that the annual dose limits are not exceeded.

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Radiation Dose to Medical Staff from Administering¹⁷⁷Lu-PSMA-DKFZ-617 Therapy

Cited by 4 publications

References 19 publications

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Radiation levels outside a patient undergoing ¹⁷⁷Lu-PSMA radioligand therapy

Radiation exposure assessment of nuclear medicine staff administering [177Lu]Lu-DOTA-TATE with active and passive dosimetry

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Radiation Dose to Medical Staff from Administering177Lu-PSMA-DKFZ-617 Therapy

Cited by 4 publications

References 19 publications

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Radiation Exposure Assessment of Nuclear Medicine Staff Administering [177Lu]Lu-DOTA-TATE with Active and Passive Dosimetry

Radiation levels outside a patient undergoing 177Lu-PSMA radioligand therapy

Radiation exposure assessment of nuclear medicine staff administering [177Lu]Lu-DOTA-TATE with active and passive dosimetry

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About

Radiation Dose to Medical Staff from Administering¹⁷⁷Lu-PSMA-DKFZ-617 Therapy

Radiation levels outside a patient undergoing ¹⁷⁷Lu-PSMA radioligand therapy