Skin dose saving of the staff in 90Y/177Lu peptide receptor radionuclide therapy with the automatic dose dispenser

Nucl Med Commun. 2016 Oct;37(10):1046-52. doi: 10.1097/MNM.0000000000000548.

Abstract

Objective: When handling Y-labelled and Lu-labelled radiopharmaceuticals, skin exposure is mainly due to β-particles. This study aimed to investigate the equivalent dose saving of the staff when changing from an essentially manual radiolabelling procedure to an automatic dose dispenser (ADD).

Materials and methods: The chemist and physician were asked to wear thermoluminescence dosimeters on their fingertips to evaluate the quantity of Hp(0.07) on the skin. Data collected were divided into two groups: before introducing ADD (no ADD) and after introducing ADD.

Results: For the chemist, the mean values (95th percentile) of Hp(0.07) for no ADD and ADD are 0.030 (0.099) and 0.019 (0.076) mSv/GBq, respectively, for Y, and 0.022 (0.037) and 0.007 (0.023) mSv/GBq, respectively, for Lu. The reduction for ADD was significant (t-test with P<0.05) for both isotopes. The relative differences before and after ADD collected for every finger were treated using the Wilcoxon test, proving a significantly higher reduction in extremity dose to each fingertip for Lu than for Y (P<0.05). For the medical staff, the mean values of Hp(0.07) (95th percentile) for no ADD and ADD are 0.021 (0.0762) and 0.0143 (0.0565) mSv/GBq, respectively, for Y, and 0.0011 (0.00196) and 0.0009 (0.00263) mSv/GBq, respectively, for Lu. The t-test provided a P-value less than 0.05 for both isotopes, making the difference between ADD and no ADD significant.

Conclusion: ADD positively affects the dose saving of the chemist in handling both isotopes. For the medical staff not directly involved with the introduction of the ADD system, the analysis shows a learning curve of the workers over a 5-year period. Specific devices and procedures allow staff skin dose to be limited.

MeSH terms

  • Automation
  • Beta Particles / therapeutic use
  • Chemistry
  • Fingers / radiation effects
  • Humans
  • Lutetium*
  • Occupational Exposure / analysis
  • Occupational Exposure / prevention & control*
  • Physicians
  • Radiation Dosage*
  • Radiation Protection
  • Receptors, Peptide / therapeutic use*
  • Skin / radiation effects*
  • Thermoluminescent Dosimetry*
  • Yttrium Radioisotopes*

Substances

  • Receptors, Peptide
  • Yttrium Radioisotopes
  • Lutetium