Radiation protection in radionuclide therapies with 90Y- conjugates

Risks and safety

Marta Cremonesi, Mahila Ferrari, Giovanni Paganelli, Annalisa Rossi, Marco Chinol, Mirco Bartolomei, Gennaro Prisco, Giampiero Tosi

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: The widespread interest in 90Y internal radionuclide treatments has drawn attention to the issue of radiation protection for staff. Our aim in this study was to identify personnel at risk and to validate the protection devices used. Methods: 90Y-MoAb (Zevalin, 15 cases, 1.1 GBq/patient) and 90Y-peptide (90Y-DOTATOC) systemic (i.v., 50 cases, 3.0 GBq/patient) and locoregional (l.r., 50 cases, 0.4 GBq/patient) treatments were considered. Radiolabelling was carried out in a dedicated hot cell. Tele-tongs, shielded (PMMA: polymethylmethacrylate) syringes/vials and an automatic dose fractionating system were used. Operators wore anti-X-ray and anti-contamination gloves, with TLD dosimeters placed over the fingertips. For i.v. administration, activity was administered by a dedicated system; for l.r. administration, during activity infusion in the brain cavity, tongs were used and TLDs were placed over the fingertips. The air kerma-rate was measured around the patients. Results: The use of devices provided a 75% dose reduction, with mean fingertip doses of 2.9 mGy (i.v. MoAbs), 0.6 mGy (i.v. peptides)/ radiolabelling procedure and 0.5 mGy/l.r. administration. The mean effective dose to personnel was 5 μSv/patient. The air kerma-rate around the patients administered i.v. 90Y-peptides were 3.5 (1 h) and 1.0 (48 h) μGy/h at 1 m. Patient hospitalisation of 6 h (l.r.)/48 h (i.v.) guaranteed that the recommended limits of 3 mSv/year to family members and 0.3 mSv/year to the general population (Council Directive 97/43/Euratom) were respected. Conclusions: When specific procedures are adopted, a substantial improvement in 90Y manipulation is attainable, reducing doses and increasing safety. For the widespread clinical use of 90Y-conjugates, a completely automatic labelling procedure is desirable.

Original languageEnglish
Pages (from-to)1321-1327
Number of pages7
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume33
Issue number11
DOIs
Publication statusPublished - Nov 2006

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Radiation Protection
Radioisotopes
Safety
Polymethyl Methacrylate
Peptides
Therapeutics
Air
Equipment and Supplies
Syringes
European Union
Hospitalization
X-Rays
Brain
Population

Keywords

  • Y-radiolabelling
  • Y-radiopharmaceuticals
  • Fingertip dosimetry
  • Optimisation
  • Radiation protection

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Radiation protection in radionuclide therapies with 90Y- conjugates : Risks and safety. / Cremonesi, Marta; Ferrari, Mahila; Paganelli, Giovanni; Rossi, Annalisa; Chinol, Marco; Bartolomei, Mirco; Prisco, Gennaro; Tosi, Giampiero.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 33, No. 11, 11.2006, p. 1321-1327.

Research output: Contribution to journalArticle

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abstract = "Purpose: The widespread interest in 90Y internal radionuclide treatments has drawn attention to the issue of radiation protection for staff. Our aim in this study was to identify personnel at risk and to validate the protection devices used. Methods: 90Y-MoAb (Zevalin, 15 cases, 1.1 GBq/patient) and 90Y-peptide (90Y-DOTATOC) systemic (i.v., 50 cases, 3.0 GBq/patient) and locoregional (l.r., 50 cases, 0.4 GBq/patient) treatments were considered. Radiolabelling was carried out in a dedicated hot cell. Tele-tongs, shielded (PMMA: polymethylmethacrylate) syringes/vials and an automatic dose fractionating system were used. Operators wore anti-X-ray and anti-contamination gloves, with TLD dosimeters placed over the fingertips. For i.v. administration, activity was administered by a dedicated system; for l.r. administration, during activity infusion in the brain cavity, tongs were used and TLDs were placed over the fingertips. The air kerma-rate was measured around the patients. Results: The use of devices provided a 75{\%} dose reduction, with mean fingertip doses of 2.9 mGy (i.v. MoAbs), 0.6 mGy (i.v. peptides)/ radiolabelling procedure and 0.5 mGy/l.r. administration. The mean effective dose to personnel was 5 μSv/patient. The air kerma-rate around the patients administered i.v. 90Y-peptides were 3.5 (1 h) and 1.0 (48 h) μGy/h at 1 m. Patient hospitalisation of 6 h (l.r.)/48 h (i.v.) guaranteed that the recommended limits of 3 mSv/year to family members and 0.3 mSv/year to the general population (Council Directive 97/43/Euratom) were respected. Conclusions: When specific procedures are adopted, a substantial improvement in 90Y manipulation is attainable, reducing doses and increasing safety. For the widespread clinical use of 90Y-conjugates, a completely automatic labelling procedure is desirable.",
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T2 - Risks and safety

AU - Cremonesi, Marta

AU - Ferrari, Mahila

AU - Paganelli, Giovanni

AU - Rossi, Annalisa

AU - Chinol, Marco

AU - Bartolomei, Mirco

AU - Prisco, Gennaro

AU - Tosi, Giampiero

PY - 2006/11

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N2 - Purpose: The widespread interest in 90Y internal radionuclide treatments has drawn attention to the issue of radiation protection for staff. Our aim in this study was to identify personnel at risk and to validate the protection devices used. Methods: 90Y-MoAb (Zevalin, 15 cases, 1.1 GBq/patient) and 90Y-peptide (90Y-DOTATOC) systemic (i.v., 50 cases, 3.0 GBq/patient) and locoregional (l.r., 50 cases, 0.4 GBq/patient) treatments were considered. Radiolabelling was carried out in a dedicated hot cell. Tele-tongs, shielded (PMMA: polymethylmethacrylate) syringes/vials and an automatic dose fractionating system were used. Operators wore anti-X-ray and anti-contamination gloves, with TLD dosimeters placed over the fingertips. For i.v. administration, activity was administered by a dedicated system; for l.r. administration, during activity infusion in the brain cavity, tongs were used and TLDs were placed over the fingertips. The air kerma-rate was measured around the patients. Results: The use of devices provided a 75% dose reduction, with mean fingertip doses of 2.9 mGy (i.v. MoAbs), 0.6 mGy (i.v. peptides)/ radiolabelling procedure and 0.5 mGy/l.r. administration. The mean effective dose to personnel was 5 μSv/patient. The air kerma-rate around the patients administered i.v. 90Y-peptides were 3.5 (1 h) and 1.0 (48 h) μGy/h at 1 m. Patient hospitalisation of 6 h (l.r.)/48 h (i.v.) guaranteed that the recommended limits of 3 mSv/year to family members and 0.3 mSv/year to the general population (Council Directive 97/43/Euratom) were respected. Conclusions: When specific procedures are adopted, a substantial improvement in 90Y manipulation is attainable, reducing doses and increasing safety. For the widespread clinical use of 90Y-conjugates, a completely automatic labelling procedure is desirable.

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