Analysis of 177 Lu-DOTATATE injection methods and their impact on the exposure of hands of nuclear medicine facility staff
Łukasz Albiniak, Hanna Piwowarska-Bilska, Marta Rowińska, Bożena Birkenfeld, Małgorzata WrzesieńAbstract
Purpose
The increasing use of peptide receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE increases the need to assess occupational radiation exposure of nuclear medicine staff, particularly to the hands. This study aimed to evaluate and compare fingertip exposure associated with three administration methods: gravitational infusion, infusion pump, and manual injection.
Materials and Methods
Dosimetric measurements were performed in two nuclear medicine centres using LiF:Mg,Cu,P thermoluminescent detectors placed on the fingertips and at the base of the middle finger of both hands of staff involved in radiopharmaceutical preparation and administration. Measurements were collected for physicists, radiopharmacists, nurses, and physicians. A total of 126 measurements were collected in four measurement sessions. The personal dose equivalent H p (0.07) was determined, normalised to administered activity (µSv/GBq), and analysed separately for preparation and administration procedures.
Results
Manual administration resulted in the highest fingertip exposure, with maximum normalized H p (0.07) values of 26.95 µSv/GBq during preparation and 40.23 µSv/GBq during administration. Infusion pump administration showed intermediate exposure levels, while gravitational infusion yielded the lowest values, often close to the minimum detectable dose. Dominant hand fingertips, particularly the thumb and index finger, were most exposed. Estimated annual doses remained well below the skin dose limit.
Conclusions
The administration technique significantly influences occupational hand exposure during 177 Lu- DOTATATE procedures. Manual administration leads to the highest doses, whereas gravitational and infusion pump methods substantially reduce staff exposure.