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Patient-specific Extravasation Dosimetry Using Uptake Probe Measurements.

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Extravasation of radiopharmaceuticals can cause significant radiation doses to tissue and skin. A monitoring system helps characterize these events, enabling accurate dose calculation and patient management.

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Area of Science:

  • Nuclear Medicine
  • Radiopharmaceutical Therapy
  • Radiation Dosimetry

Background:

  • Extravasation during radiopharmaceutical administration is a frequent issue.
  • It can lead to substantial radiation doses in underlying tissues and skin.
  • Radiation effects from extravasation are understudied, impacting patient care and regulatory compliance.

Purpose of the Study:

  • To demonstrate the utility of a dedicated radiopharmaceutical injection monitoring system.
  • To characterize extravasations for accurate tissue and skin dose calculations.
  • To guide clinical management and meet regulatory requirements for extravasation events.

Main Methods:

  • Utilized a commercial radiopharmaceutical injection monitoring system.
  • Identified and characterized extravasations of 18F-fluorodeoxyglucose and 99mTc-methylene diphosphonate in 26 patients.
  • Calculated tissue-absorbed doses using Monte Carlo simulation and MIRD dosimetry.
  • Determined skin dose equivalent using VARSKIN software.

Main Results:

  • Injection site count rate data characterized extravasation clearance in 26 patients.
  • Calculated tissue-absorbed doses ranged from 0.6 to 11.2 Gy.
  • Shallow dose equivalent to adjacent skin (10 cm2) ranged from 0.1 to 5.4 Sv.

Conclusions:

  • Unintentional radiopharmaceutical extravasations can exceed radiation protection limits.
  • An external injection monitoring system aids in prompt identification and characterization.
  • Patient-specific dosimetry improves assessment of extravasation severity and potential adverse reactions.