Clinical Best Practices for Radiation Safety During Lutetium-177 Therapy.

Area of Science:

• Therapeutic nuclear medicine
• Radiation oncology
• Medical physics

Background:

• 177 Lu therapy, a key component of theranostic cancer treatment, faces adoption challenges due to radiation safety program requirements.
• Limited radiation protection staff at smaller centers can hinder the implementation of essential safety protocols for therapeutic nuclear medicine.

Purpose of the Study:

• To facilitate the wider adoption of 177 Lu therapy, particularly in smaller institutions.
• To provide radiation safety officers (RSOs) with a comprehensive resource on best practices and operational experiences for implementing 177 Lu therapy programs.
• To offer practical guidance for establishing and managing radiation safety in therapeutic nuclear medicine settings.

Main Methods:

• Convened a panel of 11 radiation safety professionals from Canada and the United States with established 177 Lu therapy programs.
• Gathered collective operational experience through a structured question-and-answer format.
• Focused discussions on critical radiation safety aspects: facility design, safety programs, and drug/patient management.

Main Results:

• Developed a set of best practice guidelines for clinical radiation safety during 177 Lu therapy.
• Identified that 177 Lu therapy can often be safely administered in unshielded environments.
• Demonstrated that staff radiation exposure is minimal compared to other nuclear medicine programs.
• Highlighted simple preparatory measures, such as surface protection and incontinence planning, effectively control contamination.

Conclusions:

• The developed guidelines will aid RSOs in implementing safe and effective 177 Lu therapy programs, even in facilities with limited prior experience in therapeutic nuclear medicine.
• This resource supports the expansion of theranostic cancer treatments to a broader range of healthcare settings.