Evaluation of Peritoneal Fluid Extracted from Patients Administered 177Lu-DOTATATE

Patients experiencing ascites, the buildup of fluid in the peritoneal cavity, frequently undergo paracentesis to drain fluid from their peritoneal cavity via a peritoneal port. Some patients experiencing ascites may require nuclear medicine procedures to address other medical conditions. Because radiopharmaceuticals circulate throughout a patient's body, they can potentially end up in peritoneal fluid. Handling and disposal of extracted peritoneal fluid containing radioactive material requires appropriate radiation protection practices. This paper details our experience with three patients who underwent paracentesis following 177Lu-DOTATATE treatment and had megabecquerel quantities of 177Lu present in the extracted fluid. A simple method for quantification of peritoneal fluid 177Lu activity concentration, recommendations for managing 177Lu-DOTATATE patients requiring paracentesis, and proper disposal of radioactive peritoneal fluid containing is also discussed.Health Phys.