Comparison of Three Therapeutic Radiopharmaceutical Infusion Methods for Single and Multivial Applications

Area of Science:

• Nuclear Medicine
• Radiopharmaceutical Therapy
• Clinical Pharmacy

Background:

• Accurate intravenous infusion is vital for therapeutic radiopharmaceutical (TRP) safety and efficacy.
• Industry-standard TRP infusion methods include syringe pumps, gravity, and peristaltic pumps.
• Evaluation of these methods is necessary for both Food and Drug Administration (FDA)-approved and investigational TRP administrations.

Purpose of the Study:

• To outline the benefits and limitations of three TRP infusion methods: syringe pump, gravity method, and peristaltic pump.
• To evaluate these methods based on safety, adherence to the As Low As Reasonably Achievable (ALARA) principle, and ease of identifying infusion start/end.
• To assess applicability to both FDA-approved and investigational TRP infusions.

Main Methods:

• Three TRP infusion methods (syringe pump, gravity, peristaltic pump) were evaluated at a single institution.
• Syringe pump evaluated for 55 TRP infusions; gravity method deemed unsuitable due to issues.
• Peristaltic pump evaluated for over 1,585 single-vial and 30 dual-vial TRP infusions.

Main Results:

• Syringe and peristaltic pumps demonstrated successful use for FDA-approved and investigational TRP intravenous infusions.
• Both methods showed compliance with infusion criteria, ease of use, and reliability.
• The gravity method was not utilized for TRP infusions due to significant issues and uncertainties.

Conclusions:

• As the number of intravenous TRPs increases, understanding infusion method benefits and limitations is crucial.
• Syringe and peristaltic pumps are viable options for TRP administration.
• Optimal method selection should prioritize patient safety, reliability, and specific clinical application.