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Related Concept Videos

Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Gravity versus pump-driven infusion in targeted radionuclide therapy: a model-based dosimetric evaluation of extravasation.

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Related Experiment Video

Updated: May 28, 2026

Cerenkov Luminescence Imaging CLI for Cancer Therapy Monitoring
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[177Lu]Lu-PSMA extravasation: from quantitative imaging to clinical guidelines.

Julien Salvadori1, Oreste Allegrini1, Florian Ritzenthaler1

  • 1Department of Nuclear Medicine, Centre Paul Strauss, F67000 Strasbourg, France.

Physics in Medicine and Biology
|April 15, 2026
PubMed
Summary

Extravasation of lutetium-177 (177Lu) radioligands clears rapidly with conservative management, showing doses below injury thresholds. Automated dosimetry supports evidence-based, standardized treatment protocols for these rare events.

Keywords:
[177Lu]Lu-PSMAautomated dosimetryclinical managementextravasationradiopharmaceutical safety

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Area of Science:

  • Nuclear Medicine
  • Radiopharmaceutical Therapy
  • Medical Physics

Background:

  • Extravasation of therapeutic radioligands like [177Lu]Lu-PSMA-617 can cause localized radiation injury.
  • Current management strategies for radioligand extravasation lack standardization and are often empirical.

Purpose of the Study:

  • To evaluate [177Lu]Lu-PSMA extravasation using automated, time-resolved dosimetry.
  • To support evidence-based conservative management of radioligand extravasation.

Main Methods:

  • Two patients with [177Lu]Lu-PSMA extravasation received conservative treatment (massage, warmth, elevation).
  • Quantitative SPECT/CT imaging assessed clearance kinetics with early and delayed scans.
  • Automated workflow included deep learning segmentation, partial volume correction, Monte Carlo dosimetry, and kinetic modeling.

Main Results:

  • Both patients showed rapid clearance of extravasated activity (effective half-lives ~1.5 h).
  • Highest absorbed doses in sub-volumes (<1 mL) were below necrosis thresholds (<10 Gy).
  • Systemic dosimetry, including renal doses, was largely unaffected by extravasation events.

Conclusions:

  • Conservative management of [177Lu]Lu-PSMA extravasation is effective, with rapid clearance and doses below deterministic injury thresholds.
  • Automated quantitative dosimetry provides objective data for timely clinical decisions.
  • This approach facilitates the development of standardized management protocols for radioligand extravasation.