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Related Experiment Video

Updated: Apr 30, 2026

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
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Enhancing USP Compliance in Transarterial Radioembolization Using 90Y Resin Microspheres.

Xingyu Nie1, Kimyli Lemieux2, William Denton1

  • 1University of Kentucky, Lexington, Kentucky.

Journal of Nuclear Medicine Technology
|April 28, 2026
PubMed
Summary

Transitioning radiopharmaceutical preparation to a commercial nuclear pharmacy improved compliance with beyond-use date (BUD) regulations for Yttrium-90 resin microsphere (90Y-RM) treatments. This change enhanced workflow efficiency and patient safety in complex radioembolization procedures.

Keywords:
90Y-labeled resin microspheresUSP <825>dose preparationtransarterial radioembolizationworkflow

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Area of Science:

  • Nuclear medicine
  • Radiopharmacy
  • Interventional oncology

Background:

  • USP <825> mandates a 1-hour beyond-use date (BUD) for immediate-use radiopharmaceuticals.
  • This strict BUD poses workflow challenges for complex procedures like transarterial radioembolization using 90Y-labeled resin microspheres (90Y-RM).
  • Current in-house preparation methods can lead to delays and potential BUD violations.

Purpose of the Study:

  • To evaluate the impact of transitioning 90Y-RM dose preparation from in-house to a commercial nuclear pharmacy.
  • To assess the effect on USP <825> compliance, workflow efficiency, and dose accuracy.
  • To improve patient safety by ensuring radiopharmaceuticals are administered within their BUD.

Main Methods:

  • Retrospective review of 120 cases of 90Y-RM preparation and administration.
  • Comparison of an in-house preparation workflow (n=55) with a commercial nuclear pharmacy workflow (n=65).
  • Analysis of time from dose preparation to administration readiness, BUD violations, and deviation between prescribed and administered activities.

Main Results:

  • The new workflow eliminated BUD violations, achieving 100% compliance compared to 25.5% in the old workflow.
  • Median time from preparation to readiness decreased significantly.
  • Absolute deviation between prescribed and administered activities decreased from 4.3% ± 3.1% to 2.2% ± 2.1% (P < 0.001).

Conclusions:

  • Transitioning 90Y-RM preparation to a commercial nuclear pharmacy effectively achieves USP <825> compliance.
  • This change enhances workflow efficiency and improves dose accuracy for transarterial radioembolization.
  • The new model supports improved patient safety by ensuring radiopharmaceutical integrity.