Clinical evaluation of fluorine-urethane resin-coated films for preventing and managing 177Lu-DOTATATE surface contamination

Abstract

Objective

¹⁷⁷Lu-DOTATATE and ¹⁷⁷Lu-PSMA-617 used as therapeutic radiopharmaceuticals are primarily excreted in urine and may cause relatively high levels of contamination in toilets and sink areas. This study aimed to comprehensively evaluate a novel fluorine-coated film as a practical solution for the management of ¹⁷⁷Lu-DOTATATE contamination by (1) quantifying its decontamination efficiency, (2) assessing its effectiveness in clinical settings, and (3) identifying optimal applications in nuclear medicine facilities.

Methods

The developed hydrophobic films [fluorine-coated film (F-film) and fluorine-urethane resin-coated film (FU-film)] were prepared along with a commercial hydrophobic film (Aquaglide), stainless-steel plate, sink, and urine bag were used as the test materials. Contact angles were measured using the sessile-drop method. The relationship between the contact angle of each test material (excluding the sink) and the count reduction rate after applying ¹⁷⁷Lu-DOTATATE (4.93 Bq/ml, 0.1 ml) was investigated. Each measurement was performed three times. To confirm the effectiveness in a clinical setting, the FU-film was applied to a toilet bowl, and the contamination after urination by patients who were administered ¹⁷⁷Lu-DOTATATE was evaluated.

Results

A strong positive correlation (r = 0.84, p = 0.001) was observed between the contact angle of the test material surface and the reduction rate of the count after wiping with a wet paper towel. Specifically, the counts of the F-film, FU-film, and Aquaglide, which had contact angles greater than 90°, decreased by 92.1%, 96.8%, and 97.4%, respectively, and the counts on the sink and the stainless-steel plate decreased by 71.9% and 69.2%, respectively. The count of the FU-film was 23.3% lower than that of the urine bag. The density of surface contamination of the FU-film after flushing was 62.2% lower than that of the toilet bowl and was lower than the background level.

Conclusion

The developed FU-film effectively prevents and reduces ¹⁷⁷Lu-DOTATATE contamination, with a reduction rate as high as 96.8%. This is particularly useful for protecting areas where water flows directly, such as sinks and toilet bowls, and also for protecting other medical materials that may be contaminated with urine.