Zhaoqi Lu, Yanjinghui Sun, Di Zuo, Pengfei Li, Xiaorong Sun
{"title":"Lu-177-DOTATATE治疗小儿神经母细胞瘤期间患者及其他人的辐射暴露","authors":"Zhaoqi Lu, Yanjinghui Sun, Di Zuo, Pengfei Li, Xiaorong Sun","doi":"10.1097/RLU.0000000000005763","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated Lutetium-177-(DOTA°,Tyr 3 ) octreotate (Lu-177-DOTATATE) clearance in pediatric patients with neuroblastoma and assessed the effective doses received by patients, family caregivers, and medical staff during therapy.</p><p><strong>Patients and methods: </strong>Twenty-three children (3-13 y) who received Lu-177-DOTATATE between 2023 and 2024 were enrolled. External dose rates were measured at 0, 1, 2, 4, 6, 24, 48, and 96 hours post-administration to estimate patients' Lu-177-DOTATATE retention rate, the effective half-life, and the maximum cumulative effective dose around patients. Whole-body and red-marrow absorbed doses were calculated based on multi-time-point whole-body planar and SPECT/CT imaging using HERMES Dosimetry software. Whole-body effective doses to family caregivers and medical personnel were measured using thermoluminescence dosimeters (TLDs), and effective finger doses for medical staff were measured using ring TLDs.</p><p><strong>Results: </strong>The mean administered activity was 3.687±1.545 (range, 1.469-7.368) GBq. Whole-body retention rates at 1-96 hours post-administration ranged from 72.0% to 10.0%, with 99% clearance expected within 11 days. Clearance followed a biexponential decay model, with estimated effective half-lives of 1.4±0.8 and 52.3±18.6 hours for the fast and slow phases, respectively, at 2 m. Estimated maximum cumulative effective doses (within 11 days) at 1 and 2 m were 0.442±0.174 and 0.138±0.058 mSv, respectively. Absorbed doses for children were 0.159±0.076 mGy/MBq (whole body) and 0.611±0.416 mGy/MBq (red-marrow). Whole-body effective doses to family caregivers averaged 0.245±0.063 (range, 0.150-0.390) mSv. The whole-body and finger-effective doses to the radiopharmacists were 3.7±1.8 and 155.3±73.0 μSv/patient, respectively. The mean of whole-body and the median ( P25 , P75 ) of finger-effective doses to nurses were 4.7±1.4 μSv/patient and 16.7 (10, 470) μSv/patient, respectively.</p><p><strong>Conclusions: </strong>Lu-177-DOTATATE was rapidly cleared in children with neuroblastoma. Radiation exposure to others was below personal dose limits.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"480-485"},"PeriodicalIF":9.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Radiation Exposure to Patients and Others During Therapy for Pediatric Neuroblastoma With Lu-177-DOTATATE.\",\"authors\":\"Zhaoqi Lu, Yanjinghui Sun, Di Zuo, Pengfei Li, Xiaorong Sun\",\"doi\":\"10.1097/RLU.0000000000005763\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study evaluated Lutetium-177-(DOTA°,Tyr 3 ) octreotate (Lu-177-DOTATATE) clearance in pediatric patients with neuroblastoma and assessed the effective doses received by patients, family caregivers, and medical staff during therapy.</p><p><strong>Patients and methods: </strong>Twenty-three children (3-13 y) who received Lu-177-DOTATATE between 2023 and 2024 were enrolled. External dose rates were measured at 0, 1, 2, 4, 6, 24, 48, and 96 hours post-administration to estimate patients' Lu-177-DOTATATE retention rate, the effective half-life, and the maximum cumulative effective dose around patients. Whole-body and red-marrow absorbed doses were calculated based on multi-time-point whole-body planar and SPECT/CT imaging using HERMES Dosimetry software. Whole-body effective doses to family caregivers and medical personnel were measured using thermoluminescence dosimeters (TLDs), and effective finger doses for medical staff were measured using ring TLDs.</p><p><strong>Results: </strong>The mean administered activity was 3.687±1.545 (range, 1.469-7.368) GBq. Whole-body retention rates at 1-96 hours post-administration ranged from 72.0% to 10.0%, with 99% clearance expected within 11 days. Clearance followed a biexponential decay model, with estimated effective half-lives of 1.4±0.8 and 52.3±18.6 hours for the fast and slow phases, respectively, at 2 m. Estimated maximum cumulative effective doses (within 11 days) at 1 and 2 m were 0.442±0.174 and 0.138±0.058 mSv, respectively. Absorbed doses for children were 0.159±0.076 mGy/MBq (whole body) and 0.611±0.416 mGy/MBq (red-marrow). Whole-body effective doses to family caregivers averaged 0.245±0.063 (range, 0.150-0.390) mSv. The whole-body and finger-effective doses to the radiopharmacists were 3.7±1.8 and 155.3±73.0 μSv/patient, respectively. The mean of whole-body and the median ( P25 , P75 ) of finger-effective doses to nurses were 4.7±1.4 μSv/patient and 16.7 (10, 470) μSv/patient, respectively.</p><p><strong>Conclusions: </strong>Lu-177-DOTATATE was rapidly cleared in children with neuroblastoma. 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Radiation Exposure to Patients and Others During Therapy for Pediatric Neuroblastoma With Lu-177-DOTATATE.
Purpose: This study evaluated Lutetium-177-(DOTA°,Tyr 3 ) octreotate (Lu-177-DOTATATE) clearance in pediatric patients with neuroblastoma and assessed the effective doses received by patients, family caregivers, and medical staff during therapy.
Patients and methods: Twenty-three children (3-13 y) who received Lu-177-DOTATATE between 2023 and 2024 were enrolled. External dose rates were measured at 0, 1, 2, 4, 6, 24, 48, and 96 hours post-administration to estimate patients' Lu-177-DOTATATE retention rate, the effective half-life, and the maximum cumulative effective dose around patients. Whole-body and red-marrow absorbed doses were calculated based on multi-time-point whole-body planar and SPECT/CT imaging using HERMES Dosimetry software. Whole-body effective doses to family caregivers and medical personnel were measured using thermoluminescence dosimeters (TLDs), and effective finger doses for medical staff were measured using ring TLDs.
Results: The mean administered activity was 3.687±1.545 (range, 1.469-7.368) GBq. Whole-body retention rates at 1-96 hours post-administration ranged from 72.0% to 10.0%, with 99% clearance expected within 11 days. Clearance followed a biexponential decay model, with estimated effective half-lives of 1.4±0.8 and 52.3±18.6 hours for the fast and slow phases, respectively, at 2 m. Estimated maximum cumulative effective doses (within 11 days) at 1 and 2 m were 0.442±0.174 and 0.138±0.058 mSv, respectively. Absorbed doses for children were 0.159±0.076 mGy/MBq (whole body) and 0.611±0.416 mGy/MBq (red-marrow). Whole-body effective doses to family caregivers averaged 0.245±0.063 (range, 0.150-0.390) mSv. The whole-body and finger-effective doses to the radiopharmacists were 3.7±1.8 and 155.3±73.0 μSv/patient, respectively. The mean of whole-body and the median ( P25 , P75 ) of finger-effective doses to nurses were 4.7±1.4 μSv/patient and 16.7 (10, 470) μSv/patient, respectively.
Conclusions: Lu-177-DOTATATE was rapidly cleared in children with neuroblastoma. Radiation exposure to others was below personal dose limits.
期刊介绍：
Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty.
Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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