Case Report Radiation Safety Considerations in Hemodialysis Following Lu-177-PSMA-617 Therapy: A Case Report
by Yu-Yi Huang1,3*, Ting-Chum Lin1, Shih-Han Yang1, Lan-Shih Lai2, Ling-Man Hung1, Ming-Hsin Li1, Ching-Yueh Hsia4, Kuo-Cheng Huang5
1Department of Nuclear Medicine, Koo-Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
2Hemodialysis room, Department of Internal Medicine, Koo-Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
3School of Medicine, College of Medicine, National Yung Ming Chiao Tung University
4Global Medical Solutions, Taipei, Taiwan
5Department of Hematology and Medical Oncology, Koo-Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
*Corresponding author: Yu-Yi Huang, Department of Nuclear Medicine, Koo-Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
Citation: Huang YY, Lin TC, Yang SH, Lai LS, Hung LM, et al (2024) Radiation Safety Considerations in Hemodialysis Following Lu-177-PSMA-617 Therapy: A Case Report. Ann Case Report. 9: 1828. DOI:10.29011/2574-7754.101828
Received: 24 May 2024, Accepted: 28 May 2024, Published: 30 May 2024
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Abstract
Purpose: We present a patient who is undergoing regular HD and received Lu-177-PSMA-617 treatment, regarding radiation safety issues including environmental radiation, exposure of medical personnel, and the radioactivity in the dialysate.
Methods: A 78 years old man with metastatic castration-resistant prostate cancer undergoing HD received 84.4 mCi of Lu-177-PSMA-617. First HD during the 20th ~24th hours after injection, and the second HD during 68th ~71st hours. The environmental exposure rate and personnel exposure monitoring were measured. The dialysate was collected and sampled, and the activity was measured.
Results: During the first HD session, where dialysate was collected in the room, medical personnels received exposure of 3~19µSv. Dialysate was drained out in the second HD, and medical personnels received 2~4 µSv. The radiation exposure rates in the first HD were measured as follows: 3~4 µSv/hr bedside, 1.2~1.5 µSv/hr at 1 meter, and less than 0.3 µSv/hr at 4 meters. In the second HD, the rates were 2~3 µSv/hr bedside, 1.2~1.8 µSv/hr at 1 meter, and less than 0.3 µSv/hr at 4 meters. The dialysate had an activity of 6.88 mCi in 120 liters of the first HD, while in the second HD, it had 2.13 mCi in 90 liters.
Conclusion: For the medical personnel involving HD, the accumulative exposure doses were than 2~19 µSv after 20 hour of injection. The environmental exposure rate would drop to background at 4m away from the patient. The dialysate contained minimal amounts of Lu-177 radioactivity.
Keywords: Lu-177-PSMA-617; Hemodialysis; Radiation Safety; Dialysate.