VTH-C - Special Session: Medical Health Physics 10:00 - 14:30
NOTE: ALL VIRTUAL SESSIONS WILL TAKE PLACE DURING PACIFIC STANDARD TIME.
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VTH-C.1
10:00 Experience with Lu‐177 Treatment in Mobility Impaired Patients K Georgiou*, Columbia University
; PF Caracappa, Columbia University
Abstract: Outpatient Lu‐177 procedures still require an extended time in a treatment room. Medical staff may not always communicate the physical limitations or mobility impairment of patients which might affect their requirements, including bathroom needs. Such a patient led to significant room contamination and waste volume, and updates to the patient evaluation and room preparation procedures.
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VTH-C.2
10:15 Lutathera (Lu-177) Extravasation KE Berry*, Fox Chase Cancer Center
; JJ Kendrick, Fox Chase Cancer Center
Abstract: While the Medical Health Physics community was fiercely debating if extravasations of radioisotopes should be classified as a medical event, we had an extravasation of a therapeutic dose of Lutathera. This was our first radioactive therapeutic extravasation and this presentation will discuss everything from what we learned, what we did, and what we are doing now as a result. Included will be an analysis of skin dose and comparison to the medical event limit for organ dose. Listen and find out if this would have qualified as a medical event if extravasations were included rather than excluded from medical event reporting.
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VTH-C.3
10:30 Waste handling suggestions for Lu-177 dotatate in nuclear medicine MA Miller*, Cleveland Clinic
; K Amin, Cleveland Clinic; S Rayadurgam, Cleveland Clinic; R Banks, Cleveland Clinic; A Rowland, Cleveland Clinic
Abstract: Lu-177 dotatate is used to treat neuroendocrine tumors in an outpatient setting. The presence of a long lived contaminant (Lu-177m) presents challenges in managing the waste streams that are generated. Typical nuclear medicine departments handle only short half-life isotopes for decay in storage or return sources to vendors for disposal or replacement. We examine the waste streams we generate (solid, sharps, liquid) and propose solutions that others might consider to manage these streams.
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VTH-C.4
10:45 Radiation Safety Considerations for Lu-177 PSMA Radiopharmaceutical Therapy K Abdin*, Washington University in St. Louis
; D Luechtefeld, Washington University in St. Louis; M Harrod, Washington University in St. Louis; M Amurao, Washington University in St. Louis
Abstract: There are many radiation protections considerations when implementing a Lu-177 PSMA radiopharmaceutical therapy program. This presentation is geared towards sharing what we learned during the Lu-177 PSMA clinical trial at Washington University in St. Louis, so other sites can have a baseline of what works without having to go through intense troubleshooting to discover the best processes for their patients, physicians, staff and regulatory needs.
This presentation will include, but not limited to:
Developing processes and procedures, training personnel, patient and staff scheduling, delivery and receipt of Lu-177 PSMA, patient room preparations for most effective contamination control, radiopharmaceutical administration, decontamination and radioactive waste, and regulatory compliance concerns.
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VTH-C.5
11:00 Radium dichloride in peritoneal dialysate C Saganich*, Weill Cornell Medicine
; M Zgaljardic, Weill Cornell Medicine
Abstract: A patient with castration-resistant metastatic prostate cancer (mCRPC) undergoing in-home peritoneal dialysis was treated with Radium-223. There was some concern about family members and home health care workers handling and disposing contaminated dialysate in the home. Additionally, there was no previous knowledge regarding Ra-223 clearance via peritoneal dialysis compared with normally renal functioning patients. Over four treatment cycles we collected sixty-two liters of dialysate and 22 dialysate bags and tubing sets. Removable contamination and dose rate measurements were made on all dialysate materials. The cumulative fraction of administered activity and activity concentration in dialysate was assessed for each treatment cycle. Additionally, an index was established to determine if there was an increase in radium daughter activity.
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12:00 BREAK
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VTH-C.6
12:15 Pharmaceutical Grade Ge/Ga‐68 Generator D Szatkowski*, Washington University in St. Louis
; SH Kim, Washington University in St. Louis; T Jefferies, Washington University in St. Louis
Abstract: Bringing a radiopharmaceutical GMP grade Ge/Ga‐68 generator onto your facility’s radioactive materials license has many implications. We will briefly discuss some of the uses of Ga‐68 radiopharmaceuticals and then delve into a review NRC’s licensing guidance, technical specifications, breakthrough testing, survey requirements, radiopharmacy coordination and our program’s auditing procedures.
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VTH-C.7
12:30 US NRC’s Medical Decommissioning Rulemaking and Lu-177 Licensing Activities SD Figueroa*, U.S. Nuclear Regulatory Commission
Abstract: The US NRC is currently completing a decommissioning financial assurance rulemaking that addresses a petition from the Organization of Agreement States (OAS) that requests Appendix B to 10 CFR Part 30 be updated to include radionuclides that are not currently listed like Germanium-68 used in Germanium-68/Gallium-68 medical grade generators. The NRC staff will provide an update of the ongoing rulemaking activities and will inform of the Lutetium-177 medical licensing actions.
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VTH-C.8
12:45 USP 825 and How it Impacts Radiation Safety Compliance M Panichi‐Egberts*, Nuclear Diagnostic Products, Inc
Abstract: USP developed 825 specifically for radiopharmaceuticals. it is intended to provide uniform minimum standards for the preparation, compounding, dispensing and repackaging of sterile and nonsterile radiopharmaceuticals for humans and animals. These standards apply to all radiopharmaceutical processing activities as well as Sterile Intravascular Radioactive Devices (radioactive microspheres for intravascular brachytherapy), in all practice setting and to all individuals who perform these duties. Unlike previous USP 797 standards, USP 825 balances aseptic handling practices with radiation safety considerations and address immediate use radiopharmaceuticals (for use within 1 hour of preparation) as well as standards for preparations for use after 1 hour.
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VTH-C.9
13:00 Your first year as a Medical RSO C Register*, University of Missouri
; RP Nichols, University of Missouri; J England, University of Missouri; CA Wilson, University of Missouri
Abstract: One of the most exciting aspects of being a radiation safety officer is that each day is unique. This is particularly true for RSOs in charge of a medical broad scope license. The workload and experiences differ depending on the size of the medical facility, but some aspects of the job are universal. This presentation will describe a first‐hand experience of making the jump from university RSO to medical RSO in hopes that others can benefit from experiences learned, but not yet forgotten. Topics include interacting with the local regulatory agency, learning the structure and history of the Radiation Safety Committee, and working with staff medical physicists.
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VTH-C.10
13:15 How RSO Job Demands Differ in Pediatric and Adult Hospitals J Metyko*, Seattle Children's
Abstract: Health physics in dedicated pediatric hospitals is an interesting niche within the greater medical radiation safety community. Radioactive materials use, both clinical and research, has expanded greatly in pediatrics, and along with it the need for health physics support. While radiation safety regulations and best practices are the same, the challenges a RSO faces differ, at times significantly. There are also differences in culture, personality types, and required skills that might not be obvious from a job description. Working in pediatrics can be very enjoyable and rewarding, and this presentation will help you determine if pediatrics is a good fit for you.
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13:30 BREAK
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VTH-C.
13:45 Business Meeting
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