The use of lutetium-177 (177Lu)-based radiopharmaceuticals in peptide receptor nuclear therapy is increasing, but so is the number of nuclear medicine workers exposed to higher levels of radiation. In recent years, [177Lu]Lu-DOTA-TATE has begun to be widely used for the treatment of neuroendocrine tumours. However, there are few studies evaluating the occupational radiation exposure during its administration, and there are still some challenges that can result in higher doses to the staff, such as a lack of trained personnel or fully standardised procedures. In response, this study aims to provide a comprehensive analysis of occupational doses to the staff involved in the administration of [177Lu]Lu-DOTA-TATE. A total of 32 administrations of [177Lu]Lu-DOTA-TATE (7.4 GBq/session) carried out by a physician and a nurse, were studied. In total, two physicians and four nurses were independently monitored with cumulative (passive) and/or real-time (active) dosemeters. Extremity, eye lens and whole-body doses were evaluated in terms of the dosimetric quantities Hp(0.07), Hp(3) and Hp(10), respectively. It was obtained that lead aprons reduced dose rates and whole-body doses by 71% and 69% for the physicians, respectively, and by 56% and 68% for the nurses. On average, normalised Hp(10) values of 0.65 ± 0.18 µSv/GBq were obtained with active dosimetry, which is generally consistent with passive dosemeters. For physicians, the median of the maximum normalised Hp(0.07) values was 41.5 µSv/GBq on the non-dominant hand and 45.2 µSv/GBq on the dominant hand. For nurses 15.4 µSv/GBq on the non-dominant and 13.9 µSv/GBq on the dominant hand. The ratio or correction factor between the maximum dose measured on the hand and the dose measured on the base of the middle/ring finger of the non-dominant hand resulted in a factor of 5/6 for the physicians and 3/4 for the nurses. Finally, maximum normalised Hp(3) doses resulted in 2.02 µSv/GBq for physicians and 1.76 µSv/GBq for nurses. If appropriate safety measures are taken, the administration of [177Lu]Lu-DOTA-TATE is a safe procedure for workers. However, regular monitoring is recommended to ensure that the annual dose limits are not exceeded.

中文翻译：

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主动和被动剂量测定对核医学工作人员[177Lu]Lu-DOTA-TATE的辐射暴露评估

肽受体核治疗中以镥 177 (177Lu) 为基础的放射性药物的使用正在增加，但暴露于更高水平辐射的核医学工作者的数量也在增加。近年来，[177Lu]Lu-DOTA-TATE开始广泛用于神经内分泌肿瘤的治疗。然而，很少有研究评估其管理期间的职业辐射暴露，并且仍然存在一些可能导致工作人员接受更高剂量的挑战，例如缺乏经过培训的人员或完全标准化的程序。为此，本研究旨在为参与 [177Lu]Lu-DOTA-TATE 管理的工作人员提供职业剂量的综合分析。由一名医生和一名护士总共进行了 32 次 [177Lu]Lu-DOTA-TATE（7.4 GBq/疗程）给药研究。总共，两名医生和四名护士使用累积（被动）和/或实时（主动）剂量计进行独立监测。分别根据剂量学量 Hp(0.07)、Hp(3) 和 Hp(10) 评估四肢、眼晶状体和全身剂量。研究发现，铅围裙使医生的剂量率和全身剂量分别降低了 71% 和 69%，使护士的剂量率和全身剂量分别降低了 56% 和 68%。平均而言，主动剂量测定获得的归一化 Hp(10) 值为 0.65 ± 0.18 µSv/GBq，这与被动剂量计基本一致。对于医生来说，非惯用手的最大标准化 Hp(0.07) 值的中位数为 41.5 µSv/GBq，惯用手为 45.2 µSv/GBq。对于护士，非惯用手为 15.4 µSv/GBq，惯用手为 13.9 µSv/GBq。在手上测得的最大剂量与在非惯用手的中指/无名指根部测得的剂量之间的比率或校正系数导致医生的系数为 5/6，护士的系数为 3/4 。最后，最大标准化 Hp(3) 剂量导致医生为 2.02 µSv/GBq，护士为 1.76 µSv/GBq。如果采取适当的安全措施，[177Lu]Lu-DOTA-TATE 的管理对工人来说是一个安全的程序。然而，建议定期监测，以确保不超过年度剂量限值。