title: Skin dose saving of the staff in 90Y/177Lu peptide receptor radionuclide therapy with the automatic dose dispenser.
abstract: OBJECTIVE
  When handling Y-labelled and Lu-labelled radiopharmaceuticals, skin exposure is mainly due to β-particles. This study aimed to investigate the equivalent dose saving of the staff when changing from an essentially manual radiolabelling procedure to an automatic dose dispenser (ADD).
  
  
  METHODS
  The chemist and physician were asked to wear thermoluminescence dosimeters on their fingertips to evaluate the quantity of Hp(0.07) on the skin. Data collected were divided into two groups: before introducing ADD (no ADD) and after introducing ADD.
  
  
  RESULTS
  For the chemist, the mean values (95th percentile) of Hp(0.07) for no ADD and ADD are 0.030 (0.099) and 0.019 (0.076) mSv/GBq, respectively, for Y, and 0.022 (0.037) and 0.007 (0.023) mSv/GBq, respectively, for Lu. The reduction for ADD was significant (t-test with P<0.05) for both isotopes. The relative differences before and after ADD collected for every finger were treated using the Wilcoxon test, proving a significantly higher reduction in extremity dose to each fingertip for Lu than for Y (P<0.05). For the medical staff, the mean values of Hp(0.07) (95th percentile) for no ADD and ADD are 0.021 (0.0762) and 0.0143 (0.0565) mSv/GBq, respectively, for Y, and 0.0011 (0.00196) and 0.0009 (0.00263) mSv/GBq, respectively, for Lu. The t-test provided a P-value less than 0.05 for both isotopes, making the difference between ADD and no ADD significant.
  
  
  CONCLUSIONS
  ADD positively affects the dose saving of the chemist in handling both isotopes. For the medical staff not directly involved with the introduction of the ADD system, the analysis shows a learning curve of the workers over a 5-year period. Specific devices and procedures allow staff skin dose to be limited.
authors.affiliation: aMedical Physics Unit bNuclear Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia cDepartment of Industrial Engineering, University of Bologna, Bologna, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fioroni
authors.forename: Elisa
authors.initials: E
authors.lastname: Grassi
authors.forename: Cavatorta
authors.initials: C
authors.lastname: Giorgia
authors.forename: Rubagotti
authors.initials: R
authors.lastname: Sara
authors.forename: Vando
authors.initials: V
authors.lastname: Piccagli
authors.forename: Angelina
authors.initials: A
authors.lastname: Filice
authors.forename: Domiziano
authors.initials: D
authors.lastname: Mostacci
authors.forename: Annibale
authors.initials: A
authors.lastname: Versari
authors.forename: Mauro
authors.initials: M
authors.lastname: Iori
mesh_terms: D001331:Automation; D001610:Beta Particles / Q000627:therapeutic use; D002621:Chemistry; D005385:Fingers / Q000528:radiation effects; D006801:Humans; D008187:Lutetium; D016273:Occupational Exposure / Q000032:analysis / Q000517:prevention & control*; D010820:Physicians; D011829:Radiation Dosage; D011835:Radiation Protection; D018000:Receptors, Peptide / Q000627:therapeutic use*; D012867:Skin / Q000528:radiation effects*; D013819:Thermoluminescent Dosimetry; D015021:Yttrium Radioisotopes
chemical_list: D018000:Receptors, Peptide; D015021:Yttrium Radioisotopes; D008187:Lutetium