Extravasation of radiopharmaceuticals: Why report?

Steps can be taken by radiation protection personnel at medical institutions to educate practitioners and staff about extravasations, their risks and what steps can be taken to reduce their occurrence. Further research needs to be performed to better understand the incidence rate, categorization, causes, and methods of prevention. Full text

NRC Commences Rulemaking to Close Loophole in Nuclear Medicine Safety

U.S. Nuclear Regulatory Commission accepts Lucerno’s petition for rulemaking and directs the commencement of a rulemaking process to close an outdated loophole in nuclear medicine safety regulations. Press Release

Practical Tools for Patient-specific Characterization and Dosimetry of Radiopharmaceutical Extravasation

Accurate extravasation dosimetry requires characterization of the event. In this work, we developed three extravasation characterization and dosimetry tools, validated each against published data, and demonstrated their utility in a realistic clinical workflow. Full Text

Development of a classifier for [18F] fluorodeoxyglucose extravasation severity using semi-quantitative readings from topically applied detectors

The topical detector binary classifier, calibrated using quantitative static PET measurements, significantly improves extravasation detection compared to qualitative image analysis. Full Text

House-Passed Appropriations Bills Advance Nuclear Medicine Safety, Transparency

Lucerno announced that Fiscal Year 2023 bills passed this week by the U.S. House of Representatives include critical language to improve the safety of nuclear medicine treatments and increase transparency within the American healthcare system. Press Release

Extravasation Reporting Pros and Cons

In 2020 the Health Physics Society (HPS) submitted a public comment, unsupported by science, to the Nuclear Regulatory Commission regarding the reporting of extravasations. In early 2022, the radiation protection journal, Health Physics, provided a forum for discussing the HPS public comment. Lucerno, patients, experts, and HPS members provided written responses to the HPS public comment.

2022 Omnibus Includes Nuclear Medicine Patient Safety, Transparency Provisions

Lucerno announces Fiscal Year 2022 Omnibus Appropriations Act preserves critical language to protect the safety of nuclear medicine patients and enhance transparency within the American healthcare system. Then attach the press release below for full text. Press Release

Nuclear Regulatory Commission’s foot-dragging on patient irradiation suggests regulatory capture

“My analysis shows that the NRC findings predominantly parrot positions of the advisory committee and affiliated societies, such as requiring patients to determine whether a procedure was done correctly; requiring reporting only if a patient experiences permanent functional damage; or taking no action whatsoever.” Full Text

Radiopharmaceutical Extravasations: Interview with
Dr. David W. Townsend

Dr. David W. Townsend, co-inventor of the PET/CT scanner, discusses how extravasation affects standardized uptake values and treatment assessment and why extravasations often go undetected. Dr. Townsend believes that monitoring the quality of injection is as important as monitoring all other aspects of the imaging process. Watch full video here

Radiopharmaceutical Extravasations: Interview with
Dr. Marjan Boerma

Dr. Marjan Boerma, radiation biologist and professor at the University of Arkansas for Medical Sciences, discusses radiation injury to tissue and why each individual responds differently to the same dose of radiation. She comments on a specific case in which the patient has received a severe injury to the tissue from radiation, explaining what exactly happened to the cells and what should be done for helping to heal the tissue. Dr. Boerma believes that the patients with large extravasations should be followed clinically since there is a high chance of long-term effects. Watch full video here

Radiopharmaceutical Extravasations: Interview with
Dr. Jackson Kiser

Dr. Jackson Kiser, Chief of Molecular Imaging Department at Carilion Clinic, explains why complete delivery of the radiopharmaceutical is so important not only for PET/CT studies but for all nuclear medicine procedures. He provides several specific examples from his practice of how extravasation can result in misinterpretation of medical images and affect patient care. Dr. Kiser also shares his opinion on why monitoring extravasations and clinically following extravasated patients will become even more important for the rapidly growing field of radiotherapeutics. Watch full video here

Detection of Excess Presence of 99mTc-MDP Near Injection Site—A Case Report

“This case describes how detection of excess presence of 99mTc-MDP near the injection site enabled the technologist to apply mitigation tactics early in the uptake process. It also suggests that detecting an extravasation or stasis early in the injection process can be important for image interpretation and minimizing radiation dose to tissue.” Full Text