Publications

“The studies in which I have been involved identified factors such as the tools used for the injection, the technique, and the experience of the technologist that influence the probability of extravasation, rather than any patient-specific factor.” Full Text

“As part of routine monitoring of 18F-FDG PET administrations, an interesting case was identified that mimicked extravasation but represented dose leakage during infusion via an automatic injector. The Lara device provided a useful tool for more timely critical evaluation and problem solving, extending advantages to the patient and practice.” Full Text

“Topical monitoring and characterization of PET dose administration is possible and practical with the LARA device. Extravasation and partial extravasation of PET doses are not only readily detected but they are also preventable. The LARA device can provide the insights into variables that could eliminate extravasation as a cause of image quality or SUV accuracy issues.” Full Text

“Infiltrations can be reduced. Using the techniques described, our 2 departments have shown a significant reduction in infiltration rates. Our main department, with a fixed-site PET/CT scanner, began with a 13.3% infiltration rate and reduced it to under 3% for 2 consecutive years and continues to improve. The mobile PET/CT department started with a 15.5% infiltration rate, reduced it to under 5%, and has maintained it there.” Full Text (subscription required).

“Topical monitoring and characterisation of PET dose administration is possible and practical with the LARA device. Extravasation and partial extravasation of PET doses are not only readily detected but they are also preventable. The LARA device can provide the insights into variables that could eliminate extravasation as a cause of image quality or SUV accuracy issues.” Full Text

“A QIP can significantly improve and sustain injection quality; however, ongoing monitoring is needed as new technologists join the team.” Full Text

Josh Knowland of Lucerno Dynamics and Jackson W. Kiser M.D. of Carilion Clinic have presented their poster on a novel method of calculating equivalent doses to tissue in cases of radiopharmaceutical extravasation during 2020 SNMMI Mid-Winter Meeting in Tampa, Florida.

“Topical detectors could allow for real-time feedback about lung activity without the use of dynamic SPECT counting or manual probing. This would allow for ventilation to be performed without the risk of scanner contamination or the variability of manual processes.” Presentation

“Therefore, extravasation events may effect clinical interpretation of PET imaging by disproportionately affecting tumor uptake and sparing blood pool and liver uptake.” Poster

“Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported.” Full Text

The medical RSO is in a position to influence patient safety in the institution. By a combination of self-education, faculty and staff education, collaboration with management, training, and surveys and inspections, the RSO can work towards developing a culture that considers control of patient radiation doses as important as minimizing radiation doses to occupational workers. Full Text

“Deep learning techniques have been found to perform extremely well in classification tasks in recent years. Use of TACs obtained from sensors to identify and classify infiltrations is also a very recent approach in PET dose infiltration research. Combination of both these techniques is a novel approach which may play a significant role in classifying infiltrated injection or identifying good injections.” Full Text