Lara®
Real-Time Visualization (RTV)

The Latest Innovation To Ensure The Highest Level Of Precision For Your Therapeutic Radiopharmaceutical Administrations

Lara RTV can be used with any method of therapy administrations

Infusion

Get immediate feedback throughout the infusion, no matter what technique you use.

Infusion

Bolus

Easily see the characteristic bolus spike, the impact of flushing, and evidence of injection quality.

Bolus

Black line (injection arm counts) and red line (reference arm counts) reach equilibrium within minutes for an infusion and within seconds for a bolus injection, indicating complete vascular delivery of the radiopharmaceutical.

Introducing Lara RTV with Control Charts

Lucerno can apply statistical control charts to the real-time visualization on a computer monitor to help guide radiotherapeutic administration. These control charts can be based on any, or any combination, of the following:

  • previous center-specific proven ideal administrations
  • previous ideal administration by each technologist
  • preferences of the Authorized User
  • guidance from radiopharmaceutical manufacturers
  • other information to be determined by customers

Control Chart Benefits

  • Early warning system to alert technologists that their administration may have been extravasated
  • Minimizes accidental radiation exposures to patients
  • Ensures and documents effective delivery of therapy
  • Prevents waste of expensive radiotherapeutics

Control Chart Examples

Control Chart 1: Ideal Radiopharmaceutical Administration

This is a realistic example of an ideal radiopharmaceutical administration based on actual administrations.

The Lara sensor data from the administration arm (black line) remains within the dark green Control Chart area representing one standard deviation. It then drops to a level consistent with the reference arm sensor data (red line) indicating the administration was likely to be systemic with no residual radioactivity left at or near the injection site.

Control Chart 2: Controlled Push-Pause Ideal Administration
This is also an example of an ideal radiopharmaceutical administration based on real-life administrations. This example demonstrates a technologist using periodic pauses to confirm the quality of the administration. The Lara sensor data from the administration arm (black line) remains within the dark green Control Chart area representing one standard deviation. It then drops to a level consistent with the reference arm sensor data (red line) indicating the administration was likely to be systemic with no residual radioactivity left at or near the injection site.

At times 1:00 and 1:15, changes on the black line represent decreases in sensor counts. These correspond with times when the technologist briefly paused the administration while watching the Lara RTV TAC. Brief pauses like this may provide useful feedback to assess the administration. If the Lara RTV TAC black data line does not decrease during the paused administration period, it may indicate a potential problem and warrant a pause of the administration to investigate.

At time 2:15 in this example, the administration is completed, and the Lara RTV TAC decreases rapidly. The next several seconds represent the technologist preparation of a saline flush. The flush can be seen as the peak at time 2:30.

Control Chart 3: Early Administration Deviation

This is one example of a non-ideal radiopharmaceutical administration, likely caused by a venous access issue that led to an extravasation.

The Lara RTV TAC indicates that output from the administration arm sensor (black line) rises as the administration starts. At time 0:45, the black line passes out of the first standard deviation and by time 0:50 passes through the light green Control Chart region representing 2 standard deviations. In an actual administration, if the TAC passes through the Control Chart regions, the technologist may want to consider pausing to assess the quality of the administration.

In this example the technologist continued administering and the black line remains outside of the Control Chart. In this example, it is likely the patient has been extravasated.

Control Chart 4: Late-Stage Administration Complication

This is another example of a non-ideal radiopharmaceutical administration, based on a real-life extravasation likely caused by a blown vein during the administration.

In this example, the Lara RTV TAC indicates that output from the administration arm sensor (black line) rises as the administration starts. At 1:00, the technologist begins a series of pauses. Each pause results in less radiotherapeutic passing through the vein underneath the Lara sensor. Therefore, the RTV TAC decreases and confirms patent venous access. Subsequent pushes by the technologist causes the RTV TAC to increase.

However, at approximately 1:50 the technologist’s push causes the TAC to rapidly increase and seconds later exit both the dark green (1 standard deviation) and light green (2 standard deviations) regions of the Control Chart. The customer determined this push at 1:50 may have blown the vein and caused an extravasation.

In this particular case, the technologist didn’t act. Upon seeing the Lara RTV TAC quickly deviating from the Control Chart, the technologist should have assessed the situation, paused the administration, and investigated why the TAC was not decreasing.

By pausing an administration as soon as extravasation is suspected, technologists can minimize the extent of extravasation, the absorbed dose to the patient tissue and overlying skin, and the effect of the misadministration to the overall procedure.

Lara RTV combines statistical-based control charts with real-time monitoring to provide immediate insight into the quality of administration resulting in confidence in every procedure
  • Identify potential misadministration within seconds and pause administration
  • Protect patient from unnecessary radiation exposure and ensure delivery of therapy
  • Protect nuclear medicine centers from the cost of misadministered radiation and compromised therapy

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