Huang Yu-Yi, Lin Ting-Chum, Yang Shih-Han, Lai Lan-Shih, Hung Ling-Man, Li Ming-Hsin, Hsia Ching-Yueh, Huang Kuo-Cheng
Department of Nuclear Medicine, Koo-Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
School of Medicine, College of Medicine, National Yung Ming Chiao Tung University, Hsinchu City, Taiwan.
Radiol Case Rep. 2024 Nov 14;20(1):805-809. doi: 10.1016/j.radcr.2024.10.084. eCollection 2025 Jan.
We present a patient who is undergoing regular HD and received Lu-177-PSMA-617 treatment, regarding radiation safety issues including environmental radiation, exposure of medical personnel, and the radioactivity in the dialysate.
A 78 years old man with metastatic castration-resistant prostate cancer undergoing HD received 84.4 mCi (3.1 GBq) of Lu-177-PSMA-617. First HD during the 20th-24th hours after injection, and the second HD during 68th-71st hours. The environmental exposure rate and personnel exposure monitoring were measured. The dialysate was collected and sampled, and the activity was measured.
During the first HD session, where dialysate was collected in the room, medical personnels received exposure of 3-19µSv. Dialysate was drained out in the second HD, and medical personnels received 2-4 µSv. The radiation exposure rates in the first HD were measured as follows: 3-4 µSv/hr bedside, 1.2-1.5 µSv/hr at 1 meter, and less than 0.3 µSv/hr at 4 meters. In the second HD, the rates were 2-3 µSv/hr bedside, 1.2-1.8 µSv/hr at 1 meter, and less than 0.3 µSv/hr at 4 meters.The dialysate had an activity of 6.88 mCi (0.25 GBq) in 120 liters of the first HD, while in the second HD, it had 2.13 mCi (0.08 GBq) in 90 liters.
For the medical personnel involving HD, the accumulative exposure doses were than 2-19 µSv after 20 hour of injection. The environmental exposure rate would drop to background at 4m away from the patient. The dialysate contained minimal amounts of Lu-177 radioactivity.
我们介绍一位正在接受定期血液透析（HD）并接受了镥 - 177 - PSMA - 617治疗的患者，涉及辐射安全问题，包括环境辐射、医务人员暴露以及透析液中的放射性。
一名78岁患有转移性去势抵抗性前列腺癌且正在接受血液透析的男性接受了84.4毫居里（3.1吉贝可）的镥 - 177 - PSMA - 617。注射后第20 - 24小时进行第一次血液透析，第68 - 71小时进行第二次血液透析。测量了环境暴露率和人员暴露情况，并对透析液进行收集、采样及放射性活度测量。
在第一次血液透析期间，透析液在室内收集，医务人员接受的暴露剂量为3 - 19微希沃特。第二次血液透析时透析液被排出，医务人员接受的暴露剂量为2 - 4微希沃特。第一次血液透析时的辐射暴露率测量结果如下：床边为3 - 4微希沃特/小时，1米处为1.2 - 1.5微希沃特/小时，4米处小于0.3微希沃特/小时。第二次血液透析时，床边为2 - 3微希沃特/小时，1米处为1.2 - 1.8微希沃特/小时，4米处小于0.3微希沃特/小时。第一次血液透析的120升透析液中放射性活度为6.88毫居里（0.25吉贝可），而第二次血液透析的90升透析液中为2.13毫居里（0.08吉贝可）。
对于参与血液透析的医务人员，注射后20小时内累积暴露剂量为2 - 19微希沃特。在距离患者4米处，环境暴露率降至本底水平。透析液中镥 - 177放射性含量极少。
