Comparison of injection systems for luteinized therapies: Plum 360™ pump assembly vs Theranojet®ARA
E. LE BLANCHE[1], V. GUIHENEUF[2], M. BOURGEOIS[1], L. GUIHENEUC[1]
The 13th SoFRa reunion (French Society of Radiopharmacy) – Saint-Malo – 3-5 June 2024
The increase in requests for luteinized therapy has led to questions about the most appropriate injection system. Lemer Pax offers a new system: the Theranojet®ARA.
At their request, we were able to test their second (V2) and third (V3) versions over several months, and compare them technically (ergonomics, radiation protection and performance) with a system developed in-house using a Plum 360TM pump.
The aim was to see whether or not the Lemer Pax device improved ergonomics, radiation protection or performance.
METHOD:
- RADIATION PROTECTION COMPARISON:
Workstation studies carried out by a Radiation Protection Advisor (RPA) using an APVL ‘AT 1123’ survey meter on 3 luteinised injections of 7,400 MBq (1/system).
The external exposure balance was calculated based on 161 annual luteinised therapy procedures, spread over 3 manipulators.
- PERFORMANCE COMPARISON:
Recording of residual activity in post-injection vials with each injection system over more than one year of Lu-PSMA injection (n=104) at 7,400 MBq.
RESULTS:
- RADIATION PROTECTION COMPARISON:
| Homemade system | Theranojet® V2 | Theranojet® V3 | |
|---|---|---|---|
| Effective whole body dose (μSv/year) (H*(10)) | 35 | 38.1 | 33.8 |
| Extremity equivalent dose (μSv/year) (H*(0.07)) | 563.5 | 228.1 | 226 |
COMMENT: the effective whole-body doses are similar, since it is the injected patient who essentially exposes our handlers.
- PERFORMANCE COMPARISON:
| Homemade system | Theranojet® V2 | Theranojet® V3 | |
|---|---|---|---|
Activity lost in the vial (MBq) (+/- ICα=5%) | 56.28 (+/- 7.35) n = 39 | 40.23 (+/- 5.42) n = 54 | 26.17 (+/- 4.7) n = 11 |
COMMENT: Inverting the Theranojet® vial allows the entire volume to be injected, whereas the homemade system depends on the orientation of the needle in the bottle.
DISCUSIÓN – CONCLUSIÓN:
It should be noted that the radiation protection assessments concerning the in-house system were carried out in the presence of a lead screen. The alpha therapies were also tested with the Theranojet® system, which proved to be entirely suitable.
In conclusion, we observed an improvement in extremity dosimetry for staff and an increase in the quantity administered to the patient, with less loss in the injection system when using the various Theranojet® devices. This type of device makes it possible to consider increasing therapy activity with confidence. A project to purchase it from the Nantes University Hospital is underway.
Click here to access the digital version of the poster (in French)
Click here to find out more about the new Theranojet®ARA shield for injecting theranostics
[1] Radiopharmacy, Nantes University Hospital, France
[2] Radiation protection, Nantes University Hospital, France
France
