Author: Ramesh Boggula, Jay W. Burmeister 👨🔬
Affiliation: Wayne State University, Karmanos Cancer Center, Gershenson ROC, Wayne State University School of Medicine 🌍
Purpose: This study evaluated the performance of a hybrid Compton camera for real-time imaging during the administration of Lu-177-based radiopharmaceuticals, including Pluvicto and Lutathera. The aim was to dynamically monitor the distribution of radioactive material from the syringe into the patient’s body and assess the potential for extravasation at the injection site.
Methods: The hybrid Compton camera (RAVIN, M3D Inc.) uses a cadmium zinc telluride detector with 1.1% energy resolution at 662 keV and a spectroscopy range of 30–662 keV. It provides a 90° × 90° radiation field of view with full 4π coverage and a 90° × 65° optical field of view for live images. During administration, the camera captured real-time gamma-ray activity to monitor radiopharmaceutical distribution as a function of time, which was displayed on a live patient image.
Results: The hybrid Compton camera captured real-time, time-lapse images of the distribution of Lu-177 radiopharmaceutical. This allowed real-time assessment of the transfer of the radioactive drug from the syringe through the injection site into the patient’s body, allowing the potential for immediate recognition of extravasation at the injection site. Subsequent imaging allowed confirmation of a uniform distribution of the radiopharmaceutical throughout the patient’s body. Energy spectrum analysis accurately identified the characteristic peaks of Lu-177. Ionization chamber survey meter (Fluka 451P) measurements are routinely made at multiple locations on the patient after delivery to confirm appropriate distribution and exclude the possibility of extravasation. This novel device allows the potential for immediate recognition of extravasation at the injection site during administration.
Conclusion: This study establishes the hybrid Compton camera as an effective tool for real-time imaging of Lu-177 administration, allowing evaluation of successful administration and subsequent drug distribution. The results highlight the potential of this technology to improve safety and dosimetry during radiopharmaceutical therapies.