Usefulness of  Radiopharmaceuticals Auto   Injection System (RAIS) in the PET study Jeom jin Lim Seoul National University Hospital

Contents About PET study System Overview Usefulness Test Test Result 1 About PET study 2 System Overview 3 Usefulness Test 4 Test Result 5 Conclusion 6 Comment

The increase of PET equipment About PET The increase of PET equipment 2008 PET & PET/CT scanner : 130 Cyclotron : 23 1994 PET scanner : 2 Cyclotron : 3

The increase of PET Study About PET The increase of PET Study Insurance for PET Study (2006, June) No. of PET study 247,933 200,000 150,000 PET / CT 100,000 100,530 50,000 37,805 20,721 4,443 99 2,078 1994 1997 2000 2003 2004 2006 2008

The radiation exposure of PET study About PET The radiation exposure of PET study SNUH : Product : about 700mCi : No. of PET study : about 40 / day Dispense Product & Compound Injection Radiation Exposure should be reduced Examination

How to reduce the Radiation exposure? About PET How to reduce the Radiation exposure? Radiopharmaceuticals Auto Injection  System (RAIS) Examination Injection Dispense RAIS (Auto – Injector) can reduce the radiation exposure Product & compound

The overview of Auto - injector System Overview The overview of Auto - injector Auto - Injector Appearance Specifications Internal Unit Weight : 400kg Dimensions (cm) : H93 X W56 X D34 Max Radioactivity : 500mCi Injection Vol. range : 5~28mL Crude vial Dispense vial Dispense syringe Dose calibrator : semi-conductor Venting filter [UG – 05]

The accessory and flow Auto - Injector System Overview Crude vial container Dispense vial container Semiconductor dose calibrator Internal camera Disposal kit Auto - Injector

The operating procedure System Overview The operating procedure Dose setting Dose Measure Real Injection Cleansing Dispense Pre Injection Post Injection Cleansing the remain quantity Time : about 2min Injection Time : about 2~3 min Pre setting Time : about 5min Required Time : 10min / patient

The surface exposure rate at Auto-injector System Overview The surface exposure rate at Auto-injector Measure condition - Radioactivity : 350mCi - Distance : 10cm - Survey meter : ICS-323(ALOCA) Auto - injector Right side 1.7 uSv / hr Back side 3.4 uSv / hr Auto - injector FDG 350mCi Left side 1.7 uSv / hr Front side 2.7 uSv / hr

The advantage of Auto-injector System Overview The advantage of Auto-injector Patient Confidence Comfort Injection Room No need for communication Short movement line Efficiency of Work Cyclotron Use twice a day No need for dispense Reduce the radiation exposure

Usefulness test of Auto - injector Performance Evaluation - Dose Accuracy - Input, Measured and Output Dose Auto - injector Cleansing FDG Injection Preparation Radiation Exposure Evaluation - Radiation Exposure - Chest part, Hand part

Performance evaluation of Auto-injector Usefulness Test Performance evaluation of Auto-injector The kind of dose in Auto - injector FDG Injection Dose setting Cleansing Measured Dose - Measured - Dose in semiconductor dose calibrator Output Dose - Real injected dose - Measured - Dose in dose Calibrator Input Dose - Necessary Dose - Weight X 0.14

Performance evaluation of Auto-injector Usefulness Test Performance evaluation of Auto-injector The kind of dose in Auto - injector Input Dose Measured Dose Output Dose Input Dose : 3, 6, 9, 12, 15mCi Measured Dose : Semiconductor Dose Calibrator Output Dose : Dose Calibrator ( CRC-712M _ Capintec ) Case : 10 / unit % different

% different of Measured Dose (Ref. Input Dose) Test Result % different of Measured Dose (Ref. Input Dose) 5.8±1.4 % diff. 5 3.7 ± 3.4 4 3.0±2.2 2.8±2.5 3 1.5±3.6 12 2 1 3mCi 6mCi 9mCi 12mCi 15mCi

% different of Output Dose (Ref. Input Dose) Test Result % different of Output Dose (Ref. Input Dose) 5.1±2.7 % diff. 5 3.3±2.2 3.3±2.3 3.3±2.0 4 3 1.5±2.9 12 2 1 3mCi 6mCi 9mCi 12mCi 15mCi

% difference ( Measured Dose : Output Dose ) Test Result % difference ( Measured Dose : Output Dose ) % diff. 5 4 2.5±3.0 3 2 0.8±1.6 0.5±1.5 0.3±1.7 1 0.0±1.9 3mCi 6mCi 9mCi 12mCi 15mCi

Radiopharmaceutical Injection Usefulness Test Radiation exposure evaluation of Auto-injector Radiopharmaceutical Injection Manual Injection Use a auto - injector Case : 30 patients Chest and hand Average Dose : 8.5 mCi 65mm portable lead shield Pocket Dosimeter : MYDOSE Alarm (ALOKA)

Radiation Exposure (uSv/hr/patient) Test Result Result data Radiation Exposure (uSv/hr/patient) 9.2 ± 3.1 10 8 Manual Injection 6 4 0.6 ± 3.1 Use a Auto-injector 2 0.5 ± 3.1 0.5 ± 0.1 Chest Part Hand Part

Test Result Performance Evaluation Radiation Exposure Evaluation Input Dose VS Measured Dose = 3.16 ± 3.01 [ % diff. ] Input Dose VS Output Dose = 3.16 ± 3.02 [ % diff. ] Measured Dose VS Output Dose = 0.63 ± 2.22 [ % diff. ] Radiation Exposure Evaluation Manual Injection at Chest = 0.5 ± 0.1 [ uSv/hr ] Used Auto-injector at Chest = 0.6 ± 3.1 [ uSv/hr ] Manual injection at hand = 9.2 ± 3.1 [ uSv/hr ] Used Auto-injector at Hand = 0.5 ± 0.1 [ uSv/hr ]

Conclusion Measured dose and output dose in comparison to input dose showed slight differences. There was no significant differences between measured dose and output dose. In the chest part, Radiation exposure dose was slightly increased due to increased injection time. In hand part, Radiation exposure was substantially decreased. If we use the auto-injector being shielded as much as possible, radiation exposure will be reduced even though the number of PET studies is getting increased.

Comment The demerits about Auto-injector The merit about Auto-injector Insufficient program Long injection time Work efficiency Radiation Protection Higher prices confidence of Patient convenience The merit about Auto-injector

Thank You for your attention !! Seoul National University Hospital