Technical note: Investigating the suitability of existing facilities for a new Lu-177 prostate-specific membrane antigen therapy program.

BACKGROUND: 177 Lu prostate-specific membrane antigen (PSMA) therapy prolongs survival for some prostate cancer patients. To adopt this technique, institutions may need to evaluate the suitability of existing infrastructure. PURPOSE: Develop a methodology to determine whether existing facilities can accommodate a 177 Lu-PSMA therapy program. METHODS: Room suitability is defined by both the ability to accommodate 177 Lu-PSMA therapy workflow and to provide appropriate radiation shielding. Two methods of shielding calculation were performed: (1) National Council on Radiation Protection and Measurements report 151 (NCRP-151), with workload defined in terms of the activity of 177 Lu administered, and (2) using the RadPro shielding calculator. This methodology was applied to 131 I therapy, PET-CT uptake, PET-SPECT injection, and orthovoltage therapy rooms. RESULTS: 131 I therapy rooms were found to meet both shielding and workflow requirements. The shielding was found to be adequate for orthovoltage and PET-SPECT facilities, neglecting patient transit between external washrooms. The workflow was the limiting factor for these rooms due to the requirement of dedicated washrooms that shield the patient and contain possible contamination. The PET-CT facility did not meet either criteria. The NCRP-151 method generally predicted a higher dose rate on the other side of shielding than did the RadPro calculator. The dose rate on the other side of concrete shielding as predicted by the NCRP-151 method increased relative to the dose rate predicted by the RadPro calculator as shielding thickness increased. For lead shielding, the dose rate predicted by the NCRP-151 method decreased relative to the result predicted by the RadPro calculator with increasing material thickness. CONCLUSIONS: 131 I therapy, PET-CT uptake, PET-SPECT injection, and orthovoltage therapy rooms were considered. The 131 I treatment rooms were the best candidate for 177 Lu-PSMA therapy, due to their shielding and capability to accommodate the necessary workflow.

Tomographic reconstruction of a spatially-extended source from the perimeter of a restricted-access zone using a SCoTSS compton gamma imager.

It is a standard procedure in many countries that response to a nuclear or radiological accident or incident would involve mobile aerial- or ground-based survey with highly sensitive gamma-ray detectors to map the distribution of radioactivity. There may however arise situations in which ground- or air-based detectors are not able to access an area to survey for radioactive materials, therefore technologies and techniques that can estimate the position and activity of radioactive materials from a distance are under development. Tomographic reconstruction methods, well-known in medical physics, permit the reconstruction of an N-dimensional map or image, from a number of N-1-dimensional cross-sectional images, or back-projections. We are investigating a tomographic reconstruction method to reconstruct the radioactivity distribution within a restricted-access zone using measurements from a Compton gamma imager placed at several locations around the perimeter of the zone. In this work an extended source of La-140 with an activity of 35 GBq was deposited within a 500 m by 500 m zone that was surveyed from the perimeter at six locations using a Silicon photomultiplier-based Compton Telescope for Safety and Security (SCoTSS) gamma imager. The reconstructed Compton images from multiple viewpoints were then projected back into the zone to reconstruct the distribution of La-140 within it. This tomographic method reconstructed high intensity along the known location of the La-140 source, suggesting that the method is able to localize the radioactive material. A simple fit to measured counts using a point-source approximation of the source distribution yielded a strength estimate of (7 ± 2) GBq at time of deposition, a reasonable result given the presence of soil and snow attenuation. Our method provides an expedient estimate of the distribution of radioactivity using tomographic techniques. It may be used to inform decisions made on the scene in urgent situations where the distribution of radioactivity must be reconstructed from a distance.