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      Data reconciliation connected to guard bands to set specification limits related to risk assessment for radiopharmaceutical activity

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          Abstract

          Radiopharmaceuticals have been used to diagnose several diseases, particularly because the procedure is non-invasive. However, it is important that the correct amount of radiopharmaceutical is used to avoid inaccurate diagnostic results and suboptimal therapeutic outcomes. The amount of the radiopharmaceutical is measured when produced (by the supplier) and a second time (by the receiver), before it's use. When measured at the receiver, the result is corrected for its normal radioactivity decay. Even then, it is possible that both measurements should be considered nominal different or even statistically different when compared through various statistical tools. This research combines two innovative techniques in the field of clinical metrology. The first technique is data reconciliation, which not only enhances measurement accuracy but also reduces measurement uncertainty. The second technique involves using uncertainty information to establish specification limits for compliance assessments. In this way, our proposal aimed to minimize the risk of making incorrect decisions regarding the conformity of the concentration of radiopharmaceutical activity, that is, rejecting an item or batch that is within specification or accepting an item or batch that is outside of specification. A spreadsheet, based on these metrology fundamentals, is available to help the user with the calculations, presenting numerical and graphical results for some common radioisotopes. Reliable specification limits can be calculated and used to determine if the radiopharmaceutical is in accordance with its proposed application.

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          Most cited references71

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          Radiopharmaceutical therapy in cancer: clinical advances and challenges

          Radiopharmaceutical therapy (RPT) is emerging as a safe and effective targeted approach to treating many types of cancer. In RPT, radiation is systemically or locally delivered using pharmaceuticals that either bind preferentially to cancer cells or accumulate by physiological mechanisms. Almost all radionuclides used in RPT emit photons that can be imaged, enabling non-invasive visualization of the biodistribution of the therapeutic agent. Compared with almost all other systemic cancer treatment options, RPT has shown efficacy with minimal toxicity. With the recent FDA approval of several RPT agents, the remarkable potential of this treatment is now being recognized. This Review covers the fundamental properties, clinical development and associated challenges of RPT.
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            Correlation of dose with toxicity and tumour response to 90Y- and 177Lu-PRRT provides the basis for optimization through individualized treatment planning.

            Peptide receptor radionuclide therapy (PRRT) with 90Y-labelled and 177Lu-labelled peptides is an effective strategy for the treatment of metastatic/nonresectable neuroendocrine tumours (NETs). Dosimetry provides important information useful for optimizing PRRT with individualized regimens to reduce toxicity and increase tumour responses. However, this strategy is not applied in routine clinical practice, despite the fact that several dosimetric studies have demonstrated significant dose-effect correlations for normal organ toxicity and tumour response that can better guide therapy planning. The present study reviews the key relationships and the radiobiological models available in the literature with the aim of providing evidence that optimization of PRRT is feasible through the implementation of dosimetry.
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              Guidance on current good radiopharmacy practice (cGRPP) for the small-scale preparation of radiopharmaceuticals

              This guidance is meant as a guidance to Part B of the EANM “Guidelines on Good Radiopharmacy Practice (GRPP)” issued by the Radiopharmacy Committee of the EANM (see www.eanm.org), covering the small-scale “in house” preparation of radiopharmaceuticals which are not kit procedures. The aim is to provide more detailed and practice-oriented guidance to those who are involved in the small-scale preparation of, for example, PET, therapeutic or other radiopharmaceuticals which are not intended for commercial purposes or distribution.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                28 November 2023
                December 2023
                28 November 2023
                : 9
                : 12
                : e22992
                Affiliations
                [a ]Radiopharmacy, Américas Medical City, Av. Jorge Curi 550, 22775-001, Rio de Janeiro, Brazil
                [b ]Argonauta Reactor Service, Nuclear Engineering Institute, R. Hélio de Almeida 75, 21941-614, Rio de Janeiro, Brazil
                [c ]Earth and Environmental Physics Department, Physics Institute, Federal University of Bahia, Campus Universitário de Ondina, 40210-340, Salvador, Brazil
                [d ]Postgraduate Program in Geochemistry, Petroleum and Environment (POSPETRO), Federal University of Bahia, Av. Milton Santos s/n°, Salvador, 40170-110, Brazil
                [e ]Federal University of Rio de Janeiro, Chemistry Institute, Avenida Athos da Silveira Ramos 149, 21941-909, Rio de Janeiro, Brazil
                [f ]National Institute of Technology, Av. Venezuela 82 20081-312, Rio de Janeiro, Brazil
                [g ]National Institute of Metrology, Quality and Technology (INMETRO), Av. Nossa Senhora das Graças 50, 25250-020, Duque de Caxias, Brazil
                [h ]Postgraduate Programme in Metrology, Pontifical Catholic University of Rio de Janeiro, R. Marquês de São Vicente 225, 22451-900, Rio de Janeiro, Brazil
                [i ]Logistics, Operational Planning and Control, Measurement and Product Inventory Management, PETROBRAS S.A., Av. Henrique Valadares 28, 20231-030, Rio de Janeiro, Brazil
                Author notes
                []Corresponding author. Postgraduate Programme in Metrology, Pontifical Catholic University of Rio de Janeiro, R. Marquês de São Vicente 225, 22451-900, Rio de Janeiro, Brazil. elciooliveira@ 123456puc-rio.br
                Article
                S2405-8440(23)10200-3 e22992
                10.1016/j.heliyon.2023.e22992
                10731080
                38125475
                48a162d3-021a-42b0-b05d-5189a97a6146
                © 2023 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 9 August 2023
                : 22 November 2023
                : 23 November 2023
                Categories
                Research Article

                clinical metrology,consumer risk,decision limits,measurement uncertainty,pharmaceuticals,quality control

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