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RLT Institute
A 3-part illustration depicting a radioactivity measurement device and radioactive-labeled package, a patient receiving radioligand therapy, and a male health care professional disposing of waste in a radioactivelabeled waste bin.

Providing and administering RLT

This section of the Novartis RLT Institute is designed to help health care professionals (HCPs) understand radiation safety procedures for providing and administering radioligand therapies (RLTs) manufactured by Novartis. It is based on guidelines from regulatory agencies, including the Nuclear Regulatory Commission (NRC), the Department of Transportation (DOT), and the United States Pharmacopeia (USP). Topics include safe transport, administration, and postadministration protocols to prepare the patient and room for subsequent use.

Administration precautions

Radiation safety guidelines for preparing and administering RLTs enable HCPs to minimize exposure to themselves and others while maintaining compliance with approved protocols, licenses, and NRC guidelines.1

ALARA principle

The guiding principle of radiation safety, ALARA (as low as reasonably achievable), aims to minimize radiation exposure for both staff and patients. While the application differs between these groups, the same 3 protective principles apply to ensure safety.1

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Time

The duration spent near the radiation source

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Distance

Space between you and the radiation source

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Shielding

Physical barriers that reduce exposure to radiation

PPE and minimization of radiation exposure

Aseptic technique, appropriate protective equipment, and radiation shielding should be used when handling or administering RLT, adhering to the ALARA principle.1-3

General safety instructions1,4-6

When working with RLTs, it is essential to adhere to safety protocols to ensure the protection of HCPs, patients, and the environment from unnecessary radiation exposure.

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Authorized user(s)

RLTs should be administered only by or under the supervision of AUs

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Lab coat and gloves

Wear a lab coat and waterproof gloves, replacing them as necessary, eg, if contaminated

An illustration of safety goggles.

Safety glasses

Wear safety glasses to protect against accidental splashes or spills

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Personal dosimeters

Wear personal dosimeters to monitor radiation exposure and utilize effective shielding

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Time

Minimize handling time and work efficiently to reduce exposure

An illustration of forceps holding a radioactive-labeled vial.

Tongs

Use tongs or tools as needed to maximize distance and thus minimize radiation exposure

An illustration of a dose calibrator.

Radiation detection

Utilize radiation detection equipment to survey for contamination during RAM dose handling and before leaving the laboratory to minimize contamination spread

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Disposable liners

Use disposable absorbent liners in working areas, including treatment rooms and the floor path leading to restrooms, to facilitate cleanup and mitigate risks from spills and fluid accidents

An illustration of radiation spill prevention and cleaning materials.

Spill response

Train staff on immediate spill response, including the use of spill kits designed for radioactive materials and adherence to radiation safety protocols for effective contamination management

Safe handling
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References: 1. Calais J, Eulau SM, Gardner L, et al. Cancer Treat Rev. 2023;115:102524. doi:10.1016/j.ctrv.2023.102524 2. Pluvicto. Prescribing information. Novartis Pharmaceuticals Corp. 3. Lutathera. Prescribing information. Novartis Pharmaceuticals Corp. 4. Baldwin JA, Bag AK, White SL, et al AJR Am J Roentgenol. 2015;205(2):251-258. doi:10.2214/AJR.14.13283 5. American College of Radiology (ACR). ACR–ACNM–ASTRO–SNMMI Practice Parameter for Lutetium-177 (Lu-177) Dotatate Therapy. Issued 2020; Accessed January 3, 2025. 6. Data on file. Expert Working Group Experience. Novartis Pharmaceuticals Corp; 2025.