Comparison of Three Therapeutic Radiopharmaceutical Infusion Methods for Single and Multivial Applications

Abstract

A consistent and reliable intravenous infusion technique is critical for the safe and effective administration of therapeutic radiophar-maceuticals (TRPs) in clinical settings. This article aims to outline the benefits and limitations of the 3 industry-recognized TRP infusion methods: the syringe pump, gravity method, and peristaltic pump. Each infusion method was evaluated in the context of both Food and Drug Administration (FDA)–approved and investiga-tional TRP administrations. Methods: The infusion methods were evaluated on the basis of the following criteria: safety of the TRP infusion; adherence to the As Low As Reasonably Achievable (ALARA) principle; ease of identifying the start and end of a contin-uous TRP infusion. The proposed intravenous infusion criteria can be applied to the FDA-approved or investigational TRP infusions. The 3 intravenous infusion methods, syringe pump, gravity method, and peristaltic pump, were evaluated at a single institu-tion. The syringe pump was used and evaluated for 55 TRP intravenous infusions. The gravity method included extensive prepatient testing, but because of multiple issues and infusion uncertainties, this method was not used for TRP infusions. The peristaltic pump was used and evaluated for over 1,585 TRP intravenous single-vial infusions and 30 TRP dual-vial infusions. Results: On the basis of the infusion criteria compliance, ease of use, and reliability, the syringe pump and the peristaltic pump were successfully used for FDA-approved and investigational TRP intravenous infusions. Conclusion: As more intravenous TRPs are approved by the FDA and explored in investigational clinical trials, it is crucial to understand the benefits and limitations of each infusion method. The optimal infusion method should be selected on the basis of patient safety, reliability, and clinical application.