Radiation protection considerations with [89Zr]Zr-girentuximab PET and surgery
EJNMMI Res. 2025-05-23; 15(1):
DOI: 10.1186/s13550-025-01247-1
Lire sur PubMed
https://www.bordeaux-neurocampus.fr/11688
Chowdhury A(1), Morgat C(2)(3), Bailly C(4)(5), Sunderland J(6), Graves SA(6), Scott AM(7)(8), Baker S(1), Holman BF(9).
Author information:
(1)Royal Free London NHS Foundation Trust, London, UK.
(2)INCIA UMR 5287, University of Bordeaux, 33400, Talence, France.
(3)Department of Nuclear Medicine, University Hospital of Bordeaux, 33076,
Bordeaux, France.
(4)Nantes Université, Inserm, CNRS, Université d’Angers, CRCI2NA, Nantes,
France.
(5)Department of Nuclear Medicine, University Hospital, Nantes, France.
(6)Department of Radiology, University of Iowa, Iowa City, IA, USA.
(7)Department of Molecular Imaging and Therapy, Austin Health and Faculty of
Medicine, University of Melbourne, Melbourne, Australia.
(8)Olivia Newton-John Cancer Research Institute and School of Cancer Medicine,
La Trobe University, Melbourne, Australia.
(9)Royal Free London NHS Foundation Trust, London, UK. .
BACKGROUND: 89Zr is emerging as a popular positron-emitting radionuclide for
imaging; however, its 909 keV gamma emission presents shielding challenges, and
radiation exposure safety guidelines for healthcare professionals working with
the radionuclide have not been well-established. To guide assessment of the
radiation risk and necessary safety guidelines, we present laboratory dose rate
measurements of 89Zr syringes and vials, and dose rates measurements made during
the ZIRCON clinical trial ([89Zr]Zr-girentuximab) to evaluate healthcare
provider exposure during administration, imaging, and surgical procedures.
RESULTS: The maximum dose rate from a vial with no shielding was 0.334
µSv/h/MBq, and the minimum dose rate with 66 mm lead shielding was 0.004
µSv/h/MBq. The controlled spill measured 0.52 µSv/h/MBq. Dose rates 1 m from
patients who received [89Zr]Zr-girentuximab had an average of 3.90 µSv/h at
imaging. During surgery, waste measured below background levels, and a bed
assistant 0.8 m from the patient received a 5 µSv/h whole-body dose rate. The
excised kidney measured 6 µSv/h at 5 cm.
CONCLUSIONS: Our results demonstrate low radiation exposure levels associated
with 89Zr handling and exposure to the patient. With potential integration of
89Zr into clinical practice, appropriate radiation safety guidelines are needed.
Dose rate measurements can help guide development of best practices and
site-specific protocols.
CLINICAL TRIAL NUMBER: not applicable for this study; ZIRCON trial number
NCT03849118, registered on 19 February 2019.
© 2025. The Author(s).
DOI: 10.1186/s13550-025-01247-1
PMCID: PMC12102418
PMID: 40408016
Conflict of interest statement: Declarations. Ethics approval and consent to
participate: The conduct of the ZIRCON clinical trial met all local, legal, and
regulatory requirements. The trial was conducted in accordance with ethical
principles originating in the Declaration of Helsinki and the International
Conference on Harmonization (ICH) guideline E6: Good Clinical Practice (GCP).
Patients provided written informed consent. Consent for publication: Not
applicable. Competing interests: C.M. received funding from Telix
Pharmaceuticals but outside the scope of this study. C.B. has served on an
advisory board for Telix Pharmaceuticals. A.M.S. has received funding from Telix
Pharmaceuticals for research projects and clinical trials (to Institution), was
a site Investigator of the ZIRCON study, and has served on advisory boards for
Telix Pharmaceuticals (non-compensated).