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Background: The radiation exposure of nuclear medicine personnel, especially concerning extremity doses, has been a significant focus over the past two decades. This study addresses the evolving practice of NM, particularly with the rise of radionuclide therapy and theranostic procedures, which involve a variety of radionuclides such as 68Ga, 177Lu, and 131I. Traditional studies have concentrated on common radioisotopes like 99mTc, 18F, and 90Y, but there is limited data on these radionuclides, which are more and more frequently used. This study, part of the European SINFONIA project, aims to fill this gap by providing new dosimetry data through a multicenter approach. The research monitors extremity doses to hands, eye lens doses, and whole-body doses in nuclear medicine staff handling 68Ga, 177Lu, and 131I. It examines the type of activities performed and the protective measures used. The study extrapolates measured doses to annual doses, comparing them with annual dose limits, and assesses the contribution of these specific procedures to the overall occupational dose of nuclear medicine personnel. Results: Measurements were conducted from November 2020 to August 2023 across nine hospitals. The highest whole-body, eye lens and extremity doses were observed for 68Ga. Average maximum extremity doses, normalized per manipulated activity, were found of 6200 µSv/GBq, 30 µSv/GBq and 260 µSV/GBq for 68Ga, 177Lu and 131I, respectively. Average whole-body doses stayed below 60 µSv/GBq for all 3 isotopes and below 200 µSv/GBq for the eye lens dose. The variation in doses also depends on the task performed. For 68Ga there is a risk of reaching the annual dose limit for skin dose during synthesis and dispensing. Conclusions: This study's measurement campaigns across various European countries have provided new and extensive occupational dosimetry data for nuclear medicine staff handling 68Ga, 177Lu and 131I radiopharmaceuticals. The results indicate that 68Ga contributes significantly to the global occupational dose, despite its relatively low usage compared to other isotopes. Staff working in radiopharmacy hot labs, labeling and dispensing 177Lu contribute less to the finger dose compared to other isotopes. [ABSTRACT FROM AUTHOR]

Dosimetry can be a useful tool for personalization of molecular radiotherapy (MRT) procedures, enabling the continuous development of theranostic concepts. However, the additional resource requirements are often seen as a barrier to implementation. This guide discusses the requirements for dosimetry and demonstrates how a dosimetry regimen can be tailored to the available facilities of a centre. The aim is to help centres wishing to initiate a dosimetry service but may not have the experience or resources of some of the more established therapy and dosimetry centres. The multidisciplinary approach and different personnel requirements are discussed and key equipment reviewed example protocols demonstrating these factors are given in the supplementary material for the main therapies carried out in nuclear medicine, including [ 131 I]-NaI for benign thyroid disorders, [ 177 Lu]-DOTATATE and 131 I-mIBG for neuroendocrine tumours and [ 90 Y]-microspheres for unresectable hepatic carcinoma., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)