Staff Roles, Responsibilities, and Required Training

Staff memberRole or responsibilityRequired training
Medical oncology memberCommunicates with nuclear medicine team on eligible patientsWorkflow training
Enters orders in electronic health record for 177Lu-DOTATATE procedure and required medicationsEligibility training
Evaluates patients within week before each 177Lu-DOTATATE treatment and monitors for adverse events afterward
PharmacistProvides antiemetics, amino acids, and posttreatment long-acting somatostatin analog on treatment dayWorkflow training
Radiation safety officerProvides 177Lu radiation safety training to nuclear medicine staffWorkflow training
Prepares treatment room and restroom with contamination control measures; provides radiologic survey support as needed
Collects residual or unused doses and associated contaminated materials and manages inventory of those items for ultimate disposal
Reviews each record of therapeutic administration
Develops and maintains basis for release of patients after treatment
Nuclear medicine nurseChecks electronic medical record on day before treatment to ensure medication orders have been entered correctly and sends them to pharmacy on treatment dayWorkflow and radiation safety, including patient care and waste disposal
Places intravenous catheter in patient (can also be done by nuclear medicine technologist)Medication management and Alaris pump
Administers antiemetics, amino acids, and long-acting somatostatin analog
Monitors for adverse events during amino acid infusion, checks blood pressure and pulse just before and after 177Lu-DOTATATE infusion, and ensures that patient voids before and hourly after infusion
Nuclear medicine physicianGets informed consent from patients and reviews radiation safety instructions with patientWorkflow and radiation safety
Assays 177Lu-DOTATATE dose in dose calibrator, assesses intravenous line patency, performs time-out before infusion, and gives infusionGraseby pump
Assesses status and discharges patient from nuclear medicine department
Nuclear medicine technologistOrders, receives, inspects, and prepares 177Lu-DOTATATE dose for administration; prepares patient for treatment (can also be done by nurse)Workflow and radiation safety, including dose preparation and waste disposal
Surveys restroom floor and path to treatment area with Geiger counter; contacts radiation safety officer and restricts access to contaminated areas if foundGraseby pump and 177Lu-DOTATATE dose preparation
Prints patient dose administration card; measures exposure 1 m from patient, and confirms that level is below that established by radiation safety officer once all administrations are complete