Technologist Checklist for 177Lu-DOTATATE Preparation

Tech initialsStep
Protect cart with chux pads
Hang 250-mL saline bag; prime tubing with saline
Connect tubing to 3-way stopcock; prime 3-way stopcock with saline
Prime microbore tubing with saline; connect microbore tubing to 3-way stopcock
Load tubing into Graseby pump
Set rate on Graseby pump (50 mL/h); clear volume; change dose calibrator setting, sleeve, and plunger to those for 177Lu
Label syringe with patient’s name, date of birth, medical record number, drug, dose, and date
Assay vial (place gauze in bottom of pig while vial is still in dose calibrator), and record result and time; if less than 6.66 GBq or 180 mCi (7.4 GBq or 200 mCi − 10%), contact nuclear medicine physician before proceeding
Draw entire dose from vial into 30-mL syringe
Vent dose vial by attaching 20-gauge needle to 1-mL syringe (plunger removed) and inserting at tilted angle just enough to puncture vial
Draw dose by attaching 3.5-in (8.9-cm) spinal needle to 30-mL shielded syringe, inserting into vial (tilted on wedge) until reaching its bottom, and slowly withdrawing entire volume; if withdrawal is difficult, slightly loosen thumbscrew of shield (2.5-in [6.3-cm] needle can be used but will not reach bottom)
Before removing syringe, use tongs to raise vial and assess whether entire volume has been withdrawn
Slowly pull syringe straight up and out of vial
Pull back plunger to ensure that no liquid remains in hub of needle
Discard spinal needle into sharps waste bucket; attach regular needle
Remove air from syringe
Assay residual activity in vial, and record result and time
Assay syringe dose, and record result and time (nuclear medicine physician to confirm)
Connect syringe dose to 3-way stopcock and load into Graseby pump
After infusion, assay residual activity in syringe and needle