Personalized ۱۸FDG Dose Synthesis Using BG-۷۵ Generator: ۱st Year Experience at JCI Accredited Tertiary Care Hospital in Pakistan

Background: Compact cyclotrons are getting popular to fulfill enormous current demands of PET tracers. Aga Khan University Hospital, Karachi, Pakistan has acquired the first smallest footprint of BG-۷۵ Generator for ۱۸FDG-based PET/CT clinical imaging. We are sharing our experience of BG-۷۵ in the first year (December ۲۰۱۵-November ۲۰۱۶) after commissioning. Material and Methods: BG-۷۵ Generator (ABT, USA) was installed in available space without major design modification. It has a self-shielded mini-cyclotron (۷.۵ MeV proton beam, positive ion with current < ۵µA) to produce [۱۸F]F-, an automated card-based radiochemistry module to produce ۱۸FDG and automated QC module to perform tests upon each batch of ۱۸FDG. Data were collected for yields of [۱۸F]F-, ۱۸FDG, QC and radiation safety parameters. Results: Total ۵۴۵ runs in ۱۶۷ days (۳±۰۱ runs/day) were made. Average yield with ۶۰ minute bombardment using ۴.۵ µA current was ۳۷ mCi and ۲۱ mCi for [۱۸F]F- and ۱۸FDG, respectively. Total ۲۹ runs had chemistry or QC failures and were discarded. Remaining ۵۱۶ batches were used to perform imaging upon ۱۳۷۰ patients (۸±۰۳ patients/day). Radiation dose in BG-۷۵ suite and effective doses to ۰۲ operators were within statutory limits. Conclusion: BG-۷۵ Generator provides safe, dependable and sustainable supply of ۱۸F-Fluoride for ۱۸FDG and other low-volume clinical PET imaging. Its compactness and automation need minimal space and manpower. Radiation dose rate in cyclotron suite and personal dosimetry were also found within safe limits. Its Dose-on-Demand workflow offers a new concept of Personalized Dose Preparation which is currently not possible with a conventional cyclotron.

Keywords:

Cyclotron , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose ۱۸F