It's PET but not as we know it: radiation protection considerations when using a novel specimen PET-CT scanner during tumour resections for urology and head & neck patients.

Authors

L M Rowley, C Pickles, K Hodgson, S E Kallioinen, D MacDonald, G Walton, O Adesanya

Published in

EJNMMI physics. Jun 27, 2026. Epub Jun 27, 2026.

Abstract

To evaluate the radiation protection requirements for a UK first specimen PET-CT scanner, the AURA10 (Xeos, Ghent), as assessed through a clinical trial investigating its use for intra-operative surgical margin assessment in urology and head and neck (H&N) tumour removal.
A radiation risk assessment was performed to inform radiation protection requirements and training. 0.8 MBq/kg of ¹⁸Fluorine fluorodeoxyglucose and 50 MBq of ⁶⁸Gallium prostate-specific membrane antigen were administered for H&N and urology cases respectively. Whole body optically stimulated luminescence dosimeters, finger and eye ThermoLuminescent dosimeters and electronic personal dosimeters were issued to staff in theatres, recovery, and histopathology. Dose rate measurements were recorded at the position of staff members in theatres. Measured counts and dose rate from the resected specimen and swabs were obtained and contamination monitoring of the room were performed following removal of the patient.
Training sessions and dry runs with surgical staff helped identify radiation risks and optimise workflow. Occupational doses from surgeons and scrub nurses were the highest for both modalities. Doses to other theatre staff were below dose limits for members of the public in the UK. Doses to staff outside theatres, including recovery and histopathology, were found to be below threshold values. Low level contamination was present in swabs (< 6 kBq and < 250 kBq for H&N and urology cases respectively).
Thorough staff training, systems of work and shielding are required to ensure radiation doses to staff are minimised and contamination and radioactive waste are contained. There were difficult occasions during shift changes and untrained staff rota-ed in, but nuclear medicine supervision and then the introduction of theatre-based cascade trainers helped solidify learning and provide assurance to theatre staff and staff showed good compliance with the systems of work in place. Annual doses to theatre staff are heavily dependent on workload, with surgeons and scrub nurses closest to the patient receiving whole body doses of 39 µSv and 12 µSv, and finger doses of 88 µSv and 48 µSv respectively per case for H&N. Corresponding urology doses per case were measured as 7.2 µSv and 2.5 µSv for whole body and 16 µSv and below threshold values for the assisting surgeon and scrub nurse respectively.
www.
gov. URL trail registry record: Study Details | NCT06676943 | Investigating the Diagnostic Performance of High-resolution Specimen PET-CT in Determining Margin Status in Cancer Resection | ClinicalTrials.gov.

PMID:
42371266
Bibliographic data and abstract were imported from PubMed on 29 Jun 2026.

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