The present disclosure relates generally to nuclear medicine and specifically concerns 82Sr/82Rb elution systems.
The subject matter disclosed herein relate to radiopharmaceutical substances with short half-life, such as Rubidium (82Rb). Rubidium (82Rb) is used as a positron emission tomography (PET) tracer for non-invasive determination of myocardial perfusion (blood flow).
Typical 82Sr/82Rb elution systems comprise a reservoir of sterile saline solution (e.g., 0.9% Sodium Chloride Injection), one or more pumps to pump the sterile saline solution from reservoir, a source for generating radioactive isotopes in solution, a radioactivity detector to measure activity of different isotopes, a dose calibrator, a waste container, set of infusion tubing assembly, one or more sensors, a computer, and shielded enclosures on a platform meant to move the elution system. During operation of such systems, the pump moves the saline solution from the reservoir and through the generator to elute the 82Rb which is eluted in the form of 82RbCl and also to regulate the flow of sterile saline solution to the bypass line. The radioactive solution which exits the generator is then infused to a patient to be diagnosed via a patient outlet. As known among those skilled in the art, 82Rb is generated by radioactive decay of the 82Sr, and thus the rate of production of 82Rb at any given time, is a function of the activity of 82Sr remaining in the generator. The rate of 82Rb production exponentially decreases through the useful life of the generator, directly in correlation with the half-life of 82Sr.
The various shielded and non-shielded components in the elution system play a role in providing a desired dose, and ensuring a safe and an easy to clean environment. All known 82Sr/82Rb generator systems like Cardiogen-82® and RUBY-FILL® have a waste container that is on top of their respective structures, and at a higher elevation relative to the generator and/or the pump. The present inventors have identified alternate configurations of elution system that offer several advantages.
An object of the present disclosure is to provide new configurations of a rubidium elution system wherein the waste container is located in a lower section of an assembly that contains the various components of the system, such as at a lower elevation than the pump, at the same elevation than the generator, or at an elevation where the top surface of the compartment housing the waste container is lower than the elevation of the top surface of the compartment housing the generator. Another object of the disclosure is to provide safety means that are adapted to these new configurations of a rubidium elution system.
Another object of the present disclosure is to provide a method for manufacturing said new configurations of rubidium elution system.
The present disclosure concerns any of the following items:
Item 1. A rubidium elution system comprising an assembly that includes a 82Sr/82Rb generator, an activity detector, a waste container, a pump, a sensor, a tubing circuit, and at least one valve; wherein:
Item 2. The rubidium elution system of item 1, wherein the lower section consists of the lower two third of the assembly.
Item 3. The rubidium elution system of item 2, wherein the lower section consists of the lower half of the assembly.
Item 4. The rubidium elution system of any one of item 1, 2 or 3, wherein:
Item 5. The rubidium elution system of any one of items 1, 2 or 3, wherein:
Item 6. The rubidium elution system of any one of items 1 to 5, wherein the waste container is at an elevation that is lower than the pump.
Item 7. The rubidium elution system of item 4 or 5, wherein the waste container is housed within an enclosure that may be removed from the waste compartment.
Item 8. The rubidium elution system of item 4 or 5, wherein the waste compartment includes a door for accessing the waste container.
Item 9. The rubidium elution system of item 4 or 5, including a sliding mechanism or a lifting mechanism for removing the waste container from the waste compartment.
Item 10. The rubidium elution system of any one of items 1 to 9, wherein the assembly further comprises a dose calibrator that is configured to detect at least one radioisotope.
Item 11. The rubidium elution system of item 10, further comprising locking means for preventing a user of the system from changing a configuration of the dose calibrator.
Item 12. The rubidium elution system of item 11, further comprising an interface for configuring the dose calibrator, and wherein the locking means prevents the user from changing a configuration of the dose calibrator by locking the interface.
Item 13. The rubidium elution system of item 12, wherein the locking means comprises a compartment that encloses the interface, and the compartment is locked in order to prevent the user from accessing the interface.
Item 14. The rubidium elution system of any one of items 1 to 13, wherein the assembly further comprises a computer.
Item 15. The rubidium elution system of any one of items 1 to 14, wherein the assembly is positioned on a platform.
Item 16. The rubidium elution system of item 15, wherein the platform is mobile.
Item 17. The rubidium elution system of item 16, wherein the platform has wheels and a mechanism for braking and locking the wheels.
Item 18. The rubidium elution system of any one of items 1, 2 or 3, wherein the 82Sr/82Rb generator and the waste container are each enclosed in respective shielded compartments.
Item 19. The rubidium elution system of any one of items 4 or 5, wherein the waste compartment and the generator compartment are shielded.
Item 20. The rubidium elution system of any one of items 1 to 19, wherein the assembly is housed in a cabinet structure.
Item 21. The rubidium elution system of any one of items 1 to 20, further comprising a controller that is configured to control the pump and the at least one valve that permit delivery of a radioactive solution at a constant radioactivity rate.
Item 22. The rubidium elution system of any one of items 1 to 21, wherein the pump is a syringe pump or a peristaltic pump.
Item 23. The rubidium elution system of item 22, wherein the pump is a peristaltic pump.
Item 24. The rubidium elution system of item 23, wherein the peristaltic pump comprises a motor a pump component, and the peristaltic pump is horizontally oriented such that the motor is located at an elevation that is the same as that of the pump component.
Item 25. The rubidium elution system of any one of items 1 to 24, wherein said at least one valve comprises a valve upstream within the system relative to the generator and a valve downstream from the generator.
Item 26. The rubidium elution system of item 25, further comprising a bypass line that connects the valve upstream relative to the generator and the valve from downstream the generator.
Item 27. The rubidium elution system of item 25 or 26, wherein the at least one valve includes a pinch valve or a divergence valve.
Item 28. The rubidium elution system of item 27, wherein the at least one valve includes a pinch valve.
Other objects, advantages and features of the present disclosure will become more apparent upon reading of the following non-restrictive description of specific embodiments thereof, given by way of examples only with reference to the accompanying drawings.
As used herein, the terms “elution system”, “rubidium elution system” and “82Sr/82Rb elution system” can be used interchangeably and refer to a strontium-rubidium infusion system for use in generating a radioactive solution containing rubidium-82, measuring the radioactivity in the solution generated by the system, and infusing the radioactive solution to a patient in order to perform various studies on a patient's organ, such as heart or kidney.
As used herein, the terms “cart” or “system” or “trolley” are intended to encompass a platform. Said platform can be mobile or stationary.
The material used for “shielding” is made up of any radiation attenuating material, including, but not limited to, depleted uranium (U), lead (Pb), tin (Sn), antimony (Sb), tungsten (W), bismuth (Bi), any other material, or any combination thereof, as long as it provides a barrier to the radioactivity of rubidium or strontium
As used herein, the term “shielded component” refers to components of the system that are surrounded by a shielding material, and may refer to the generator, the dose calibrator, the activity detector, the waste container, and/or the tubing line or a part of the tubing line.
As used herein, the term “non-shielded components” refers to components of the system that are not shielded, such as the pump, the valves, the saline reservoir, the computer, the controller of the system, the interface of the dose calibrator, and/or the tubing line or a part of the tubing line.
As used herein, the term “cabinet structure” refers to an outer structure of the system that extend upward from a platform and houses an assembly. The cabinet structure may be formed of any radiation resistant material, including, but not limited to, stainless steel, injection-molded polyurethane, or any other suitable materials or combination thereof.
As used herein, the term “supporting accessories” refers to items such as wheels, lever, paddle, additional saline reservoir, drawer system for housing vials, and a handle for facilitating movement of the system.
As used herein, the expression “locking means for preventing access to the interface by a user of the system” refers to any mechanism, system, or technology to provide security against access by a user to the interface, such as a locked compartment enclosing the interface of the dose calibrator, the requirement for input of a security code or security data (RFID, biometric, numeric, audible, or the like) for modifying the parameters of the interface, integrating the interface into the dose calibrator in such a way that the interface is rendered not accessible, or the like. In an embodiment, only the manufacturer have access to the interface of the dose calibrator. In another embodiment, no one has access to the interface. Being placed outside the primary assembly, the dose calibrator is therefore accessible and it is advantageous to prevent a user from modifying the interface parameters in order to ensure that the dose calibrator remains set properly for the rubidium elution system of the present disclosure.
The generator column may be prepared in accordance with U.S. Pat. No. 8,071,959, the entire contents of which are incorporated herein by reference.
The generator system should be able to perform all the desired functions without unwanted and hazardous effects. 82Rb has a half-life of 75 seconds, and its potential impurities, 82Sr and 85Sr, have a half-life of 25.3 days and 64.8 days, respectively. It is essential that patients are not exposed to these undesired isotopes, of which both are characterized by a long half-life. Accordingly, in order to ensure adequate safety, quality control testing of the generator is performed on daily basis prior to use. The daily quality control process for the generator includes collecting an eluted sample in a shielded vial for evaluation, and measuring the activity of the sample in a dose calibrator. Further, the sample is retained to permit decay of all active rubidium, after which a second stage of breakthrough testing is performed. The measured initial activity and the final activity are used to calculate the breakthrough information. The United States Pharmacopeia (USP) provides relevant regulatory limits for breakthrough of strontium of 0.02 μCi of 82Sr/mCi of 82Rb activity and 0.2 μCi of 85Sr/mCi of 82Rb activity. Further, to ensure a higher degree of safety, a system may impose a more stringent limit of 50% of the USP limits.
A constant activity-rate refers to an activity-rate delivered with respect to time wherein the activity-rate is constant with respect to a predetermined constant activity concentration. A method to deliver a constant activity-rate dose is described in U.S. Pat. No. 7,813,841, which is incorporated herein by reference.
Different elution strategies that can be used for patient infusions include:
In certain embodiments, the rubidium elution system includes a controller configured to control the pump and the at least one valve so as to deliver a solution of rubidium at a constant activity rate to a patient.
In an embodiment as the one shown in
Preferably, the waste door 31 of the waste compartment 18 has an upper edge and lower edge, the upper edge of the waste door 31 is located at a lower elevation than the elevation of the opening 35 of the generator compartment 17. In an embodiment, the elevation of the upper edge of the waste door 31 is from about 5 inches to about 12 inches above the platform 11, more preferably from about 10 to about 12 inches above the platform 11, and further preferably at 10±0.5 inches above the platform 11, or further preferably at 11±0.5 inches above the platform 11, or further preferably at 12±0.5 inches above the platform 11. In another embodiment, the lower edge of the waste door 31 is from about 15 inches to about 30 inches above the platform 11. In certain aspects, the assembly 32 is defined with an upper section and a lower section. According to the present disclosure, the waste container 14 is preferably located in the lower section of the assembly 32. In an embodiment, the lower section represents the lower two third of the assembly 32. In another embodiment, the lower section represents the lower half of the assembly 32. Positioning the waste container 14 in the lower section of the assembly 32 offers several advantages for the user and for the system, such as distancing the waste container from the user's eyes, lowering the center of gravity that provides higher stability of the system, making it easier to clean and decontaminate in case of a spilling or overflow, and easier to replace the waste container, and preventing any waste overflow to run through electronic components that may result in shorting-out the system. It also leaves additional space for the pump 8 that is usually located on the upper portion of the assembly 32. More particularly, the new configurations allow the pump 8 to be horizontally oriented, as illustrated in
In certain aspects, the term “about” preferably refers to 20% of the corresponding value. In other aspects, the term “about” preferably refers to 10% of the corresponding value.
According to certain preferred embodiments, the top surface of the waste compartment 18 is at a first elevation; and the top surface of the generator compartment 17 is at a second elevation; and the first elevation is lower than the second elevation.
According to another preferred embodiment, the waste compartment 18 and the generator compartment 17 are at the same elevation.
According to a further preferred embodiment, the waste container 14 is at an elevation, which is lower than the pump 8.
In the presently disclosed rubidium elution systems, when emptying the waste container 14 is necessary, the user may i) open the door 20 of the cabinet structure, ii) open the door 31 of the waste compartment 18, iii) pull horizontally the enclosure 33, iv) disconnect the waste line (not shown) attached thereto, and v) lift the waste container 14 so as to remove it from its enclosure 33.
In certain embodiments, the 82Sr/82Rb generator, the dose calibrator, the waste container, and the activity detector are enclosed within respective shielded compartments. Preferably, each of the 82Sr/82Rb generator, the dose calibrator, the waste container, and the activity detector is enclosed within a respective shielded compartments. The door 31 of the waste compartment 18 is preferably shielded. The opening of the generator is also preferably shielded.
In certain embodiments, the pump 8 that can be embodied by a syringe pump, a peristaltic pump, or another type of pump. In the embodiment of the present invention shown in
The present disclosure includes embodiments where the dose calibrator is accompanied with its own interface that configures the dose calibrator for detection of rubidium, and with embodiments where the calibrator has no interface and is controlled by the computer. In a preferred embodiment, the system further includes a locking means for preventing a user from reconfiguring the dose calibrator in such a way that the dose calibrator remains configured as initially configured by the manufacturer. In a preferred embodiment, the dose calibrator is configured to detect rubidium and/or strontium. In a further preferred embodiment, the dose calibrator is configured to detect rubidium. Since strontium and rubidium are in an instant equilibrium, one can use the measured quantity of rubidium to calculate the quantity of strontium that is present in a solution after the initial content in rubidium has decayed. On way to prevent a user from reconfiguring the dose calibrator is to prevent access to the interface of the dose calibrator. In an embodiment, the locking means comprises an identification system for allowing access to the interface and reconfiguring the dose calibrator by the manufacturer of the system and not the user of the system. In another embodiment, the locking means comprises a locked compartment 30 as shown in
In certain aspects, the computer of the rubidium elution system is configured to proceed with a quality control test (breakthrough tests) at pre-determined time, upon user's request and at least once a day. The computer is configured to prevent a patient infusion when the quality control test result determines that the strontium concentration is equal to or above 0.01 μCi of 82Sr/mCi of 82Rb activity or equal to or above 0.1 μCi of 85Sr/mCi of 82Rb activity.
In other aspects, the rubidium elution system comprises a computer screen includes a speaker for providing an audible or visible alert for one or more different operations of system.
In certain embodiments, the rubidium elution system comprises a computer having a processor and a memory communicatively connected to the processor when the system is functioning. Memory has processor-executable instructions that, when executed on the processor, cause the system to perform representative functions of the system. Certain embodiments may also be provided as a computer-implemented method. Additionally, certain embodiments may be implemented as computer-executable instructions stored on computer-readable storage media. Computer readable storage media may be distinguished from computer-readable communications media that include transitory signals.
While the presently disclosed subject matter has been described in detail with reference to certain preferred embodiments, it should be appreciated that the present disclosure is not limited to those precise embodiments. Rather, in view of the present disclosure, which describes the current best mode for practicing the disclosed embodiments, many modifications and variations would present themselves to those skilled in the art without departing from the scope, and spirit of the presently disclosed subject matter.
This application claims the benefit of priority to U.S. Provisional Application No. 62/721,033, filed Aug. 22, 2018, the entire contents of which are incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US2019/047684 | 8/22/2019 | WO | 00 |
Number | Date | Country | |
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62721033 | Aug 2018 | US | |
62721033 | Aug 2018 | US |