90Y Zevalin Manipulation description

The sole complete system solving the problem of 90Y Zevalin manipulation in its whole complexity. Your operation will be properly organised and you will be protected at the same time. We protect you not only against beta radiation but also against the Bremsstrahlung. The ALARA system applied here results in shortening the time of manipulation.

  • 1.

    The activity of the delivered solution 90Y (90YCl3) and the volume X that contains 1500MBq 90Y is calculated (1500 MBq is an initial standard activity of 90Y for labelling the preparation Zevalin). Measuring of activity is carried out in a dose calibrator, exploiting the Bremsstrahlung, after locating the preparation in the Aluminium capsule PT327R0 having a 5mm thick wall. The vial is then to be located in the Slanted stand PT278R0 (combined shielding Al+Pb).

  • Zevelin manipulation description - 1
  • 2.

    Component parts of the kit are to be taken out of a refrigerator and let wait at least 10min at a room temperature. Stoppers of vials are to be treated by ethanol. Solutions of reaction components, located in a Stand for vials PT279R0, are extracted into three syringes before starting to label Zevalin in following volumes:

    1. Acetate buffer 1,2 x X ml 1ml syring is used in general (a volume less than 1ml) with extracting needle 0,70 x 40 (black), breathing needle 0,50 x 16 (orange)
    2. Antibody - always 1,3 ml 2 ml syringe with extracting needle 0,70 x 40 (black), breathing needle 0,50 x 16 (orange)
    3. Adjusting buffer 10 – (X + 1,2X + 1,3) ml 10 ml syringe with extracting needle 0,90 x 70 (yellow), breathing needle  0,50 x16 (orange) Syringes with needles - now containing certain volumes of components - remain prepared in the vials. They are subsequently used in operations described in following text.

    The reaction vial of the kit is to be located into the Slanted stand PT280R0 which is to be closed with the upper part of the shielding having a tapered orifice.

    The needle 0,70x40mm (black) is introduced into the reaction vial. The Modified hemostat PT172R0 helps to handle and fix the needle.
    The previously prepared volume of acetate buffer (see Op.2.1.) is added into the reaction vial using the fixed black needle.

  • Zevelin manipulation description - 2
  • 3.

    The required volume X (see Op.1) is to be marked on the surface of 1 ml syringe (preferably by a coloured felt pen) and the syringe is inserted into the shield PT328R0.

    Two needles - extracting 0,60x60 (blue) and breathing 0,70x40 (black) - are introduced into the vial with 90YCl3, located in the Slanted stand PT278R0. See the picture a.

    The PT278R0 is now completed with the syringe in its shield.

    X ml of solution is extracted from the vial in the stand PT278R0 into the 1ml syringe covered by the PT328R0 and without measuring the activity is immediately added into the reaction vial. The 1ml syringe should be located in the working radius of the manipulating person to be able to use it in further steps (measurement) of the cycle.

  • Zevelin manipulation description - 3
  • 4.

    Mixing up of the solutions of acetate buffer and 90Y is to be done immediately by repeated sliding the stand PT280R0 without rotating and rolling over the stand.

    1,3 ml (standardly) of antibody is now to be added (see Op. 2.2). The solution is mixed up immediately as previously.

    Reaction components are now incubated for 5min at a room temperature. Digital time measuring with alarm is recommended to ensure the exact time interval.

    X ml of saline solution (the same volume as 90Y) is to be withdrawn into the 1ml syringe during the incubation time and immediately added into the vial containing the rest of 90Y (the volume of the solution in the vial is now conformable to the volume at the start of the preparation). The 1ml syringe with the extracting needle 0,60x60 (blue) is now to be taken out of the vial without being disconnected(the air bubble originated by withdrawing of saline solution will eject the solution into the vial quantitatively).

    The vial containing 90Y is now to be measured under the same conditions as at the start of the preparation (Op.1 - the same volume of radioactive solution and the same geometry of location inside the Aluminium capsule PT327R0). The difference of measured activities at the start and at this operation represents the final activity in the reaction vial.

    Extracting and breathing needles are inserted into the reaction vial located in the stand PT280R0. See the picture b in step 3 above.

    The adjusting buffer is now added into the reaction solution slowly through the extracting needle thus mixing the solution continuously without occurance of foaming. The resulting volume of solution is 10ml. The activity has been assessed already.

  • Zevelin manipulation description - 4
  • 5.

    The control of radiochemical purity (described separately - see here).

    A stopper is placed into the lower central part of the Portable casket PT297R1 and fixed by a screw and subsequently also the cylindrical shield of the 10ml syringe is to be installed. The above mentioned assembly is to be located near the stand PT280R0 .

    By virtue of knowledge of the activity of the labelled preparation (Op.13) and its final volume - 10ml - the volume containing the activity required for the patient´s therapy is to be calculated. The stand PT280R0 containing the reaction vial is completed with a shield for 10ml syringe (Braun Omnifix with a screw). The calculated volume of labelled preparation is to be withdrawn  through the extracting needle into the 10ml syringe.

    Than the syringe is relocated into the transport container PT297R1 where also a stopper is connected to cover the cone of the syringe. This unit is now transported to a patient to be administered automatically.

  • Zevelin manipulation description - 1
  • Zevelin manipulation description - 5
  • 6.

    Administration of 90Y must be accomplished slowly. The time of administration should be at least 10min. The administration is performed with help of the Automatic administering stand PT353R110ml for Zevalin.

    1. A connecting piece with injection part with a diaphragm with a needle in it connected to the 2ml auxiliary syringe, a syringe containing saline solution and a short connecting tube are prepared in the stand beforehand. The cone of the needle is to be fastened in jaws.
    2. The cannula indwelling in the patient´s vein is now connected to the outgoing tube of the administering stand.
    3. The syringe with the labelled preparation is to be relocated from the transport container PT297R1 into the automatic administering stand PT353R1. (The 2ml auxiliary syringe is replaced by the 10ml syringe with activity). The 10ml syringe remains in the upper - shielding - part of the PT297R1 throughout the manipulation steps described above.
    4. The administration is now accomplished automatically. The syringe with Zevalin is discharged first than the saline solution flushes the system.
  • Zevelin manipulation description - 6
  • 7.

    Waste manipulation - Movable tables are recommended to be used for administration, either the PT149R1 or the PT275R0 both of them being equipped with a shielded container the latter being completed by a shielding screen with 20mm of Pb. Used contaminated materials are deposited in the shielded container immediately after the administration has been finished.

  • Zevelin manipulation description - 7

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