This practice parameter was developed collaboratively by the American College of Radiology (ACR), the American College of Nuclear Medicine (ACNM), the American Society for Radiation Oncology (ASTRO), and the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
This practice parameter is intended to guide appropriately trained and licensed physicians performing therapy with unsealed radiopharmaceutical sources. Such therapy requires close cooperation and communication between the physicians who are responsible for the clinical management of the patient and those who administer radiopharmaceutical therapy and manage the attendant side effects. Adherence to this parameter should help to maximize the efficacious use of radium-223, maintain safe conditions, and ensure compliance with applicable regulations.
Application of this parameter should be in accordance with the ACR–SPR Technical Standard for Diagnostic Procedures Using Radiopharmaceuticals, as that standard relates to the handling of radiopharmaceuticals, radiation safety, and radiation protection of patients, personnel, and the public [1]. There must also be compliance with applicable laws and regulations.
The goal of therapy with unsealed radiopharmaceutical sources is to provide either cure or significant prolongation of disease specific survival, and effective reduction and/or prevention of adverse disease-related symptoms or untoward events while minimizing treatment-associated side effects and complications.