Personalized (18)FDG Dose Synthesis Using BG-75 Generator: 1st 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-75 Generator for (18)FDG-based PET/CT clinical imaging. We are sharing our experience of BG-75 in the first year (December 2015-November 2016) after commissioning. MATERIAL AND METHODS: BG-75 Generator (ABT, USA) was installed in available space without major design modification. It has a self-shielded mini-cyclotron (7.5 MeV proton beam, positive ion with current < 5µA) to produce [(18)F]F-, an automated card-based radiochemistry module to produce (18)FDG and automated QC module to perform tests upon each batch of (18)FDG. Data were collected for yields of [(18)F]F-, (18)FDG, QC and radiation safety parameters. RESULTS: Total 545 runs in 167 days (3±01 runs/day) were made. Average yield with 60 minute bombardment using 4.5 µA current was 37 mCi and 21 mCi for [(18)F]F- and (18)FDG, respectively. Total 29 runs had chemistry or QC failures and were discarded. Remaining 516 batches were used to perform imaging upon 1370 patients (8±03 patients/day). Radiation dose in BG-75 suite and effective doses to 02 operators were within statutory limits. CONCLUSION: BG-75 Generator provides safe, dependable and sustainable supply of (18)F-Fluoride for (18)FDG 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.