Evidence map›Paper›PMID 42224225›Full record

ArticlePloS one2026

Real-time detection of extravasation events of diagnostic and therapeutic radiopharmaceuticals in oncology.

Noemi Cucurachi, Federica Fioroni, Elisa Grassi, Nicola Panico, Laura Verzellesi, Andrea Botti, Alessandro Fraternali, Massimo Roncali, Rexhep Durmo, Angelina Filice and 1 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Noemi CucurachiMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Federica FioroniMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Elisa GrassiMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.ORCID https://orcid.org/0000-0003-3302-4351
Nicola PanicoDepartment of Physics, University of Bologna, Bologna, Italy.
Laura VerzellesiMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.ORCID https://orcid.org/0000-0002-2615-381X
Andrea BottiMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Alessandro FraternaliNuclear Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Massimo RoncaliNuclear Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Rexhep DurmoNuclear Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Angelina FiliceNuclear Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Mauro IoriMedical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadiopharmaceutical extravasation-when injected activity remains in soft tissue rather than entering the bloodstream-can compromise quantification in positron emission tomography/computed tomography (PET/CT) and, in therapeutic settings, deliver high local radiation doses. These effects may lead to inaccurate Standardized Uptake Value (SUV) measurements, potential misdiagnosis, repeat examinations, and to avoid patient risk. We assessed a simple, real-time approach for detecting extravasation during administration to enable immediate management and quantitative correction.

resultsReal-time monitoring with portable gamma detectors was applied to 885 diagnostic PET examinations (18F-FDG, 68Ga-DOTATOC/TATE, 68Ga-PSMA-11) and 15 administrations of 177Lu-DOTATATE therapy. In the diagnostic cohort, 53 extravasation events were identified and confirmed on PET images. Analysis of dose-rate-time curves yielded practical thresholds for extravasation detection: Δpinnor = 0.30 and ΔRt = 388 µSv/h. A statistically significant association was observed between SUV correction factors and specific curve parameters, enabling prospective adjustment of SUV before image interpretation. In the therapeutic cohort, one extravasation was observed, with an estimated absorbed self-dose of 11.6 Gy to the affected region. The monitoring enabled timely intervention that limited unnecessary exposure and workflow disruption. Feasibility analyses indicated that, for diagnostic procedures, a single detector can be sufficient for reliable extravasation identification and for deriving SUV correction factors.

conclusionsA real-time, detector-based strategy can identify radiopharmaceutical extravasation during injection, support immediate mitigation, and preserve diagnostic accuracy by allowing early SUV correction. In therapeutic applications, it can reduce risk by prompting management of rare but consequential events. The operational simplicity, low cost, and effectiveness demonstrated across both diagnostic and therapeutic scenarios support integration of this approach into routine clinical practice, with the added practicality that a single detector appears adequate for diagnostic workflows.

Indexed as

Extravasation of Diagnostic and Therapeutic MaterialsNeoplasmsRadiopharmaceuticalsFluorodeoxyglucose F18HumansOctreotideOrganometallic CompoundsPositron Emission Tomography Computed TomographyFluorodeoxyglucose F18OctreotideOrganometallic CompoundsRadiopharmaceuticals

Identifiers

PMID42224225
PMCPMC13225388

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.