Publications by authors named "Max Amurao"

The historic and ongoing evolution of the practice, technology, terminology, and implementation of programs related to quality in the medical radiological professions has given rise to the interchangeable use of the terms Quality Management (QM), Quality Assurance (QA), and Quality Control (QC) in the vernacular. This White Paper aims to provide clarification of QM, QA, and QC in medical physics context and guidance on how to use these terms appropriately in American College of Radiology (ACR) Practice Parameters and Technical Standards, generalizable to other guidance initiatives. The clarification of these nuanced terms in the radiology, radiation oncology, and nuclear medicine environments will not only boost the comprehensibility and usability of the Medical Physics Technical Standards and Practice Parameters, but also provide clarity and a foundation for ACR's clinical, physician-led Practice Parameters, which also use these important terms for monitoring equipment performance for safety and quality.

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Background: Biological specimens from patients who have received radiopharmaceuticals are often collected for diagnostic testing and sent to clinical laboratories. Residual radiation has long been assumed to be minimal. However, literature is sparse and may not represent the specimen volumes or spectrum of radionuclides currently seen at National Cancer Institute (NCI)-designated cancer centers.

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Article Synopsis
  • The purpose of this study was to guide radiation oncology centers in using Lutetium-177-dotatate (Lu) therapy for treating midgut neuroendocrine tumors, based on experiences from an expanded access protocol.
  • The methodology involved creating a dedicated treatment area, utilizing an IV pump for infusion, monitoring exposure levels, and assessing patient toxicity, along with conducting a failure modes and effects analysis (FMEA).
  • Results showed 22 patients were treated successfully, with a significant reduction in nausea and emesis rates after changing to peripherally inserted central catheters (PICC) and improving the amino acid formulation, confirming Lu-dotatate can be safely administered in an outpatient setting.
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