Feedback on the use of the new Posijet® from Lemer Pax

Galvez D., Cormier N., Froger S. Pharmacy Department, Hôpital Privé du Confluent, Nantes

JFMN (Francophone Nuclear Medicine Days) 2017 – Nantes – May 29, 2017

As part of a partnership between the Hôpital Privé du Confluent and Lemer Pax, the nuclear medicine department tested and contributed to the development of the new generation of mobile automatic injectors for high‑energy radiotracers, including fluorinated tracers: the Posijet®.

Objectives: To verify its functionalities, assess its performance, and optimize its routine use while ensuring patient safety.

MATERIALS AND METHODS

From March to December 2016, ten technologists and two radiopharmacists—users of the previous generation of injectors—evaluated various characteristics of a Posijet® provided by Lemer Pax: autonomy, ergonomics, connectivity, safety features, traceability, failures, radiation protection, and costs.

RESULTS

1. Activity Data
   • 1,328 patients injected
   • 339 mother solutions used (single‑dose/multi‑dose), covering four different ¹⁸F tracers
2. Autonomy
   • 1,037 cumulative hours of use
   • 8‑hour autonomy → equivalent to one full working day
3. Connectivity
   • Standard connections:
     • 240 V
     • Ethernet
     • Wi‑Fi
   • Software interoperability (bidirectional data synchronization)
   • Integration into our workflow while improving medication circuit safety
4. Safety
   • New volumetric activity control function
     • Injected dose strongly correlated with the prescribed activity
     • Alerts the user before injection if a significant discrepancy is detected compared to the supplier’s delivery note
   • Multiple injection modes (automatic and manual) + pressure feedback ensuring injection rates adapted to each patient
     • Improved comfort and preservation of venous access
5. Handling
   • Motor‑assisted movement
     • Real comfort for technologists despite the 380 kg weight
6. Traceability
   • A traceability label including all legal information is printed for each patient
   • Data are stored in the Posijet® and can be exported via spreadsheet
7. Failures and Incidents (No major failure prevented use during a session)
   • 20 different types of alerts and error messages recorded
   • Their frequency decreased over time due to:
     • User learning curve
     • Mechanical improvements: wider vial support, syringe retention, new guiding cones…
     • Software improvements: 8 software versions deployed
   • Remote access available for troubleshooting by Lemer Pax technical support
8. Radiation Protection
   • No significant dosimetric deviation compared to our 2015 values
9. Costs
   • Financial investment includes the Posijet® and the sterile proprietary kits, whose daily cost must be considered
   • However, the vent needle + 0.22 µm filter allows dilution of the mother solution
     • This avoids high concentrations at the beginning of the session and enables recovery of the full activity in the vial
   • After analysis, this should allow the radiopharmacy to optimize the quantities of 18F tracers ordered

CONCLUSION

The Posijet® fully complies with regulatory requirements regarding safety, traceability, and radiation protection. It proved reliable, functional, easy to use, and reassuring for both staff and patients. Further improvements are still expected.

Click here to access the digital version of the poster (in French)

Click here to learn more about the Posijet®, the autonomous unit for fractionation and injection of high‑energy radiopharmaceuticals