Patient Communication and Radiation Safety in [ 177 Lu]Lu-PSMA Radiopharmaceutical Therapy: International Survey of 102 Theranostic Centers

[177Lu]Lu-PSMA radiopharmaceutical therapy (RPT) is increasingly administered worldwide in both inpatient and outpatient settings. Despite its growing use, there is no harmonized international guidance on what patients should be told before, during, and after therapy. This study aimed to capture current clinical practice and expert opinion to identify areas of consensus and divergence to develop a patient information template. Methods: An international survey was conducted among theranostic centers performing [177Lu]Lu-PSMA RPT. The questionnaire covered pretreatment procedures, therapy procedures, radiation precautions guidance, and posttreatment procedures. Inpatient and outpatient settings were evaluated separately. Results: In total, 102 centers from 23 countries participated. High agreement was observed for most pretreatment procedures, core therapy aspects, and general posttreatment guidance. In contrast, substantial variability was identified in posttreatment radiation precautions, particularly regarding distancing measures, duration of precautions, transportation after discharge, household and hygiene recommendations, and guidance affecting social interactions. Conclusion: This international survey demonstrated broad consensus for core clinical procedures but showed variability in posttreatment radiation precautions after RPT. By summarizing current practice and translating it into a patient information template, this project supports more consistent patient guidance across diverse clinical settings.