Dextrose Solutions Yield Radiochemical Impurities: The “Sweet” Scans

Journal of Nuclear Medicine Technology

Azu Owunwanne¹  B. David Collier¹  Mercy Mathew¹  Eman Al-Enizi¹  Nafisah Kazem¹ 

[1] Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait Department of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait

关键词: radiochemicals;    radiopharmaceuticals;    ^99mTc;    dextrose;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Objective:If additional chemicals are inadvertently introduced in the preparation of radiopharmaceutical kits, radiochemical impurities may be formed. We report our experience with erroneously diluting 99mTc-pertechnetate eluate with 5% dextrose solution rather than normal saline during the preparation of 99mTc-tetrofosmin, 99mTc-methylene diphosphonate (MDP), 99mTc-stannous colloid, and 99mTc-mebrofenin.Methods:Scintigrams for 3 of the 4 radiochemicals unintentionally prepared with 5% dextrose were found to have an altered biodistribution. Therefore, radiopharmacy procedures for the day were reviewed, and instant thin-layer chromatography (ITLC) was performed.Results:Scintigrams showed an altered biodistribution consistent with an impurity. Review of procedures that day uncovered the error of using 5% dextrose to dilute the 99mTc eluate. The altered biodistribution on 99mTc-stannous colloid, 99mTc-MDP, and 99mTc-mebrofenin scintigrams consisted of cardiac blood-pool activity (possibly as a result of slow clearance of 99mTc-dextrose), soft-tissue background activity (possibly as a result of interstitial distribution of 99mTc-dextrose), renal and bladder activity (possibly as a result of renal elimination of 99mTc-dextrose), and gallbladder activity (possibly as a result of hepatobiliary excretion of 99mTc-dextrose). Both scintigrams and ITLC showed no evidence of impurities for the 99mTc-tetrofosmin prepared using 5% dextrose.Conclusion:Unintended preparation of radiochemicals with 5% dextrose rather than normal saline often results in the production of impurities, possibly 99mTc-dextrose. Because some but not all commercial radiochemical kits prepared with 5% dextrose will suffer this fate, nuclear medicine physicians reviewing the day’s images will be confronted with a confusing combination of expected and grossly abnormal findings.

【 授权许可】

Unknown