Extravasation of a Therapeutic Dose of 131I-Metaiodobenzylguanidine: Prevention, Dosimetry, and Mitigation

Journal of Nuclear Medicine

Raghuveer K. Halkar¹  Dacian V. Bonta¹  Naomi Alazraki¹ 

[1] Nuclear Medicine Service, Department of Radiology and Imaging Sciences, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, Georgia Nuclear Medicine Service, Department of Radiology and Imaging Sciences, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, Georgia Nuclear Medicine Service, Department of Radiology and Imaging Sciences, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, Georgia

关键词: radiopharmaceutical therapy;    skin radiation injury;    extravasation dosimetry;   

DOI  :  10.2967/jnumed.110.083725

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

After the extravasation of a therapeutic dose of 131I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol. Methods: Before therapy infusion, proper placement is verified by administering 37 MBq of 99mTc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity. Results: No extravasation incidents have occurred since the verification procedure was instituted. Conclusion: To protect against radiation injury from extravasation of therapeutic radionuclides, test administration of a small 99mTc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.

【 授权许可】

Unknown