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First published online May 15, 2009, 10.2967/jnmt.109.061903
doi:10.2967/jnmt.109.061903
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Journal of Nuclear Medicine Technology Volume 37, Number 2, 2009 107-110
© 2009 by Society of Nuclear Medicine

Chocolate Intake Associated with Failed Labeling of 99mTc Red Blood Cells

Hussam Bustani1, Cecile Colavolpe2, Isabelle Imbert-Joscht2, Patrick Havlik2, Pascale Pisano1 and Benjamin Alain Guillet1

1 Radiopharmacie, CHU Nord, Marseille, France; and 2 Service de Médecine Nucléaire, CHU Nord, Marseille, France

Correspondence: For correspondence or reprints contact: Guillet Benjamin, Radiopharmacie Service de Médecine Nucléaire, CHU Nord, Chemin des Bourrelly, 13015 Marseille, France. E-mail: benjamin.guillet{at}ap-hm.fr

ABSTRACT

Red blood cells (RBC) labeled in vivo with 99mTc-pertechnetate are used worldwide in nuclear medicine departments. Methods: Here, we present a case of 99mTc-RBC labeling failure associated with chocolate intake in a 25-y-old woman, resulting in uninterpretable images. Because of this clinical observation, we performed in vitro RBC labeling on blood samples from volunteers after they consumed chocolate. Results: Chocolate intake inhibited the labeling rate, compared with the control condition, and significantly increased the 99mTc free fraction (34.1% ± 11.3% vs. 14.0% ± 1.2%). Conclusion: We cannot explain how this interaction could occur, but cacao components are known to modulate red cell and plasma oxidoreductive status and to modify red cell membrane permeability and plasticity. Therefore, for patients who can be considered likely to consume chocolate, such as young patients, we recommend that they limit their consumption of chocolate for 12 h before RBC labeling.

Key Words: chocolate intake; RBC labeling; 99mTc; stannous pyrophosphate






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