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Research ArticleImaging

Abnormal Biologic Distribution Related to Normal Saline Among 99mTc-Dimercaptosuccinic Acid Scans

Turkiya Mahmood Al Bulushi, Khalsa Zahran Al-Nabhani, Deeksha Shetty, Marwa Hamed Al Sabahi and Abdulhakeem Al-Rawahi
Journal of Nuclear Medicine Technology March 2023, 51 (1) 38-43; DOI: https://doi.org/10.2967/jnmt.122.264241
Turkiya Mahmood Al Bulushi
1Nuclear Medicine Department and Molecular Imaging Center, Royal Hospital, Ministry of Health, Muscat, Oman; and
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Khalsa Zahran Al-Nabhani
1Nuclear Medicine Department and Molecular Imaging Center, Royal Hospital, Ministry of Health, Muscat, Oman; and
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Deeksha Shetty
1Nuclear Medicine Department and Molecular Imaging Center, Royal Hospital, Ministry of Health, Muscat, Oman; and
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Marwa Hamed Al Sabahi
1Nuclear Medicine Department and Molecular Imaging Center, Royal Hospital, Ministry of Health, Muscat, Oman; and
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Abdulhakeem Al-Rawahi
2Oman Medical Specialty Board, Muscat, Oman
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Abstract

The primary aim was to describe the incidence and causes of abnormal distribution of 99mTc-dimercaptosuccinic acid (99mTc-DMSA) among patients who underwent renal scans in Royal Hospital (Oman) in 2020. The secondary aim was to assess the effect of a specific batch of normal saline A (batch 132129) compared with another normal saline, B (batches 132589 and 133325), used in the preparation of 99mTc-DMSA on the abnormal biodistribution of 99mTc-DMSA. Methods: This was an ambidirectional cohort study that included all patients who underwent 99mTc-DMSA renal scanning between January and December 2020. Both prospective and retrospective data collection was used. The collected data included possible causes of abnormal biodistribution, quality of 99mTc-DMSA and normal saline, and time of 99mTc-DMSA injection. Results: The total incidence of abnormal biodistribution was 26.5%, with the most common cause being a high creatinine level (29%). Normal saline batch A was significantly associated with abnormal biodistribution (49.7%), compared with batch B (6.6%) (P < 0.001). This association was more prominent among patients injected with the 99mTc-DMSA preparation after 2 h (83.0%) compared with before 2 h (13.3%). Conclusion: A high incidence of abnormal biodistribution of 99mTc-DMSA was detected and—for what is the first time, to our knowledge, in the literature—a specific preservative-free, normal saline that is up to standard has been identified as a significant cause of abnormal biodistribution. Nuclear medicine professionals and pharmaceutical companies should take note of this possible cause of abnormal 99mTc-DMSA biodistribution.

  • renal scintigraphy
  • 99mTc-DMSA
  • normal saline
  • biodistribution
  • liver uptake

Footnotes

  • Published online Oct. 4, 2022.

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Journal of Nuclear Medicine Technology: 51 (1)
Journal of Nuclear Medicine Technology
Vol. 51, Issue 1
March 1, 2023
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Abnormal Biologic Distribution Related to Normal Saline Among 99mTc-Dimercaptosuccinic Acid Scans
Turkiya Mahmood Al Bulushi, Khalsa Zahran Al-Nabhani, Deeksha Shetty, Marwa Hamed Al Sabahi, Abdulhakeem Al-Rawahi
Journal of Nuclear Medicine Technology Mar 2023, 51 (1) 38-43; DOI: 10.2967/jnmt.122.264241

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Abnormal Biologic Distribution Related to Normal Saline Among 99mTc-Dimercaptosuccinic Acid Scans
Turkiya Mahmood Al Bulushi, Khalsa Zahran Al-Nabhani, Deeksha Shetty, Marwa Hamed Al Sabahi, Abdulhakeem Al-Rawahi
Journal of Nuclear Medicine Technology Mar 2023, 51 (1) 38-43; DOI: 10.2967/jnmt.122.264241
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Keywords

  • renal scintigraphy
  • 99mTc-DMSA
  • normal saline
  • biodistribution
  • liver uptake
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