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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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  • FIGURE 1.
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    FIGURE 1.

    Anterior and posterior images of adult with abnormal 99mTc-DMSA distribution pattern in liver, colon, and background.

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    FIGURE 2.

    (A) Fused sagittal image of 99mTc-DMSA study of child with history of cross-fused ectopic kidney, showing high background, liver, and colon uptake. (B) Corresponding CT image. (C) Corresponding SPECT image.

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    TABLE 1.

    Medical Conditions and Medication Affect 99mTc-DMSA Biodistribution

    CausePatients (n)
    High creatinine26
    Medication/urinary alkalinizer3
    Fatty liver1
    Liver and spleen enlargement1
    Poor quality control measures for 99mTc-DMSA0
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    TABLE 2.

    Quality Control Test Results for Eluted Solutions and Final Products

    TestAccepted limitAverage result
    99Mo breakthrough<0.1%0.02%
    Al+3 breakthroughEluted spot less intensely colored than standard solutionAll passed
    99mTc pH4.0–8.05.0
    99mTc-DMSA pH2.5–3.53.1
    Labeling efficiency≥95%98.2%
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    TABLE 3.

    Institutional Investigation Results Compared with Manufacturer Specifications for Normal Saline Quality Control

    TestAccepted limitNormal saline
    Batch A (132129)Batch B (132589)Batch B (133325)
    Visual inspectionClear, colorlessClear, colorlessClear, colorlessClear, colorless
    pH4.5–7.05.55.65.8
    Osmolarity (mmol/L)308287282280
    Endotoxin/pyrogen (IU/mL)<2.5<2.5<2.5<2.5
    SterilityNo growth or turbiditySterileSterileSterile
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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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