RT Journal Article SR Electronic T1 Abnormal Biological Distribution Related to Normal Saline Among Technetium-99m dimercaptosuccinic acid (99mTc-DMSA) Scans JF Journal of Nuclear Medicine Technology JO J. Nucl. Med. Technol. FD Society of Nuclear Medicine SP jnmt.122.264241 DO 10.2967/jnmt.122.264241 A1 Al Bulushi, Turkiya Mahmood A1 Al Nabhani, Khalsa Zahran A1 Shetty, Deeksha A1 Al Sabahi, Marwa Hamed A1 Al-Rawahi, Abdulhakeem YR 2022 UL http://tech.snmjournals.org/content/early/2022/10/04/jnmt.122.264241.abstract AB Aim: The primary aim is to describe the incidence and causes of abnormal distribution of 99mTc-DMSA among patients who underwent renal scans in Royal Hospital (Oman), in 2020. The secondary aim is to assess the effect of a specific batch of normal saline A (batch NO 132129) compared to another normal saline B (batches NO 132589 and NO 133325) used in the preparation of 99mTc-DMSA on the abnormal biodistribution of 99mTc-DMSA. Methods: An ambidirectional cohort study that included all patients who underwent DMSA renal scan between January and December 2020. Both prospective and retrospective data collection were utilized. Collected data included possible causes of abnormal biodistribution, quality of 99mTc-DMSA and normal saline, and time of 99mTc-DMSA injection. Data analysis was conducted by SPSS-25. Results: The total incidence of abnormal biodistribution was 26.5% with the most common cause being high creatinine (29%). Normal saline batch A, used in the preparation, was found to be significantly associated with abnormal biodistribution (49.7%) compared to batch B (6.6%) (p-< 0.001). This association was more prominent among patients injected after two hours with 99mTc-DMSA preparation (83.0%) compared to within two hours (13.3%). Conclusion: High incidence of abnormal biodistribution of 99mTc-DMSA was detected and for the first time in the literature, a specific preservative-free, normal saline that is up to standard, has been identified as a significant cause of abnormal biodistribution. Therefore, it should be listed by nuclear medicine professionals and pharmaceutical companies as a possible cause for abnormal 99mTc-DMSA biodistribution.