PT - JOURNAL ARTICLE AU - Turkiya Mahmood Al Bulushi AU - Khalsa Zahran Al-Nabhani AU - Deeksha Shetty AU - Marwa Hamed Al Sabahi AU - Abdulhakeem Al-Rawahi TI - Abnormal Biologic Distribution Related to Normal Saline Among <sup>99m</sup>Tc-Dimercaptosuccinic Acid Scans AID - 10.2967/jnmt.122.264241 DP - 2023 Mar 01 TA - Journal of Nuclear Medicine Technology PG - 38--43 VI - 51 IP - 1 4099 - http://tech.snmjournals.org/content/51/1/38.short 4100 - http://tech.snmjournals.org/content/51/1/38.full SO - J. Nucl. Med. Technol.2023 Mar 01; 51 AB - 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 &lt; 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.