RT Journal Article
SR Electronic
T1 Dextrose Solutions Yield Radiochemical Impurities: The “Sweet” Scans
JF Journal of Nuclear Medicine Technology
JO J. Nucl. Med. Technol.
FD Society of Nuclear Medicine
SP 33
OP 36
VO 31
IS 1
A1 Eman Al-Enizi
A1 Nafisah Kazem
A1 Azu Owunwanne
A1 B. David Collier
A1 Mercy Mathew
YR 2003
UL http://tech.snmjournals.org/content/31/1/33.abstract
AB Objective:If additional chemicals are inadvertently introduced in the preparation of radiopharmaceutical kits, radiochemical impurities may be formed. We report our experience with erroneously diluting 99mTc-pertechnetate eluate with 5% dextrose solution rather than normal saline during the preparation of 99mTc-tetrofosmin, 99mTc-methylene diphosphonate (MDP), 99mTc-stannous colloid, and 99mTc-mebrofenin. Methods:Scintigrams for 3 of the 4 radiochemicals unintentionally prepared with 5% dextrose were found to have an altered biodistribution. Therefore, radiopharmacy procedures for the day were reviewed, and instant thin-layer chromatography (ITLC) was performed. Results:Scintigrams showed an altered biodistribution consistent with an impurity. Review of procedures that day uncovered the error of using 5% dextrose to dilute the 99mTc eluate. The altered biodistribution on 99mTc-stannous colloid, 99mTc-MDP, and 99mTc-mebrofenin scintigrams consisted of cardiac blood-pool activity (possibly as a result of slow clearance of 99mTc-dextrose), soft-tissue background activity (possibly as a result of interstitial distribution of 99mTc-dextrose), renal and bladder activity (possibly as a result of renal elimination of 99mTc-dextrose), and gallbladder activity (possibly as a result of hepatobiliary excretion of 99mTc-dextrose). Both scintigrams and ITLC showed no evidence of impurities for the 99mTc-tetrofosmin prepared using 5% dextrose. Conclusion:Unintended preparation of radiochemicals with 5% dextrose rather than normal saline often results in the production of impurities, possibly 99mTc-dextrose. Because some but not all commercial radiochemical kits prepared with 5% dextrose will suffer this fate, nuclear medicine physicians reviewing the day’s images will be confronted with a confusing combination of expected and grossly abnormal findings.