Cargando…
Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage
Sporadic supply interruptions of select radiopharmaceuticals on the global market require consideration of alternative agents to support continuity of essential nuclear medicine examinations. During an acute shortage of Xenon-133 and technetium-99 metastable (Tc-99m) diethylene-triamine-pentaacetate...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436323/ https://www.ncbi.nlm.nih.gov/pubmed/28553184 http://dx.doi.org/10.4103/1450-1147.203063 |
_version_ | 1783237377318191104 |
---|---|
author | Young, Colin Raymond Prasad, Kalpna |
author_facet | Young, Colin Raymond Prasad, Kalpna |
author_sort | Young, Colin Raymond |
collection | PubMed |
description | Sporadic supply interruptions of select radiopharmaceuticals on the global market require consideration of alternative agents to support continuity of essential nuclear medicine examinations. During an acute shortage of Xenon-133 and technetium-99 metastable (Tc-99m) diethylene-triamine-pentaacetate (DTPA), our institution used aerosolized Tc-99m hydroxymethylene diphosphonate (HDP), a radiopharmaceutical traditionally used in bone scintigraphy, in lieu of traditional ventilation agents, for two cases of suspected pulmonary embolism. Similar to Tc-99m-DTPA, Tc-99m-HDP was readily available and easily compounded in our pharmacy, and tolerated well by patients. Identical delivery equipment was used for administration of Tc-99m-HDP as that used in Tc-99m-DTPA, and thus, there was no requirement for a negative pressure room. Similar to Tc-99m-DTPA and unlike Xenon-133, Tc-99m-HDP allowed direct comparison of all 8 ventilation-perfusion images. In addition, the cost per dose of Tc-99m-HDP proved to be less than Tc-99m-DTPA. Despite these favorable characteristics of Tc-99m-HDP, our experience identified an important challenge in obtaining an optimal flux override ratio of > 3 in a reasonable time frame while obtaining ventilation and perfusion images sequentially despite reversing the imaging order in an attempt to overcome this limitation. Although our experience with Tc-99m-HDP in these two cases was favorable, more clinical experience and investigation are warranted before Tc-99m-HDP can be incorporated as a standard alternative ventilation agent. |
format | Online Article Text |
id | pubmed-5436323 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-54363232017-05-26 Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage Young, Colin Raymond Prasad, Kalpna World J Nucl Med Case Report Sporadic supply interruptions of select radiopharmaceuticals on the global market require consideration of alternative agents to support continuity of essential nuclear medicine examinations. During an acute shortage of Xenon-133 and technetium-99 metastable (Tc-99m) diethylene-triamine-pentaacetate (DTPA), our institution used aerosolized Tc-99m hydroxymethylene diphosphonate (HDP), a radiopharmaceutical traditionally used in bone scintigraphy, in lieu of traditional ventilation agents, for two cases of suspected pulmonary embolism. Similar to Tc-99m-DTPA, Tc-99m-HDP was readily available and easily compounded in our pharmacy, and tolerated well by patients. Identical delivery equipment was used for administration of Tc-99m-HDP as that used in Tc-99m-DTPA, and thus, there was no requirement for a negative pressure room. Similar to Tc-99m-DTPA and unlike Xenon-133, Tc-99m-HDP allowed direct comparison of all 8 ventilation-perfusion images. In addition, the cost per dose of Tc-99m-HDP proved to be less than Tc-99m-DTPA. Despite these favorable characteristics of Tc-99m-HDP, our experience identified an important challenge in obtaining an optimal flux override ratio of > 3 in a reasonable time frame while obtaining ventilation and perfusion images sequentially despite reversing the imaging order in an attempt to overcome this limitation. Although our experience with Tc-99m-HDP in these two cases was favorable, more clinical experience and investigation are warranted before Tc-99m-HDP can be incorporated as a standard alternative ventilation agent. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5436323/ /pubmed/28553184 http://dx.doi.org/10.4103/1450-1147.203063 Text en Copyright: © 2017 World Journal of Nuclear Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Young, Colin Raymond Prasad, Kalpna Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title | Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title_full | Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title_fullStr | Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title_full_unstemmed | Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title_short | Initial Experience in the Use of Technetium-99 Metastable Hydroxymethylene Diphosphonate as an Alternative Ventilation Agent During Periods of Interim Shortage |
title_sort | initial experience in the use of technetium-99 metastable hydroxymethylene diphosphonate as an alternative ventilation agent during periods of interim shortage |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436323/ https://www.ncbi.nlm.nih.gov/pubmed/28553184 http://dx.doi.org/10.4103/1450-1147.203063 |
work_keys_str_mv | AT youngcolinraymond initialexperienceintheuseoftechnetium99metastablehydroxymethylenediphosphonateasanalternativeventilationagentduringperiodsofinterimshortage AT prasadkalpna initialexperienceintheuseoftechnetium99metastablehydroxymethylenediphosphonateasanalternativeventilationagentduringperiodsofinterimshortage |