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NM 4103 Section 4 Radiopharmaceutical Characteristics 99mTc Sodium Pertechnetate Eluted from 99Mo generator Tested for 99Mo and Al breakthrough Can be used for preparation of 99mTc-labeled radipharmaceuticals (kits) or Used to image Thyroid and Meckel’s diverticulum (without mixing in a kit) 99mTc Preparation: – – – – Heating HSA Wash particles Particles – Macroaggregated Albumin (MAA) Number: 1-12 million particles per mg Shape: irregular Size: 10-90 µm Checked for particle size Vial and syringe should be aggitated Used for lung perfusion imaging 99mTc Kit Preparation: – Add 99mTc to kit, mix Weak chelates and tend to degrade with time – Phosphates (MDP, HDP) Prevented with tin and antioxidants Used for bone imaging 99mTc Preparation: – – Add acid Heat in water bath Particles – Sulfur Colloid Size: 0.1 to 1 µm Larger particles could be trapped in the lungs Used for imaging liver/spleen, bone marrow, lymphoscintigraphy, GI bleed, and gastric emptying. 99mTc Preparation – Pentetate (DTPA) Add 99mTc to kit, mix Used for renal and aerosol lung imaging. 99mTc Preparation – In Vitro Method (Ultratag® kit) – Draw blood, add to vial of stannous citrate/acid citrate dextrose(acd). Add sodium hypochlorite. Add ACD. Add 99mTc and incubate. In Vivo Method labeled Red Blood Cells Sn2+ injected into patient. Wait 20 minutes, then 99mTc injected into patient Used to image GI bleed, liver hemangioma, gated blood pool (MUGA) 99mTc Iminodiacetic Acid (IDA) DISIDA (Hepatolite®) & Mebrofenin (Choletec®) Preparation – Add 99mTc to kit, mix Used for hepatobiliary imaging. 99mTc Hexamethylpropylene Amine Oxime (Ceretec®) Preparation of 99mTc HMPAO – Add 99mTc to kit, mix Should be used within 4 hours of preparation. Used for brain imaging and labeling leukocytes 99mTc Preparation – – Sestamibi (Cardiolite®) Add 99mTc to kit Heat in boiling water bath for 10 minutes. Used for imaging cardiac perfusion, parathyroid adenomas and breast tumors (Miraluma®). 99mTc Preparation – Tetrofosmin (Myoview®) Add 99mTc to kit, mix and incubate for 15 minutes. Used for myocardial perfusion 99mTc MAG3 Preparation: – – – – Add 99mTc to kit Add filtered air (to oxidize excess Sn2+ ) Heat in water bath for 10 min Cool for 15 min Light sensitive Used for imaging renal function 99mTc Preparation: – – – Neurolite® Isotonic saline added to vial A 99mTc added to vial B Add vial A to B and incubate for 30 minutes Used for Brain perfusion imaging 99mTc DMSA Preparation: – – Add 99mTc to kit vial Incubate for 10 minutes Light sensitive Used for renal cortical imaging 99mTc Gluceptate Preparation: – 99mTc – addto kit vial Incubate for 15 minutes Used for renal imaging 131 I Sodium Iodide Supplied in capsule or liquid Oral administration Used for thyroid uptake measurement and thyroid treatment 123 I Sodium Iodide Cyclotron produced Capsule or liquid Oral administration Used for thyroid uptake measurement and thyroid imaging 123 I or 131 I MIBG Preparation – 131I – – and MIBG is refluxed for 72 hrs Cooled Passed through anion exchange column Used for imaging pheochromocytoma and for treatment of neuroblastoma 111 Preparation: – – In DTPA Adding dilute DTPA to solution of 111InCl3 in acetate buffer, pH 5 Heat for 15 minutes in boiling water bath Used for cisternography and gastric emptying (liquid phase) 133 Xenon Noble gas and is chemically inert Produced by fission of 235U in the reactor Shelf life is 14 days after calibration Should be handled in a proper fumehood Used for ventilation lung imaging 201 Tl Thallous Chloride Cyclotron produced Used for myocardial perfusion imaging 111 Blood is drawn – – In Labeled Leukocytes Heparin or ACD added as anticoagulant Hetastarch added to enhance sedimentation Leukocytes are separated – Sedimentation, centrifuge, washing Labeled with 111In Oxine Used for detecting infection or abscesses. 99mTc Blood is drawn – – Labeled Leukocytes Heparin or ACD added as anticoagulant Hetastarch added to enhance sedimentation Leukocytes are separated – Sedimentation, centrifuge, washing Labeled with 99mTc HMPAO (Ceretec®) Used for detecting inflammation, abscess or other infections (also Chrohn’s disease) 111In Murine monoclonal antibody Preparation: – – – Prostascint® 111InCl3 added to vial Incubate for 30 mintues Filtered to remove particulate matter Used for primary or metastatic prostate cancer. 111In Radiolabeled Peptide Preparation: – – Petetreotide (OctreoScan®) 111InCl3 added to reaction vial Incubate for 30 minutes Used for neuroendocrine tumors – Carcinoids, gastrinomas, neuroblastomas, pituitary adenomas, medullary thyroid cancer