NM 4103 Section 4 Radiopharmaceutical Characteristics

99m Tc Sodium Pertechnetate Eluted from 99 Mo generator Tested for 99 Mo and Al breakthrough Can be used for preparation of 99m Tc-labeled radipharmaceuticals (kits) or Used to image Thyroid and Meckel’s diverticulum (without mixing in a kit)

99m Tc Macroaggregated Albumin (MAA) Preparation: – Heating HSA – Wash particles Particles – Number: 1-12 million particles per mg – Shape: irregular – Size: µ m Checked for particle size Vial and syringe should be aggitated Used for lung perfusion imaging

99m Tc Phosphates (MDP, HDP) Kit Preparation: – Add 99m Tc to kit, mix Weak chelates and tend to degrade with time – Prevented with tin and antioxidants Used for bone imaging

99m Tc Sulfur Colloid Preparation: – Add acid – Heat in water bath Particles – Size: 0.1 to 1 µ m Larger particles could be trapped in the lungs Used for imaging liver/spleen, bone marrow, lymphoscintigraphy, GI bleed, and gastric emptying.

99m Tc Pentetate (DTPA) Preparation – Add 99m Tc to kit, mix Used for renal and aerosol lung imaging.

99m Tc labeled Red Blood Cells Preparation – In Vitro Method (Ultratag® kit) Draw blood, add to vial of stannous citrate/acid citrate dextrose(acd). Add sodium hypochlorite. Add ACD. Add 99m Tc and incubate. – In Vivo Method Sn 2+ injected into patient. Wait 20 minutes, then 99m Tc injected into patient Used to image GI bleed, liver hemangioma, gated blood pool (MUGA)

99m Tc Iminodiacetic Acid (IDA) DISIDA (Hepatolite®) & Mebrofenin (Choletec®) Preparation – Add 99m Tc to kit, mix Used for hepatobiliary imaging.

99m Tc Hexamethylpropylene Amine Oxime (Ceretec®) Preparation of 99m Tc HMPAO – Add 99m Tc to kit, mix Should be used within 4 hours of preparation. Used for brain imaging and labeling leukocytes

99m Tc Sestamibi (Cardiolite®) Preparation – Add 99m Tc to kit – Heat in boiling water bath for 10 minutes. Used for imaging cardiac perfusion, parathyroid adenomas and breast tumors (Miraluma®).

99m Tc Tetrofosmin (Myoview®) Preparation – Add 99m Tc to kit, mix and incubate for 15 minutes. Used for myocardial perfusion

99m Tc MAG3 Preparation: – Add 99m Tc to kit – Add filtered air (to oxidize excess Sn 2+ ) – Heat in water bath for 10 min – Cool for 15 min Light sensitive Used for imaging renal function

99m Tc Neurolite® Preparation: – 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

99m Tc DMSA Preparation: – Add 99m Tc to kit vial – Incubate for 10 minutes Light sensitive Used for renal cortical imaging

99m Tc Gluceptate Preparation: – 99m Tc 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 – 131 I and MIBG is refluxed for 72 hrs – Cooled – Passed through anion exchange column Used for imaging pheochromocytoma and for treatment of neuroblastoma

111 In DTPA Preparation: – Adding dilute DTPA to solution of 111 InCl 3 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 235 U 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 In Labeled Leukocytes Blood is drawn – Heparin or ACD added as anticoagulant – Hetastarch added to enhance sedimentation Leukocytes are separated – Sedimentation, centrifuge, washing Labeled with 111 In Oxine Used for detecting infection or abscesses.

99m Tc Labeled Leukocytes Blood is drawn – Heparin or ACD added as anticoagulant – Hetastarch added to enhance sedimentation Leukocytes are separated – Sedimentation, centrifuge, washing Labeled with 99m Tc HMPAO (Ceretec®) Used for detecting inflammation, abscess or other infections (also Chrohn’s disease)

111 In Prostascint® Murine monoclonal antibody Preparation: – 111InCl3 added to vial – Incubate for 30 mintues – Filtered to remove particulate matter Used for primary or metastatic prostate cancer.

111 In Petetreotide (OctreoScan®) Radiolabeled Peptide Preparation: – 111InCl3 added to reaction vial – Incubate for 30 minutes Used for neuroendocrine tumors – Carcinoids, gastrinomas, neuroblastomas, pituitary adenomas, medullary thyroid cancer