title: Retention of 99mTc-DMSA(III) and 99mTc-nanocolloid in different syringes affects imaging quality.
abstract: (99m)Tc-dimercaptosuccinic acid [DMSA(III)] and colloidal human serum albumin ((99m)Tc-nanocolloid) are widely used radiopharmaceuticals. Recently, in our institution we encountered image quality problems in DMSA scans after changing the brand of syringes we were using, which triggered us to look into the adsorption properties of syringes from different brands for (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid. We also describe a clinical case in which adsorption of (99m)Tc-DMSA(III) caused inferior imaging quality. DMSA and nanocolloid were labeled with (99m)Tc following manufacturer guidelines. After synthesis, syringes with (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid were stored for 15, 30, 60, and 120 min. We evaluated Luer Lock syringes manufactured by different brands such as Artsana, Henke-Sass-Wolf, B. Braun Medical N.V., CODAN Medizinische Geräte GmbH & Co KG, Becton Dickinson and Company, and Terumo Europe. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid was acceptably low for all syringes (<13%), except for two brands with (99m)Tc-DMSA(III) adsorption rates of 36 and 30%, respectively, and for one brand with a (99m)Tc-nanocolloid adsorption rate of 27%. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid reaches critical levels in syringes produced by two brands, potentially causing poor image quality--for example, in DMSA scans using pediatric radiopharmaceutical doses. It is advised to check the compatibility of any radiopharmaceutical with syringes as an integral part of the quality assurance program.
authors.affiliation: aDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+ bNUTRIM, Maastricht University, Maastricht, The Netherlands cDepartment of Nuclear Medicine, UniKlinikum RWTH Aachen, Aachen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bauwens
authors.forename: Ivo
authors.initials: I
authors.lastname: Pooters
authors.forename: Jochen
authors.initials: J
authors.lastname: van der Pol
authors.forename: Felix M
authors.initials: FM
authors.lastname: Mottaghy
authors.forename: Marinus
authors.initials: M
authors.lastname: van Kroonenburgh
mesh_terms: D000327:Adsorption; D016477:Artifacts; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D013594:Syringes; D013668:Technetium Tc 99m Aggregated Albumin / Q000737:chemistry*; D019783:Technetium Tc 99m Dimercaptosuccinic Acid / Q000737:chemistry*
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid; D019783:Technetium Tc 99m Dimercaptosuccinic Acid