title: Subcutaneous Extravasation of Sr-89: Usefulness of Bremsstrahlung Imaging in Confirming Sr-89 Extravasation and in the Decision Making for the Choice of Treatment Strategies for Local Radiation Injuries Caused by Sr-89 Extravasation.
abstract: A male patient in his 20s presented at our clinic with pain caused by bone metastases of the primitive neuroectodermal tumor, and Sr-89 was administrated to palliate the pain. After receiving the injection, the patient complained of a slight burning pain at the catheterized area. Slight reddening and small circular swelling (diameter, 0.5 cm) were observed at the catheterized area. Sr-89 extravasation was suspected. To estimate the amount of subcutaneous Sr-89 leakage, bremsstrahlung imaging was immediately performed. We speculated that the skin-absorbed dose from subcutaneous infiltration of Sr-89 was 1.78 Gy. The mildest clinical sign of local radiation injury was erythema. The received dose was higher than 3 Gy, and the time of onset was from 2 to 3 weeks. In our patient, local radiation injuries (LRIs) did not occur. Though requiring further verification, subsequent bremsstrahlung imaging and estimation of the skin-absorbed dose from the subcutaneous infiltration of Sr-89 are useful in confirming Sr-89 extravasation and in the decision making for the choice of treatment strategies for LRIs caused by Sr-89 extravasation.
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University.
authors.forename: Joji
authors.initials: J
authors.lastname: Kawabe
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Higashiyama
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University.
authors.forename: Kohei
authors.initials: K
authors.lastname: Kotani
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsushima
authors.affiliation: Department of Radiology, Osaka City University Hospital.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaga
authors.affiliation: Department of Dermatology, Graduate School of Medicine, Osaka City University.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsuruta
authors.affiliation: Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University.
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
keywords: Bremsstrahlung imaging; Extravasation; Local radiation injury; Sr-89