Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 643  
CASE REPORT
Year : 2017  |  Volume : 16  |  Issue : 2  |  Page : 156-159

Initial experience in the use of technetium-99 metastable hydroxymethylene diphosphonate as an alternative ventilation agent during periods of interim shortage


Walter Reed National Military Medical Center, Bethesda, MD, USA

Correspondence Address:
Colin Raymond Young
Department of Radiology, Walter Reed National Military Medical Center, 8901 Rockville Pike Bethesda, MD
USA
Login to access the Email id


DOI: 10.4103/1450-1147.203063

PMID: 28553184

Rights and Permissions

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. Disclaimers: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government. The identification of specific products or scientific instrumentation does not constitute endorsement or implied endorsement on the part of the author, DoD, or any component agency. While we generally excise references to products, companies, manufacturers, organizations, etc. in government produced works, the abstracts produced and other similarly situated researcher presents a special circumstance when such product inclusions become an integral part of the scientific endeavor. Copyright Statement: The first author is a military service member. This work was prepared as part of the authors official duties. Title 17 U.S.C 105 provides that 'Copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. 101 defines a U.S. Government work as a work prepared by a member or employee of the U.S. Government as a part of that person's official duties.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1055    
    Printed25    
    Emailed0    
    PDF Downloaded87    
    Comments [Add]    
    Cited by others 2    

Recommend this journal