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Assessment of Residual [99mTc]Tc-Tetrofosmin Activity in Routine Nuclear Medicine Practice at Hospital Kuala Lumpur

Fong RY, Jaffar NM, Chung RJL, Tong HL, Aminudin S, Lau KW

J Nucl Med Technol, 2025 Mar 05;53(1):57-62.
PMID: 39909580 DOI: 10.2967/jnmt.124.268886

Myocardial perfusion imaging using the radiopharmaceutical [99mTc]Tc-tetrofosmin plays a crucial role in diagnosing cardiac conditions. However, variations in the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration may impact imaging quality and patient safety. This study aimed to evaluate the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration during routine nuclear medicine procedures at Hospital Kuala Lumpur, assessing compliance with department protocols and variability among different syringe brands. Methods: A single-center prospective observational study was conducted using stratified quota sampling, encompassing 396 samples across 3 syringe brands (SJ, BD, and Ciringe). Residual activity was measured immediately after administration, and statistical analysis was performed to compare brands and assess compliance with the department dosage protocol range of 333-555 MBq. Results: All injected activities aligned with the department protocol dose, with a mean effective activity of 451.23 ± 30.73 MBq and a mean residual activity of 12.63% ± 4.73%. However, variability in residual activity was observed among syringe brands. BD exhibited the highest mean residual activity (16.45%), significantly differing from SJ (9.95%) and Ciringe (11.50%) (P < 0.001). Conclusion: Rigorous syringe selection is crucial in myocardial perfusion imaging procedures to minimize residual activity and ensure compliance with dosimetry standards, emphasizing the importance of integrating pharmacy practices into nuclear medicine protocols. Standardized protocols and quality assurance measures are essential to optimize imaging outcomes and prioritize patient safety. These findings highlight the importance of ongoing monitoring and interdisciplinary collaboration to navigate residual activity management effectively in routine nuclear medicine practice.

Matched MeSH terms: Organotechnetium Compounds*
Fulltext Caroli's disease: functional diagnosis using 99mTc diethyl-iminodiacetic acid (IDA) hepatobiliary scintigraphy

Lai FM, Paramsothy M, Goh KL, Boey C

Singapore Med J, 1997 Apr;38(4):164-5.
PMID: 9269396

A case of Caroli's disease is presented and the findings of various imaging modalities are discussed with emphasis on the role of Technetium 99mTc diethyl-iminodiacetic acid scan in reaching the final diagnosis. The 'beaded' appearance of the dilated intrahepatic ducts seen in this scan is believed to be pathognomonic for this condition.

Matched MeSH terms: Organotechnetium Compounds*
Fulltext The role of 99mtechnetium (Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in the diagnosis of a rare cause of obstructive jaundice

Lai FM, Paramsothy M, George J, Yip CH

Singapore Med J, 1996 Jun;37(3):261-3.
PMID: 8942223

This paper illustrates the role of 99m-Technetium(Tc) diethyl-iminodiacetic acid (EHIDA) hepatobiliary scintigraphy in a patient who developed obstructive jaundice as a result of afferent loop syndrome, which is a rare occurrence. The computed tomographic (CT) and ultrasonographic findings are also described.

Matched MeSH terms: Organotechnetium Compounds*
Diagnostic Evaluation of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography in the Differential Diagnosis of Parkinsonism in Hospital Kuala Lumpur: A preliminary experience

Kamarulzaman K, Abd Razak N, Mawardi AS, Amir Hassan SZ

Med J Malaysia, 2024 Nov;79(6):690-702.
PMID: 39614786

INTRODUCTION: Parkinsonian syndrome encompasses a group of movement disorders characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While Idiopathic Parkinson's disease is the most common cause, several other etiologies can also result in parkinsonism. Identifying the specific type of Parkinsonian syndrome is essential due to its varying therapeutic and prognostic implications. This study aims to evaluate the role of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography (Tc-99m TRODAT-1 SPECT-CT) in patients with parkinsonism.
MATERIALS AND METHODS: The clinical data and scintigraphy findings of patients referred to the Department of Nuclear Medicine, Hospital Kuala Lumpur for Tc-99m TRODAT-1 SPECT-CT from July 2022 to July 2023 were retrospectively reviewed. Follow-up with primary team was conducted to determine the clinical implications and subsequent therapeutic management of the patients.
RESULTS: Tc-99m TRODAT-1 SPECT-CT was performed on sixteen patients (10 females and 6 males) with a mean age of 55.2 years (range 26 to 75 years). Five patients exhibited normal scintigraphy findings, while eleven patients showed abnormal Tc-99m TRODAT-1 SPECT-CT results. The scintigraphy findings led to changes in therapeutic management for 81.3% of the patients. Additionally, 19% of the patients were referred for further evaluation with Fluorine-18 fluorodeoxyglucose PET to assist in diagnosing atypical Parkinsonian disease.
CONCLUSIONS: Tc-99m TRODAT-1 SPECT-CT is a readily available tool for assessing presynaptic dopamine transporters in patients with parkinsonism. This study demonstrated that Tc-99m TRODAT-1 SPECT-CT significantly impacts the diagnostic and therapeutic outcomes for patients with parkinsonism.

Matched MeSH terms: Organotechnetium Compounds
Laparoscopic Management of Dialysate Leakage Secondary to Necrotic Peritoneum

Huang CK, Wang HH, Nor Hanipah Z

J Laparoendosc Adv Surg Tech A, 2016 Nov;26(11):921-924.
PMID: 27560500

Peritoneal dialysate leakage is a well-known complication of continuous ambulatory peritoneal dialysis (CAPD). In late leakage, it is usually managed conservatively and subsequently converted to hemodialysis. We hereby report a case of peritoneal dialysate leakage secondary to necrotic peritoneum, which was managed by laparoscopic excision of the affected peritoneum. Regeneration of new peritoneum was documented and the patient could resume CAPD successfully.

Matched MeSH terms: Organotechnetium Compounds