“Technetium (99mTc) albumin aggregated”的意思、由来-开放百科全书

Kits for preparing ^99mTc-MAA are available in the United States from only a single manufacturer; Jubilant DraxImage. The kits are delivered to nuclear pharmacies as lyophilized powders of non-radioactive ingredients sealed under nitrogen. A nuclear pharmacist adds anywhere from 50 - 100 mCi of Na[^99mTcO₄] to the reaction vial to make the final product, in the pH range of 3.8 to 8.0. After being allowed to react at room temperature for 15 minutes to ensure maximum labeling of the human albumin with ^99mTc, the kit can then be diluted with sterile normal saline as needed.

Quality control

No less than 90% of MAA particles can be between 10 - 90 micrometres in size and no particles may exceed 150 micrometres due to the risk of pulmonary artery blockade.^[3]^[4]

No less than 90% of the radioactivity present in the product must be tagged to albumin particles. Thus, no more than 10% soluble impurities may be present.^[5]

Dosage and imaging

The typical adult dose for a lung imaging study is 40-150 Megabecquerels (1-4 mCi) (containing between 100,000 - 200,000 albumin particles).^[6]^[7] The particle burden should be lowered for most pediatric patients and lowered to 50,000 for infants.^[8] The use of more than 250,000 particles in a dose is controversial as little extra data is acquired from such scans while there is an increased risk of toxicity.^[9]^[10] Patients with pulmonary hypertension should be administered a minimum number of particles to achieve a lung scan (i.e. 60,000). In any patient by administering a greater quantity of particles than necessary for the diagnostic procedure increases the risks of toxicity.

Because of gravity effects, patients administered ^99mTc MAA should be in the supine position to ensure as even a distribution of particles throughout the lungs as possible.

The total percentage of particles trapped in the lungs can be determined through a whole body scan after the administration of ^99mTc MAA through the equation:

References

1. ^{{cite journal|last1=MacDonald|first1=A.|last2=Burrell|first2=S.|title=Infrequently Performed Studies in Nuclear Medicine: Part 1|journal=Journal of Nuclear Medicine Technology|date=14 August 2008|volume=36|issue=3|pages=132–143|doi=10.2967/jnmt.108.051383|pmid=18703616}}
2. ^{{cite journal|last1=Gandhi|first1=SunnyJ|last2=Babu|first2=Sanjay|last3=Subramanyam|first3=Padma|last4=Sundaram|first4=PalaniswamyShanmuga|title=Tc-99m macro aggregated albumin scintigraphy - indications other than pulmonary embolism: A pictorial essay|journal=Indian Journal of Nuclear Medicine|date=2013|volume=28|issue=3|pages=152–62|doi=10.4103/0972-3919.119546|pmc=3822414|pmid=24250023}}
3. ^¹{{cite book|last1=Saha|first1=Gopal B.|title=Fundamentals of nuclear pharmacy|pages=143–167|date=1992|publisher=Springer-Verlag|location=New York|isbn=978-1-4757-4027-1|edition=3rd|chapter=Quality Control of Radiopharmaceuticals|doi=10.1007/978-1-4757-4027-1_8}}
4. ^{{cite journal|last1=Fukuoka|first1=Masamichi|last2=Kobayashi|first2=Tetsu|last3=Satoh|first3=Takemichi|last4=Tanaka|first4=Akira|last5=Akiko|first5=Kubodera|title=Studies of quality control of 99mTc-labelled macroaggregated albumin—Part 1. Aggregation of non-mercaptalbumin and its conformation|journal=Nuclear Medicine and Biology|date=July 1993|volume=20|issue=5|pages=643–648|doi=10.1016/0969-8051(93)90034-R|pmid=8358350}}
5. ^{{cite book|title=British Pharmacopoeia|isbn=9780113230204|edition=Ph. Eur. 9.0|chapter-url=https://www.pharmacopoeia.com/bp-2017/radiopharmaceutical/technetium--99mtc--albumin-injection.html?date=2017-01-01|chapter=Technetium (99mTc) Albumin Injection|author=British Pharmacopoeia Commission|year=2016}}
6. ^{{cite journal|last1=Bajc|first1=M.|last2=Neilly|first2=J. B.|last3=Miniati|first3=M.|last4=Schuemichen|first4=C.|last5=Meignan|first5=M.|last6=Jonson|first6=B.|title=EANM guidelines for ventilation/perfusion scintigraphy|journal=European Journal of Nuclear Medicine and Molecular Imaging|date=27 June 2009|volume=36|issue=8|pages=1356–1370|doi=10.1007/s00259-009-1170-5|pmid=19562336}}
7. ^{{cite journal|last1=Parker|first1=J. A.|last2=Coleman|first2=R. E.|last3=Grady|first3=E.|last4=Royal|first4=H. D.|last5=Siegel|first5=B. A.|last6=Stabin|first6=M. G.|last7=Sostman|first7=H. D.|last8=Hilson|first8=A. J. W.|title=SNM Practice Guideline for Lung Scintigraphy 4.0|journal=Journal of Nuclear Medicine Technology|date=26 January 2012|volume=40|issue=1|pages=57–65|doi=10.2967/jnmt.111.101386|pmid=22282651}}
8. ^{{cite book|last1=Zolle|first1=Ilse|title=Technetium-99m pharmaceuticals|date=2007|publisher=Springer|location=Berlin|isbn=978-3-540-33989-2|page=187|edition=1st|chapter=Monographs of 99mTc Pharmaceuticals}}
9. ^{{cite journal|last1=Dworkin|first1=HJ|last2=Gutkowski|first2=RF|last3=Porter|first3=W|last4=Potter|first4=M|title=Effect of particle number on lung perfusion images: concise communication.|journal=Journal of Nuclear Medicine |date=March 1977|volume=18|issue=3|pages=260–2|pmid=839273|url=http://jnm.snmjournals.org/content/18/3/260.long}}
10. ^{{cite journal|last1=Kaplan|first1=W D|last2=Come|first2=S E|last3=Takvorian|first3=R W|last4=Laffin|first4=S M|last5=Gelman|first5=R S|last6=Weiss|first6=G R|last7=Garnick|first7=M B|title=Pulmonary uptake of technetium 99m macroaggregated albumin: a predictor of gastrointestinal toxicity during hepatic artery perfusion.|journal=Journal of Clinical Oncology|date=November 1984|volume=2|issue=11|pages=1266–1269|doi=10.1200/JCO.1984.2.11.1266|pmid=6491704}}

Preparation

Quality control

Dosage and imaging

References

Further reading