scholarly journals Detection of Excess Presence of 99mTc-MDP Near Injection Site—A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
James R. Crowley ◽  
Iryna Barvi ◽  
Debbie Greulich ◽  
Jackson W. Kiser
Keyword(s):  
Nuclear Medicine ◽  
Case Report ◽  
Radiation Dose ◽  
Injection Site ◽  
Patient Management ◽  
Image Interpretation ◽  
Poor Quality ◽  
Venous Stasis ◽  
Injection Process ◽  
Uptake Process

Nuclear medicine extravasations and prolonged venous stasis may cause poor quality and quantification errors that can affect image interpretation and patient management. Radiopharmaceutical remaining near the administration site means that some portion of the radioactivity is not circulating as required for the prescribed uptake period. This case describes how detection of excess presence of 99mTc-MDP near the injection site enabled the technologist to apply mitigation tactics early in the uptake process. It also suggests that detecting an extravasation or stasis early in the injection process can be important for image interpretation and minimizing radiation dose to tissue.

Radioactive Excretion in Human Milk Following Administration of Technetium Tc 99m Macroaggregated Albumin

PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 231-234
Author(s):  
W. B. Pittard ◽  
R. Merkatz ◽  
B. D. Fletcher
Keyword(s):  
Nuclear Medicine ◽  
Breast Milk ◽  
Human Serum Albumin ◽  
Radiation Dose ◽  
Human Milk ◽  
Radiation Hazard ◽  
Base Line ◽  
Pulmonary Emboli ◽  
Lung Scan ◽  
Total Body

Albumin-tagged sodium pertechnetate (technetium) is routinely used in nuclear medicine for scanning procedures of the lung. The rate of excretion of this radionuclide into breast milk and the resultant potential radiation hazard to the nursing infant have received little attention. Therefore the milk from a nursing mother who required a lung scan because of suspected pulmonary emboli using an intravenous injection of 4 mCi of technetium Tc 99 macroaggregated human serum albumin was monitored. Albumin tagging severely limited the entrance of technetium into her milk and the radio-activity of the milk returned to base line by 24 hours. A total of 2.02 µCi of technetium was measured in the 24-hour milk collection after technetium injection and 94% of this amount was excreted by 15.5 hours. This amount of technetium administered orally to a newborn would deliver a total body radiation dose of .3 mrad. Therefore, an infant would receive trivial doses of radiation if breast-feeding were resumed 15.5 hours after administration of the radionuclide to the mother and nursing can clearly be resumed safely 24 hours after injection.

scholarly journals Is nuclear medicine really safe?

2002 ◽  
Vol 45 (spe) ◽  
pp. 115-118
Author(s):  
Nicole Colas-Linhart
Keyword(s):  
Nuclear Medicine ◽  
Human Serum Albumin ◽  
Radiation Dose ◽  
Serum Albumin ◽  
Human Serum ◽  
Absorbed Dose ◽  
Cellular Level ◽  
Whole Body ◽  
Absorbed Doses ◽  
Standard Models

In nuclear medicine, radiation absorbed dose estimates calculated by standard models at the whole body or organ are very low. At cellular level, however, the heterogeneity of radionuclide distributions of radiation dose patterns may be significant. We present here absorbed doses at cellular level and evaluate their possible impact on the usually assumed risk/benefit relationships in nuclear medicine studies. The absorbed dose values calculated are surprisingly high, and are difficult to interpret. In the present study, we show calculated doses at the cellular level and discuss possible biological consequences, for two radiopharmaceuticals labelled with technetium-99m: human serum albumin microspheres used for pulmonary scintigrapies and HMPAO used to labelled leukocytes.

scholarly journals Management of tubal ectopic pregnancy with methotrexate in the setting of symptomatic Coronavirus disease 2019 (COVID-19): A case report

2021 ◽  
Vol 13 (3) ◽  
pp. 277-281
Author(s):  
N.M. Millan ◽  
J Morano ◽  
L Florez ◽  
J Carugno ◽  
C.A. Medina
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Supportive Care ◽  
Medical Management ◽  
Patient Management ◽  
Therapeutic Option ◽  
Careful Consideration ◽  
Management Options ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies

Background: Coronavirus Disease 2019 (COVID-19) represents a complex therapeutic challenge. As the pandemic progresses, patients are presenting with ectopic pregnancies (EPs) and symptomatic COVID-19. Objective: We present the management of a patient with multiple medical comorbidities and tubal EP in the setting of severe symptomatic COVID-19 infection where all management options were precluded. Methods: Case report with literature review of management of tubal EP in the setting of severe symptomatic COVID-19 infection. Result: After careful consideration of options, the patient underwent successful medical management with methotrexate while receiving supportive care for COVID-19. Conclusions: Methotrexate proved to be the safest therapeutic option in this patient. Management of patients with severe COVID-19 and gynaecologic emergencies should be individualised and carefully reviewed with evolving knowledge of COVID-19.

scholarly journals Patient radiation dose assessment system for diagnostic nuclear medicine procedures: Implementation and first results

2020 ◽  
Vol 35 (4) ◽  
pp. 380-385
Author(s):  
Dea Dundara-Debeljuh ◽  
Slaven Jurkovic ◽  
Ivan Pribanic ◽  
Neva Girotto ◽  
Svjetlana Grbac-Ivankovic ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Radiation Dose ◽  
Radiation Risk ◽  
Assessment System ◽  
Dose Assessment ◽  
Medical Documentation ◽  
Diagnostic Nuclear Medicine ◽  
Nuclear Medicine Procedures ◽  
Radiation Dose Assessment ◽  
Patient Radiation Dose

Dose assessment of diagnostic nuclear medicine procedures is necessary to further optimize respective procedure, estimate radiation risk, improve radiation safety and verify compliance of local practice with guidelines. In line with Council Directive 2013/59/EURATOM, patient medical documentation should include information related to radiation exposure. The aim of this work is to present the patient radiation dose assessment system designed for routine clinical use, that uses in-house designed worksheets for dose calculation based on relevant parameters introduced by the ICRP publications. Dose reports provide information about the absorbed dose delivered to the target and non-target organs of interest and the effective dose for each diagnostic procedure. The data from the dose reports was used to investigate average patient exposure levels during a one-year period and the results are presented. The implemented system has improved the quality of services provided and understanding of radiation risks. Moreover, the presented results have stimulated further optimization of nuclear medicine processes.

scholarly journals (Radio)Theranostic Patient Management in Oncology Exemplified by Neuroendocrine Neoplasms, Prostate Cancer, and Breast Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 39
Author(s):  
Irina Velikyan
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Nuclear Medicine ◽  
Personalized Medicine ◽  
Patient Management ◽  
Neuroendocrine Neoplasms ◽  
Medicine Development ◽  
Oncological Patients

The role of nuclear medicine in the management of oncological patients has expanded during last two decades. The number of radiopharmaceuticals contributing to the realization of theranostics/radiotheranostics in the context of personalized medicine is increasing. This review is focused on the examples of targeted (radio)pharmaceuticals for the imaging and therapy of neuroendocrine neoplasms (NENs), prostate cancer, and breast cancer. These examples strongly demonstrate the tendency of nuclear medicine development towards personalized medicine.

scholarly journals Central retinal artery and vein occlusion as a complication of persistent hyaloid artery – a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mirjana Bjeloš ◽  
Ana Križanović ◽  
Mladen Bušić ◽  
Biljana Kuzmanović Elabjer
Keyword(s):  
Case Report ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Neovascular Glaucoma ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Venous Stasis ◽  
Vein Occlusion ◽  
Arterial Inflow ◽  
Retinal Artery

Abstract Background In this case report, we present for the first time central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of persistent hyaloid artery (PHA). Case presentation In August 2019, a six-year-old male patient manifested right eye (RE) excessive tearing, conjunctival injection and pain. On examination, RE demonstrated light perception and intraocular pressure of 36 mmHg. The diagnoses of neovascular glaucoma, CRVO and CRAO were established as affirmed with fluorescein angiography (FA). PHA was not reported. Extensive work-up and family history were unremarkable. The child was born on term after uncomplicated twin pregnancy. In December 2019, he was referred to our Centre. Transillumination revealed fully dilated, non-reactive RE pupil, clear lens and tubular remnant of HA containing blood cells in its lumen freely rotating in the anterior vitreous. Conclusions PHA results from failure of apoptosis during gestation. It can easily be observed during the red reflex screening at neonatal wards. We hypothesized that PHA twisting led to torsion of the residual primordial common bulb, branching off to HA and CRA with CRAO occurring first. The consequential CRVO presumably advanced by venous stasis due to decrease in arterial inflow. Liquid vitreous appears as early as 4 years of age enabling PHA to whirl more freely. Thus, in case of PHA, we advocate FA to be performed and if connection with retinal artery is proven, parents should be informed on the possible devastating complications and prompt surgical treatment should be considered.

Dosimetrie bei Anwendung von 131I bei benignen Schilddrüsenerkrankungen: DIN 6861-1

Radiopraxis ◽  
2018 ◽  
Vol 11 (04) ◽  
pp. E30-E40
Author(s):  
Heribert Hänscheid ◽  
Frederik A. Verburg
Keyword(s):  
Nuclear Medicine ◽  
Radiation Dose ◽  
European Association ◽  
Internal Radiation ◽  
Medical Internal Radiation Dose

Bei der Behandlung benigner Schilddrüsenerkrankungen mit 131I ist eine prätherapeutische Dosimetrie zur Bemessung der Therapieaktivität und eine Abschätzung der therapeutisch verabreichten Energiedosis in Deutschland gesetzlich vorgeschrieben. Zur Durchführung der Dosimetrie existieren Handlungsempfehlungen der Deutschen Gesellschaft für Nuklearmedizin und der European Association of Nuclear Medicine. Um Methodik und Verfahrensablauf der Dosisbestimmungen national weiter zu harmonisieren, wird aktuell die Norm DIN 6861 – 1 erstellt. Die DIN 6861 – 1 übernimmt viele Empfehlungen der Leitlinien als Forderungen und führt bei den Berechnungen zu vergleichbaren Ergebnissen. Im Detail finden sich aber auch Unterschiede, z. B. wird bei den Berechnungen die Abhängigkeit der absorbierten Energiedosis von der Größe des therapierten Volumens explizit berücksichtigt. Beim Formalismus verlässt die DIN 6861 – 1 die tradierten Schreibweisen und verwendet die international zunehmend als Standard für die Dosimetrie bei innerer Exposition akzeptierte Nomenklatur des Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Dem Nutzer wird durch die neue DIN-Norm zudem eine vollständige Liste der für eine nachvollziehbare Dosimetrie notwendigen Dokumentation an die Hand gegeben.

scholarly journals Case report: Chlorpromazine and deep venous thrombosis

2019 ◽  
Vol 11 (2) ◽  
pp. 16-19 ◽  
Author(s):  
Matthew Joseph Reed ◽  
Sean Comeau ◽  
Todd R. Wojtanowicz ◽  
Bharat Reddy Sampathi ◽  
Sofia Penev ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Providers ◽  
Case Reports ◽  
Manic Episode ◽  
Venous Stasis ◽  
Poor Sleep ◽  
Care Providers ◽  
Content Type ◽  
Difficulty Breathing ◽  
Typical Antipsychotics

Purpose Since the development of antipsychotic drugs in the 1950s, a variety of studies and case reports have been published that suggest an association between exposure to typical antipsychotics and venous thromboembolisms (VTE). Therefore, when starting treatment with antipsychotics, especially low-potency typical antipsychotics and clozapine, health-care providers must account for the patient’s existing VTE risk factors. Design/methodology/approach In this case report, the authors describe the development of a pulmonary embolism associated with use of chlorpromazine in the treatment of an acute manic episode in a 51-year-old female patient with bipolar disorder type 1. Findings The patient was brought to the emergency room by the police on a legal hold for bizarre behaviors at a bus stop, which included incessantly yelling at bystanders. The patient was found to have disorganized thoughts, poor sleep, rapid speech, labile mood, distractibility, auditory hallucinations and grandiose delusions. During the course of her stay, the patient received extensive IM chlorpromazine for extreme agitation, in addition to chlorpromazine 200 mg IM Q8H, which was later decreased to chlorpromazine 100 mg chlorpromazine IM/PO Q8H. On day 4 of the treatment, the patient experienced difficulty breathing, hypoxia and tachycardia and was found to have bilateral expiratory wheezes. CT angiography showed sub-segmental pulmonary embolus and the patient was transferred to MICU service. The patient was then intubated and started on heparin by the medical team. Over the course of the next day, her respiratory distress resolved and the patient was extubated. Originality/value It is possible that chlorpromazine may indeed increase VTEs, and there are various physiological postulations regarding the mechanism of action. However, multiple confounding variables existed in the authors’ report, including venous stasis and the use of restraints, tobacco and valproic acid. Each of these variables has been shown to increase VTE occurrence. Further controlled studies are necessary to identify the true relationship between antipsychotics and VTEs.

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