Dacian V Bonta1, Raghuveer K Halkar, Naomi Alazraki. 1. Nuclear Medicine Service, Department of Radiology and Imaging Sciences, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, Georgia 30033, USA.
Abstract
UNLABELLED: After the extravasation of a therapeutic dose of (131)I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol. METHODS: Before therapy infusion, proper placement is verified by administering 37 MBq of (99m)Tc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity. RESULTS: No extravasation incidents have occurred since the verification procedure was instituted. CONCLUSION: To protect against radiation injury from extravasation of therapeutic radionuclides, test administration of a small (99m)Tc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.
UNLABELLED: After the extravasation of a therapeutic dose of (131)I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol. METHODS: Before therapy infusion, proper placement is verified by administering 37 MBq of (99m)Tc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity. RESULTS: No extravasation incidents have occurred since the verification procedure was instituted. CONCLUSION: To protect against radiation injury from extravasation of therapeutic radionuclides, test administration of a small (99m)Tc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.
Authors: Jason M Williams; Lori R Arlinghaus; Sudheer D Rani; Martha D Shone; Vandana G Abramson; Praveen Pendyala; A Bapsi Chakravarthy; William J Gorge; Joshua G Knowland; Ronald K Lattanze; Steven R Perrin; Charles W Scarantino; David W Townsend; Richard G Abramson; Thomas E Yankeelov Journal: Eur J Nucl Med Mol Imaging Date: 2016-08-25 Impact factor: 9.236
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