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Unintentional human skeletal imaging with 99mTc-methylene diphosphonate 45 months beyond expiration
1Instituto Nacional del Cancer, Asuncion, Paraguay. eduardo_galiano@hotmail.com
Abstract:
Eight patients were inadvertently administered, and imaged with, 99mTc-labeled MDP which was 45 months expired. Two cases are presented. All patients were subsequently imaged with normal MDP. The images obtained with expired MDP were clinically acceptable. No differences in scan abnormalities were observed compared with normal MDP for any of the patients. None of the patients suffered any side effects attributable to the expired MDP.
Insights
Expired technetium-99m labeled methylene diphosphonate (MDP) was inadvertently administered to eight patients for bone imaging. The expired radiopharmaceutical yielded clinically acceptable images with no observed differences in scan abnormalities or patient side effects.
Area of Science:
- Nuclear Medicine
- Radiopharmacy
- Diagnostic Imaging
Background:
- Technetium-99m labeled methylene diphosphonate (MDP) is a widely used radiotracer for bone scintigraphy.
- Radiopharmaceutical expiration dates are critical for ensuring optimal imaging performance and patient safety.
- Inadvertent administration of expired agents can occur, necessitating evaluation of their clinical utility.
Observation:
- Eight patients were inadvertently administered 99mTc-MDP that was 45 months past its expiration date.
- Bone imaging was performed using the expired 99mTc-MDP.
- All patients subsequently underwent imaging with freshly prepared MDP for comparison.
Findings:
- Images acquired with the expired 99mTc-MDP were clinically acceptable.
- No discernible differences in scan abnormalities were noted between images obtained with expired and normal MDP.
- No adverse events or side effects were attributed to the administration of the expired radiopharmaceutical.
Implications:
- Expired 99mTc-MDP may retain diagnostic utility for bone scintigraphy under certain circumstances.
- This finding suggests a potential for extended usability of 99mTc-MDP beyond its labeled shelf-life, warranting further investigation.
- Clinical decisions should consider the potential for acceptable imaging quality even with expired radiotracers, balancing resource availability with diagnostic needs.