A comparison of parameters of kits for 99mTc-radiopharmaceuticals for a cerebral perfusion diagnostics


Authors: Jiří Štěpán
Authors‘ workplace: Klinika nukleární medicíny FN Brno a LF MU Brno
Published in: NuklMed 2013;2:7-12
Category: Original Article

Overview

Introduction:
[99mTc]technetium-exametazime was the first neutral lipophilic technetium compound able to pass through the blood–brain barrier. [99mTc]technetium-bicisate is another such a complex used in a clinical practice. Both radiopharmaceuticals are prepared by labeling of cold kits of various manufacturers, which differ by their parameters compared in this work.

Methods:
A comparison of kits parameters mentioned in summaries of product characteristics (SPC), a determination of a radiochemical purity (RCP), a medical consultation of an imaging capability.

Results:
Parameters of kits for [99mTc]technetium-exametazime: BRAIN-SPECT KIT, NEUROSCAN, STABILISED CERETEC, and [99mTc]technetium-bicisate: NEUROLITE are mentioned respectively: a volume of a preparation: 5 ml, 5 ml, 7 ml, 4 ml; a maximum activity: 2.22 GBq, 1 GBq, 1.11 GBq, 3.7 GBq; a possibility of a dilution: yes, yes, yes, no; a volume of a vial: 9 ml, 10 ml, 11 ml, 5 ml; a kit stability before and after the labelling: 1 y / 1 h, 1 y / 0.5 h, 1 y / 5 h, 1.5 y / 8 h; obtained RCP / a percentage content of a free pertechnetate: 87.8 ± 0.6 / 5.9 ± 1.4, 86.6 ± 2.8 / 4.0 ± 2.7, 91.6 ± 0.9 / 1.9 ± 0.4, 97.2 ± 0.7 / not determined; comparable imaging capabilities; similar approved indications.

Conclusion:
Main [99mTc]-bicisate (NEUROLITE) advantages against [99mTc]-exametazime (other kits) are the best stability, even not reached by STABILISED CERETEC, and a use of an [99mTc]eluate without any special restrictions. Nevertheless it isn't suitable for a leucocyte labelling. Among kits for [99mTc]-exametazim STABILISED CERETEC is characterized by its longer stability and BRAIN-SPECT KIT by the highest activity. A use of kits with the long stability (NEUROLITE, STABILISED CERETEC) reaching the highest RCP is advantageous by reason of the highest relative bioavailability for a brain.

Key words:
[99mTc]technetium-exametazime, [99mTc]technetium-bicisate, d,l-hexamethylpropylene amine oxime (HMPAO), L,L-ethyl cysteinate dimer (ECD), radiochemical purity, free pertechnetate


Sources

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Labels
Nuclear medicine Radiodiagnostics Radiotherapy
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