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Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Research Article

Does Heparin Affect 99mTc-MAA In Vitro Stability?

Author(s): Teresa Scotognella*, Valerio Lanni, Fabiana Moresi, Alessio Rizzo, Andrea Guarneri and Venanzio Valenza

Volume 15, Issue 3, 2022

Published on: 11 April, 2022

Page: [199 - 204] Pages: 6

DOI: 10.2174/1874471015666220204142608

Price: $65

Abstract

Introduction: Pulmonary embolism (PE) can be diagnosed by perfusion lung scintigraphy using human albumin macroaggregates labelled 99mTc (99mTc-MAA). When PE is suspected, subcutaneous Low Molecular Weight Heparin (LMWH) should be administered even before the results of the PE diagnostic flowchart. In our study, we aimed to evaluate a possible interaction (in vitro interference) between 99mTc-MAA and LMWH.

Methods: The reconstitution of MAA kit was performed according to the manufacturer's instruction. After labelling, we carried out the following preparations: a standard dose of 99mTc-MAA alone, as control; 99mTc-MAA and enoxaparin at different ratios. According to the manufacturer's instruction, the radiochemical purity was performed and evaluated immediately (T0), after 15 and 30 minutes after incubation (T15 and T30).

Results: We compared the radiochemical purity of 99mTc-MAA with: (i) radiochemical purity of 99mTc-MAA and enoxaparin (11 ratio), (ii) radiochemical purity of 99mTc-MAA and enoxaparin (0.5 ratio), and (iii) radiochemical purity of 99mTc-MAA and enoxaparin (ratio 2). No significant differences were found between all the measured parameters at each time point for each ratio. We also tested the stability of 99mTc-MAA in physiological conditions (at 37°C in PBS): the initial radiochemical purity of 99mTc-MAA was 99.78%. The values of 99mTc-MAA radiochemical purity were high in all conditions of possible interaction with LMWH, with values ranging from 98.00% at T0 to 95% at T30.

Conclusion: We found no statistically significant change in the in vitro stability of 99mTc-MAA in the presence of enoxaparin, excluding a possible direct interference. Future studies will be needed to check the 99mTc-MAA stability under physiological conditions.

Keywords: Heparin, 99mTc-MAA, in vitro stability, perfusion lung scintigraphy, enzymatic proteolysis, radiochemical, purity.

Graphical Abstract
[1]
Zöphel, K.; Bacher-Stier, C.; Pinkert, J.; Kropp, J. Ventilation/perfusion lung scintigraphy: what is still needed? A review considering tech-netium-99m-labeled macro-aggregates of albumin. Ann. Nucl. Med., 2009, 23(1), 1-16.
[http://dx.doi.org/10.1007/s12149-008-0187-3] [PMID: 19205833]
[2]
Saha, G.B. Fundamentals of Nuclear Pharmacy, 6th ed; Springer, 2010.
[http://dx.doi.org/10.1007/978-1-4419-5860-0]
[3]
MAASOL. Summary of Product Characteristic, GE Healthcare S.r.l. Milano. 2014. Available at: . https://ec.europa.eu/health/documents/community-register/2019/20190111143442/anx_143442_en.pdf
[4]
Parker, J.A.; Coleman, R.E.; Grady, E.; Royal, H.D.; Siegel, B.A.; Stabin, M.G.; Sostman, H.D.; Hilson, A.J. SNM practice guideline for lung scintigraphy 4.0. J. Nucl. Med. Technol., 2012, 40(1), 57-65.
[http://dx.doi.org/10.2967/jnmt.111.101386] [PMID: 22282651]
[5]
McDonagh, J.; Bolster, A.A.; Murray, T.; Milligan, M.; Hilditch, T.E. Thyroid and stomach uptake in 99mTc–MAA lung perfusion scans. NMC, 2004, 25(4), 423-424.
[http://dx.doi.org/10.1097/00006231-200404000-00110]
[6]
Ajdari, S.E.; Qutbi, M. Rapid decomposition of 99mTc–MAA complex during lung perfusion imaging. Clin. Nucl. Med., 2019, 44(8), 674-675.
[http://dx.doi.org/10.1097/RLU.0000000000002643] [PMID: 31274621]
[7]
Konstantinides, S.V.; Meyer, G.; Becattini, C.; Bueno, H.; Geersing, G.J.; Harjola, V.P.; Huisman, M.V.; Humbert, M.; Jennings, C.S.; Ji-ménez, D.; Kucher, N.; Lang, I.M.; Lankeit, M.; Lorusso, R.; Mazzolai, L.; Meneveau, N.; Ní Áinle, F.; Prandoni, P.; Pruszczyk, P.; Righini, M.; Torbicki, A.; Van Belle, E.; Zamorano, J.L. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur. Heart J., 2020, 41(4), 543-603.
[http://dx.doi.org/10.1093/eurheartj/ehz405] [PMID: 31504429]
[8]
Zolle, I. Technetium-99m Pharmaceuticals. Preparation and Quality Control in Nuclear Medicine; Springer, 2007.
[http://dx.doi.org/10.1007/978-3-540-33990-8]
[9]
Lee, R.G.L.; Hill, T.C.; Rolla, A.P.; Clouse, M.E. Thyroid activity on technetium-99m macroaggregated albumin lung scans. J. Nucl. Med., 1983, 24(8), 749-750.
[PMID: 6223991]
[10]
Campeau, R.J.; Lichtenstein, R.J.; Ward, T.L.; Alster, D.K. Incidental detection of hyperthyroidism during a perfusion lung scan for sus-pected pulmonary emboli. Clin. Nucl. Med., 1991, 16(4), 251-252.
[http://dx.doi.org/10.1097/00003072-199104000-00009] [PMID: 1646096]

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