Impact of disposable syringes type choice on myocardial perfusion imaging procedures with [99mTc]Tc-tetrofosmin

6 October 2022

T. Ladriere1,2 , C. Desmonts 1, 3, P.-A. Zimmermann 1, D. Peyronnet 1, 2, D. Agostini 1, 4, J. Vigne 1, 2, 5 1 Department of Nuclear Medicine, CHU de Caen Normandie, Normandy University, UNICAEN, 14000 Caen, France.
2 Department of Pharmacy, CHU de Caen Normandie, Normandy University, UNICAEN, 14000 Caen, France.
3 Normandie Université, UNICAEN, INSERM U1086, INSERM ANTICIPE, Caen 14000, France
4 Normandie Université, UNICAEN, UR 4650, Caen 14000, France
5 Normandie Université, UNICAEN, INSERM U1237, PhIND, Institut Blood and Brain @ Caen Normandie, Centre Cyceron, Caen 14000, France.

Background
Residual activity in dispensing syringes is a problem that has been sporadically reported with various radiopharmaceuticals. Studies with [99mTc]Tc-tetrofosmin are non-consistent so far. The aim was to quantify the residual activity of [99mTc]Tc-tetrofosmin in different syringes in a clinical setting and to assess its impact on the clinical imaging procedure.

Methods
The residual activity of [99mTc]Tc-tetrofosmin was measured in 3 types of syringes: 3-parts lubricated and non-lubricated syringes and 2-parts syringe (n ≥ 30 for each syringe). The residual activity was located and quantified using a CzT SPECT camera and radiocounting then was correlated with different clinical parameters and processed by multiple linear regression analysis.

Results
Residual activity was different in all syringe types but lubricated syringes showed significantly higher levels with a mean ± SD of 26.12 ± 10.21% (p<0.001). For these syringes, the residual activity was mainly located on the lubricated body. They also have a positive and significant impact on the standardized counting duration of patients acquisitions.

Conclusion
Lubricated syringes with high residual activity should be avoided as they increase the risk of prolonging patient acquisition time and potentially increasing the risk of poor image quality.

Keywords: Myocardial perfusion imaging ; tetrofosmin ; radiopharmaceuticals ; syringes ; adsorption

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