Extravasation of a therapeutic dose of 131I-metaiodobenzylguanidine: prevention, dosimetry, and mitigation.

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.

• Authors: Dacian V Bonta, Raghuveer K Halkar, Naomi Alazraki
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 52 Issue 9 Pg. 1418-22 (Sep 2011) ISSN: 1535-5667 [Electronic] United States
• PMID: 21795365 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• 3-Iodobenzylguanidine
• Sodium Pertechnetate Tc 99m

Topics

• 3-Iodobenzylguanidine (administration & dosage, adverse effects, therapeutic use)
• Algorithms
• Beta Particles
• Dermis (blood supply)
• Extravasation of Diagnostic and Therapeutic Materials
• Infusions, Intravenous
• Models, Theoretical
• Photons
• Radiometry (methods)
• Radiopharmaceuticals (administration & dosage, adverse effects, therapeutic use)
• Regional Blood Flow (physiology)
• Skin (blood supply, radiation effects)
• Sodium Pertechnetate Tc 99m (adverse effects)