Extravasation of a Therapeutic Dose of I-131-Metaiodobenzylguanidine: Prevention, Dosimetry, and Mitigation

作者：Bonta Dacian V^*; Halkar Raghuveer K; Alazraki Naomi

来源：Journal of Nuclear Medicine, 2011, 52(9): 1418-1422.

DOI：10.2967/jnumed.110.083725

• radiopharmaceutical therapy
• skin radiation injury
• extravasation dosimetry

After the extravasation of a therapeutic dose of I-131-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 (99)mTc-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 (99)mTc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.

• 出版日期2011-9-1