Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping
| Autor: | Mohammad Naser Forghani, Vahid Reza Dabbagh, Ramin Sadeghi, Kayvan Sadri, Mahdi Asadi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Phytic Acid Coronavirus disease 2019 (COVID-19) Pertechnetate Breast Neoplasms Economic shortage Low specific activity Health Services Accessibility chemistry.chemical_compound Breast cancer Humans Medicine Aged Molybdenum Radioisotopes Sentinel Lymph Node Biopsy business.industry COVID-19 Organotechnetium Compounds Middle Aged Sentinel node medicine.disease Axilla medicine.anatomical_structure chemistry Lymphatic Metastasis Feasibility Studies Female Lymph Nodes Radiopharmaceuticals Cardiology and Cardiovascular Medicine business Nuclear medicine Gamma probe |
| Zdroj: | Lymphatic Research and Biology. 19:134-140 |
| ISSN: | 1557-8585 1539-6851 |
| DOI: | 10.1089/lrb.2020.0063 |
| Popis: | Background: In the current study, we reported our experience on sentinel node mapping of breast cancer patients during the extreme shortage of Mo99-Tc99m generators using Tc-99m phytate. Methods and Results: During the period from March 7, 2019, to April 18, 2020, due to disruption of molybdenum supply chain, we used low specific activity Tc-99m pertechnetate elute (0.5-2 mCi of 99mTcO4 in 5 mL) for each kit preparation. Two or three intradermal periareolar injections were done for each patient (0.02-0.1 mCi/0.2 mL for each injection). Immediately following injection, dynamic lymphoscintigraphy was done. Surgery was done the same day of injection and the axillary sentinel node was sought using a gamma probe. Overall, 35 patients were included in the study. The specific activity of the Tc-99m elute (in 5 mL) used for kit preparation was 2 mCi/10 mg in four, 1.5 mCi/10 mg in eight, 1.25 mCi/10 mg in eight, 1 mCi/10 mg in three, 0.75 mCi/10 mg in five, and 0.5 mCi/10 mg of 99mTc-Phytate in seven patients. For the first four groups of patients, we used two 0.2 mL injections, while in the latter two groups, three 0.2 mL injections were used. At least one sentinel node was detected in all patients but three in whom axilla was involved. Conclusion: Sentinel node biopsy can be achieved with low specific activity of Tc-99m elute at the time of Mo99-Tc-99m generator shortage. If special personal protection is used, sentinel node mapping can be done in nuclear medicine departments with excellent results despite the COVID-19 pandemic and disruption of generator shipment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|