Technetium Tc 99m Albumin Aggregated

Technetium Tc 99m albumin aggregated is an injection, and classified as a radiopharmaceutical; these are radioactive agents, generally used to help find and treat certain types of disease or to study organ functions in the body.

Overview

Technetium Tc 99m albumin aggregated is a radiopharmaceutical used in nuclear medicine; the medical specialty that involves the use of radioactive substances to diagnose and treat disease. It is made up of a sterile aqueous suspension of the metastable nuclear isomer technetium-99, labeled to the albumin aggregate particles of humans. It is regularly used for lung perfusion scanning, whereby a doctor can evaluate the circulation of blood and air in a patient's lungs.

Less commonly, it is applied to visualize a peritoneovenous shunt, which is a process used to drain peritoneal fluid into the veins during the treatment of conditions like refractory ascites. It is also used sometimes for isotope venography, to make the blood veins visible in an x-ray. The benefit of this is that any obstructions, abnormalities or irregularities in the blood veins can be pinpointed and located, enabling swift action to treat the problem if necessary.

Conditions Treated

Technetium Tc 99m albumin aggregated is a diagnostic aid, commonly used to help diagnose the following conditions (list not comprehensive):

  • Regional lung perfusion
  • Pulmonary neoplasm
  • Pulmonary tuberculosis
  • Emphysema

In venography, it is used to help visualize regions of the vascular system, primarily in the lower extremities to localize deep venous thrombosis. When such a problem is located, it can be treated most effectively, so the visualization is extremely helpful.

Type of medicine:

  • Radiopharmaceutical

Side effects:

First of all, there have been reports of idiosyncratic or hemodynamic reactions related to the administration of Technetium Tc 99m albumin aggregated. Allergic reactions are possible, as is the case with any protein-containing preparation, so the appropriate medicines should be on hand to treat any allergic reaction as and when it occurs.

The following list of side effects consists of those that are the most common and clinically significant, but is not necessarily comprehensive. The first few are very rare, and should be checked by a doctor or nurse if they occur:

  • Cyanosis (a bluish discoloration of the skin around the area of application). You can help yourself with minor cases by warming the affected areas, but if the symptoms are severe then see your doctor for advice. Some intervention may be necessary to ensure this side effect doesn't persist.
  • Wheezing, troubled breathing or tightness in chest. Although these symptoms are known side effects of Technetium Tc 99m albumin aggregated, they could also be early manifestations of more severe respiratory distress, so don't ignore them. Seek advice from your healthcare professional as early as possible, in order to prevent the onset of something more serious.
  • Confusion, faintness, fever, and skin rashes have also been reported, and all should be looked at by a healthcare professional if they occur. Don't be dismissive of any of these symptoms, because they all could be early signals of something more serious taking place.

The next few side effects are mild, and should subside as your body adjusts to the medicine. Your nurse or doctor may be able to tell you how you can reduce or prevent these side effects, but check with them if the symptoms become severe or won't go away:

  • Blushing or redness in the face. This is a fairly common side effect, and not to be seen as something that requires medical attention unless symptoms persist or become bothersome.
  • Increased sweating. This is a slightly less common side effect, but nevertheless widely reported after the administration of Technetium Tc 99m albumin aggregated. Again, if symptoms persist or become bothersome then seek advice from a physician, but otherwise, they should pass naturally.

Other side effects that have been reported include burning, bleeding and blistering, coldness, a feeling of pressure, hives, inflammation, infection, itching, lumps, numbness, rash, pain, scarring, stinging, soreness, swelling, tingling, tenderness, ulceration, or warmth around the injection site.

Some of these side effects may be more distressing than others; if you have any fears or doubts about side effects you are experiencing, you are best advised to consult your healthcare professional for some guidance or further examination to ensure your safety.

Dosage

Radiopharmaceuticals are only to be administered by, or under the supervision of, a physician who has undergone extensive training in the safe handling and use of radioactive materials, and who has authorization from the Nuclear Regulatory Commission (NRC) and/or the appropriate Agreement State agency as required. Outside the U.S., authorization should come from the appropriate authority.

Technetium Tc 99m albumin aggregated is to be administered by slow intravenous injection, while the patient is in a recumbent position. During the injection process, the aspiration of blood back into the syringe is to be avoided as this can lead to the formation of blood clots that contain the radioactive material inside the syringe. The consequence of this would be focal areas where radioactivity is higher during the imaging process.

A single dosage of Technetium Tc 99m albumin aggregated for adults should consist of 125,000 to 2,000,000 particles. Pediatric dosages should contain substantially fewer particles - a maximum guideline for newborns would be 50,000 particles, and for one-year-olds no more than 165,000.

Due to the risk of allergic reaction associated with Technetium Tc 99m albumin aggregated, there should be epinephrine, antihistamines and corticosteroid agents on hand during the administration process.

Major drug interactions

There are certain medicines that should not be used together under any circumstances, but in some cases, two different medicines can be used together even if there is a known interaction that could occur. In these cases, your physician may want to adjust the dosage or take some other precaution. Always tell your healthcare professional if you are currently taking any other medicine, whether it is prescription or non-prescription.

Warnings

Technetium Tc 99m albumin aggregated should not be used on patients with the following conditions:

  • Hypersensitivity
  • Severe pulmonary hypertension

There have been no adverse reactions attributed specifically to Technetium Tc 99m albumin aggregated, but there are reports of deaths occurring following the administration of albumin aggregated with patients that had pre-existing cases of the conditions listed above.

It is not yet known whether Technetium Tc 99m albumin aggregated can cause fetal harm in pregnant women, or if it can affect reproductive capacity. No studies have been performed in animals or humans on this subject. Therefore, any examination using radiopharmaceuticals, particularly elective ones, should be performed during the first few days after the onset of menses.

Technetium Tc 99m will be present in human milk during lactation for up to 24 hours after being administered. Consequently, breastfeeding should be substituted with formula feedings immediately following Technetium Tc 99m albumin aggregated administration with nursing mothers.

Storage

Unreconstituted reaction vials should be stored at 2 to 25 degrees Centigrade, or 36 to 37 degrees Fahrenheit. After labeling with Technetium Tc 99m, the solution should be stored at 2 to 8 degrees Centigrade (36 to 46 degrees Fahrenheit) in a suitable lead shield. After 6 hours, the solution should be discarded.

Summary

Technetium Tc 99m albumin aggregated is a very useful substance for diagnostic purposes, and although its use poses very few risks to the patient there are some adverse reactions reported, and some of its effects remain unconfirmed at this time (such as whether it is dangerous during pregnancy). It is an effective way of observing the flow of blood and oxygen in the lungs for patients who have lung problems, and it also helps to visualize the blood vessels during x-ray scanning to locate a deep vein thrombosis, among other things.

The side effects associated with Technetium Tc 99m albumin aggregated are mostly tolerable, with very few reports of adverse reactions. If any of the side effects do occur, and become bothersome, then patients should seek advice from a healthcare professional. Reports of negative interactions between Technetium Tc 99m albumin aggregated and other drugs are nil, but nevertheless, patients should inform their physician of any medications they are taking when they are to have the radiopharmaceutical substance administered.

Technetium Tc 99m albumin aggregated should only be used by professional, trained, certified individuals, by slow injection, taking care not to draw any blood back into the syringe. Storage of the substance must be handled carefully to ensure the right conditions are met. When stored and administered adequately, Technetium Tc 99m albumin aggregated can help to diagnose and treat a variety of conditions related to the blood vessels. Dosage indications should be adhered to, and pediatric injections require a significantly lower dosage to ensure the safety of the patient.

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017