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2000
Volume 18, Issue 1
  • ISSN: 1874-4710
  • E-ISSN: 1874-4729

Abstract

Background and Purpose

Radiopharmaceuticals are radioactive compounds used for diagnostic or therapeutic purposes which are most often administered intravenously. Adverse events that may induce both adverse reactions and drug-to-drug interactions with changes in expected biodistribution, potentially affecting patient safety and diagnostic accuracy. Adverse reactions are relatively rare due to the small doses and under-reporting is the norm. The aim of this study is to increase awareness of the need to report in order to create protocols for the management of such adverse events among professionals in a Nuclear Medicine Department.

Methods

A reporting system was established a decade ago through an electronic form to enhance adverse event registration. The radiopharmacist collects data for further communication with National Health authorities and develops an annual report with recommendations on the management of these adverse events.

Results

A total of 128 reports were collected, including 65 cases of extravasations, 18 adverse reactions, and 45 drug interactions. Over the years, reporting has been increasing, adverse reactions occurred at a higher incidence than reported in the literature, and each anomalous biodistribution was analysed for possible drug interaction. The annual reports have been used to develop a local guideline for the management of adverse reactions and recommendations for discontinuation of treatment to avoid interactions with radiopharmaceuticals.

Conclusion

The recognition of adverse events associated with radiopharmaceuticals is increasing, underlining the need for vigilant reporting and improved management strategies. An efficient reporting system promotes awareness of possible interactions between radiopharmaceuticals and other medicines and their potential adverse reactions to enhance patient safety.

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2025-03-01
2025-10-16
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References

  1. SilinderM.A. YektaÖ. Adverse reactions to radiopharmaceuticals (ARRP).Particularly To Technetium Radiopharmaceuticals. FABAD J. Pharm. Sci.200833109117
    [Google Scholar]
  2. WHO Meeting on International Drug Monitoring: the Role of National Centres ( 1971: Geneva, Switzerland) & World Health Organization ( 1972) . International drug monitoring: the role of national centres, report of a WHO meeting [ held in Geneva from 20 to 25 September 1971] . World Health Organization https://apps.who.int/iris/handle/10665/40968 (Accessed Septembre 4, 2023.).
  3. World Health Organization. Quality Assurance and Safety of Medicines Team. ( 2002) . Safety of medicines: a guide to detecting and reporting adverse drug reactions: why health professionals need to take action. World Health Organization. https://apps.who.int/iris/handle/10665/67378 (Accessed Septembre 4, 2023.).
  4. HesslewoodS. LeungE. Drug interactions with radiopharmaceuticals.Eur. J. Nucl. Med.199421434835610.1007/BF00947972 8005160
    [Google Scholar]
  5. SilbersteinE.B. RyanJ. Prevalence of adverse reactions in nuclear medicine.J. Nucl. Med.1996371185192 8543992
    [Google Scholar]
  6. SampsonC.B. HesslewoodS.R. Adverse reactions to and drug incompatibilities with radiopharmaceuticals. Radiopharmaceuticals using radioactive compounds in pharmaceuticals and medicine. TheobaldA.E. Ellis Horwood Limited1989
    [Google Scholar]
  7. AdverseE.R.F. British Nuclear Medicine Society. https://www.bnms.org.uk/page/AdverseEventReportingInformation (Accessed September 1, 2023).
    [Google Scholar]
  8. HesseB. VinbergN. BerthelsenA.K. BallingerJ.R. Adverse events in nuclear medicine cause for concern?Eur. J. Nucl. Med. Mol. Imaging201239578278510.1007/s00259‑012‑2071‑6 22310855
    [Google Scholar]
  9. van der PolJ. VööS. BuceriusJ. MottaghyF.M. Consequences of radiopharmaceutical extravasation and therapeutic interventions: A systematic review.Eur. J. Nucl. Med. Mol. Imaging20174471234124310.1007/s00259‑017‑3675‑7 28303300
    [Google Scholar]
  10. SchreuderN. KoopmanD. JagerP.L. KosterinkJ.G.W. van PuijenbroekE. Adverse events of diagnostic radiopharmaceuticals: A systematic review.Semin. Nucl. Med.201949538241010.1053/j.semnuclmed.2019.06.006 31470933
    [Google Scholar]
  11. SchreuderN. JacobsN.A. JagerP.L. KosterinkJ.G.W. van PuijenbroekE.P. Patient-reported adverse events of radiopharmaceuticals: a prospective study of 1002 patients.Drug Saf.202144221122210.1007/s40264‑020‑01006‑2 33094442
    [Google Scholar]
  12. BotellaJ. GallegoJ.L. Fernandez-FernandezJ. Sanz-GuajardoD. de MiguelA. RamosJ. FrancoP. EnriquesR. Sanz-MorenoC. The bone scan in patients with aluminium-associated bone disease.Proc. Eur. Dial. Transplant Assoc. Eur. Ren. Assoc.198521403409 3991532
    [Google Scholar]
  13. de FranciscoA.L.M. MacíaM. AlonsoF. GarcíaP. GutierrezE. QuintanaL.F. QuirogaB. TorregrosaI. Onco-Nephrology: Cancer, chemotherapy and kidney.Nefrologia201939547348110.1016/j.nefro.2018.10.016
    [Google Scholar]
  14. PalmerA.M. WattI. DieppeP.A. Soft-tissue localization of 99mTc-hydroxymethylene diphosphonate due to interaction with calcium.Clin. Radiol.199245532633010.1016/S0009‑9260(05)80085‑6 1516343
    [Google Scholar]
  15. ParkC.H. KimH.S. ShinH. KimH.C. Hepatic uptake of Tc-99m MDP on bone scintigraphy from intravenous iron therapy (Blutal).Clin. Nucl. Med.1997221176276410.1097/00003072‑199711000‑00006 9363385
    [Google Scholar]
  16. ShinE. OhM. SungC. KimK.H. RyuJ.S. Altered Biodistribution of 99mTc-DPD on bone scan after intravenous iron supplement.Nucl. Med. Mol. Imaging201751434734910.1007/s13139‑017‑0486‑5 29242729
    [Google Scholar]
  17. CarrE.A.Jr CarrollM. MontesM. Effect of vitamin D3, other drugs altering serum calcium or phosphorus concentrations, and desoxycorticosterone on the distribution of Tc-99m pyrophosphate between target and nontarget tissues.J. Nucl. Med.1981226526534 6262465
    [Google Scholar]
  18. MurphyK.J. LineB.R. MalfetanoJ. Etidronate therapy decreases the sensitivity of bone scanning with methylene diphosphonate labelled with technetium-99m.Can. Assoc. Radiol. J.1997483199202 9193420
    [Google Scholar]
  19. ChenW.L. PerngM.Y. HweiD.Z. YuM.D. Therapeutic drug monitoring can avoid iatrogenic alterations caused by 99mTcmethylene diphosphonate (MDP)-gentamicin interaction. J. Nucl. Biol. Med., 1994384)(1132134 7632757
    [Google Scholar]
  20. SovijärviA.R. PöyhönenL. KellomäkiL. MuittariA. Effects of acute and long-term bronchodilator treatment on regional lung function in asthma assessed with krypton-81m and technetium-99m-labelled macroaggregates.Thorax198237751652010.1136/thx.37.7.516 6215738
    [Google Scholar]
  21. GomesM.L. OliveiraM.B.N. Bernardo-FilhoM. Drug interaction with radiopharmaceuticals: Effect on the labeling of red blood cells with technetium-99m and on the bioavailability of radiopharmaceuticals. Braz. Arch. Biol. Technol., 200245spe14314910.1590/S1516‑89132002000500020
    [Google Scholar]
  22. ApeldoornL. VoermanH.J. HoefnagelC.A. Interference of MIBG uptake by medication: A case report.Neth. J. Med.199546523924310.1016/0300‑2977(94)00098‑0 7783826
    [Google Scholar]
  23. KhafagiF.A. ShapiroB. FigL.M. MalletteS. SissonJ.C. Labetalol reduces iodine-131 MIBG uptake by pheochromocytoma and normal tissues.J. Nucl. Med.1989304481489 2738677
    [Google Scholar]
  24. TinazziM. CiprianiA. MatinellaA. CannasA. SollaP. NicolettiA. ZappiaM. MorganteL. MorganteF. PacchettiC. SciarrettaM. DallocchioC. RossiS. MalentacchiM. CeravoloR. FrosiniD. SestiniS. BoviT. BarbuiC. [123I]FP-CIT single photon emission computed tomography findings in drug-induced Parkinsonism.Schizophr. Res.20121391-3404510.1016/j.schres.2012.06.003 22727453
    [Google Scholar]
  25. EisingE.G. ReinersC. Influences on evaluability of radionuclide ventriculography in chemotherapy patients.Nucl. Med. Commun.199819324125010.1097/00006231‑199803000‑00008 9625499
    [Google Scholar]
  26. FulhamM.J. BrunettiA. AlojL. RamanR. DwyerA.J. Di ChiroG. Decreased cerebral glucose metabolism in patients with brain tumors: An effect of corticosteroids.J. Neurosurg.199583465766410.3171/jns.1995.83.4.0657 7674016
    [Google Scholar]
  27. BrunettiA. FulhamM.J. AlojL. De SouzaB. NiemanL. OldfieldE.H. Di ChiroG. Decreased brain glucose utilization in patients with Cushing’s disease.J. Nucl. Med.1998395786790 9591575
    [Google Scholar]
  28. RoelckeU. BlasbergR.G. von AmmonK. HoferS. VontobelP. MaguireR.P. RadüE.W. HerrmannR. LeendersK.L. Dexamethasone treatment and plasma glucose levels: Relevance for fluorine-18-fluorodeoxyglucose uptake measurements in gliomas.J. Nucl. Med.1998395879884 9591593
    [Google Scholar]
  29. HesslewoodS.E. European system for reporting adverse reactions to and defects in radiopharmaceuticals: Annual report 2001.Eur. J. Nucl. Med. Mol. Imaging200330BP87BP94
    [Google Scholar]
  30. PintoS.R. SantosL.F.C. dos ReisS.R.R. BastosM.K. da Silva GomesV. de Oliveira VieiraT. Santos-OliveiraR. Adverse reactions to radiopharmaceuticals: a survey based on clinical cases using criteria of systematic review.Ther. Innov. Regul. Sci.201852110911310.1177/2168479017716717 29714615
    [Google Scholar]
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