Version May 2024
Blood pool imaging: IV: Between 1/3 (0.33) and whole vial of stannous pyrophosphate, followed by 15 to 20 mCi (555 to 740 MBq) of sodium pertechnetate Tc 99m.
Myocardial infarction imaging: IV: 10 to 15 mCi (370 to 555 MBq).
Skeletal imaging: IV: 5 to 15 mCi (185 to 555 MBq).
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Cardiovascular: Flushing, hypotension
Central nervous system: Chills, dizziness
Dermatologic: Pruritus, skin rash
Gastrointestinal: Nausea, vomiting
Hypersensitivity: Hypersensitivity reaction
Miscellaneous: Fever
There are no contraindications listed in the manufacturer’s labeling.
Special handling:
• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and healthcare personnel. Use only under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority. Note: Contents of kit are not radioactive; however adequate shielding is required after addition of radioactive material.
Other warnings/precautions:
• Appropriate use: Brain imaging should precede bone imaging to avoid false negatives or false positives. Patients should be adequately hydrated prior to and after dosing; instruct patients to void frequently for 4 to 6 hours following administration to decrease radiation exposure to the bladder. If a brain scan is anticipated, it should precede bone imaging procedures.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, Intravenous:
Technescan PYP: Sodium pyrophosphate 11.9 mg [pyrogen free; vial contents to be combined with Technetium Tc 99m pertechnetate sodium (not included)]
Yes
IV:
Blood pool imaging: Administer stannous pyrophosphate IV 15 to 30 minutes prior to IV sodium pertechnetate Tc 99m. Inject by direct venipuncture. Avoid heparinized catheters. Perform cardiac imaging 10 minutes following sodium pertechnetate Tc 99m administration.
Cardiac and skeletal imaging: For IV administration (over 10 to 20 seconds); avoid heparinized catheters. Bone imaging is optimal 1 to 6 hours after administration; cardiac imaging is optimal 60 to 90 minutes after administration. Patients should be adequately hydrated before and after dosing; instruct patients to void as often as possible following administration to decrease radiation exposure to the bladder.
Radiopharmaceutical; use appropriate precautions for handling and disposal.
Imaging agent: Skeletal imaging agent to detect areas of altered osteogenesis; cardiac imaging agent used as an adjunctive agent for the diagnosis of acute myocardial infarction; blood pool imaging agent for gated blood pool imaging or detection of GI bleeding sites
Radiopharmaceutical: Use appropriate precaution for handling, disposal, and minimizing exposure to patients and healthcare personnel. Use under supervision of experienced personnel. Should be stored in original lead container or adequate radiation shield.
None known.
There are no known significant interactions.
Pregnancy status should be evaluated prior to use in women of reproductive potential (SNM 2010).
The manufacturer recommends elective studies be conducted during the first 10 days of the menstrual cycle in women of reproductive potential.
Technetium Tc 99m can be detected in fetal tissue; the amount depends upon the specific formulation, route of administration, and stage of pregnancy (Adelstein 1999).
In general, the potential for a radiopharmaceutical to cause fetal harm depends on the dose absorbed by the fetus and the stage of pregnancy. High doses of radiopharmaceuticals used for therapeutic procedures are more likely to result in fetal harm. A medically required diagnostic procedure can usually be modified to decrease fetal risk. Elective diagnostic procedures should be delayed until after delivery (ACR-SPR 2018; Adelstein 1999; ICRP 2000; SNM 2010).
Technetium Tc 99m is present in breast milk.
The manufacturer recommends substituting formula for breastfeeding. Alternately, women can pump and store milk prior to the procedure, then bottle feed using the stored milk for a period of ≤12 hours after imaging with technetium Tc 99m pyrophosphate (Harding 1995).
Elective diagnostic procedures should be delayed until breastfeeding has stopped (SNM 2010). Women who are breastfeeding and caring for individuals undergoing nuclear medicine procedures do not need any additional precautions (ABM [Mitchell 2019]).
Excretion of technetium Tc 99m into colostrum is widely variable and information is limited; therefore, recommendations related to early breastfeeding cannot be made (Mountford 1989; Rubow 1994).
Radioactive diagnostic agent which decays by isomeric transition to emit a photon that can be detected by imaging
Half-life elimination: Physical: ~6 hours
Excretion: Urine (~40% within 24 hours)
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