^99mTc-1-Thio-D-Glucose in Lymphoma Patients: Safety, Pharmacokinetics and Dosimetric Characteristics

Purpose: To study the safety of ^99mTc-1-Thio-D-Glucose (^99mTc-TG) using, as well as its pharmacokinetics and dosimetric characteristics.
Material and methods: The pharmacokinetics of 99mTc-TG was studied in 12 patients with lymphomas. The study was performed after a bolus injection of 729 ± 102 MBq ^99mTc-TG. Whole body anterior and posterior planar imaging was performed at 2, 4, 6, and 24 hours post-injection. In addition, all patients underwent SPECT/CT scanning at 2 hours and only SPECT at 4 and 6 hours after injection. To determine the dynamics of ^99mTc-TG accumulation in organs and tissues, the corresponding regions of interest (ROI) were outlined on each of the scans. Absorbed doses were calculated using a specialized OLINDA/EXM 1.1 program using phantoms of adult women and men.
Results: The study showed that the administration of ^99mTc-TG is well tolerated by patients and is not accompanied by any side effects. The specified radiopharmaceutical has favorable dosimetric properties. Thus, in the present study, effective doses ranged from 5.0 to 9.8 mSv. SPECT/CT revealed high uptake of ^99mTc-TG in all nodular lesions detected according to standard diagnostic methods. There was also agreement between visualization of extranodal lesions using ^99mTc-TG SPECT/CT and standard diagnostic methods in all cases of the brain, neck, chest and abdomen lesions. In our study, the use of ^99mTc-TG SPECT/CT allowed us to detect a bone lesion that was not visualized on CT. This finding was an indication for an additional MRI examination, which confirmed a lymphoma lesion of the humerus. 2 hours after the injection of ^99mTc-TG, the tumor-background ratio reached 3.3 ± 1.2, then decreased to 2.30 ± 1.42 after 4 hours and then did not change significantly, so the optimal time for performing SPECT is 2 hours after the introduction of ^99mTc-TG.
Conclusion: ^99mTc-TG is well tolerated by patients and has favorable dosimetric properties. ^99mTc-TG SPECT/CT may become the only method for molecular imaging of lymphoma in patients living in countries and regions with limited or no access to PET.

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