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. 2023 Feb 23;32(1):28-34.
doi: 10.4274/mirt.galenos.2022.77598.

Leukocyte Labeling with Tc-99m-HMPAO: The Role of Leucocyte Numbers and Medication on the Labeling Efficacy and Image Quality

Emre Karayel  1   2 , Meltem Ocak  3 , A Seher Birteksöz Tan  4
Affiliations

Leukocyte Labeling with Tc-99m-HMPAO: The Role of Leucocyte Numbers and Medication on the Labeling Efficacy and Image Quality

Emre Karayel et al. Mol Imaging Radionucl Ther. .

Abstract
in English, Turkish

Objectives: The aim of this study is to evaluation of Tc-99m-hexamethylpropyleneamineoxime (HMPAO)-labeled leukocytes in terms of radiochemical, biochemical, and microbiological quality controls and to examine the effect of leukocyte numbers of the blood obtained from patients and the medications currently used by the patients on the radiochemical yields of Tc-99m-HMPAO-labeled leukocytes, and imaging quality was evaluated.

Methods: Thirty paients were included in our study who applied to Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine for Tc-99m-HMPAO-labeled leukocyte scintigraphy. Devices and chemicals used in the preparation of Tc-99m-HMPAO-labeled laukocytes were compared with other nuclear medicine clinics. Tc-99m-HMPAO-labeled leukocytes were evaluated in terms of radiochemical, biochemical, and microbiological quality controls. The effect of leukocyte numbers of the blood obtained from patients and the medications currently used by the patients on the radiochemical yields of Tc-99m-HMPAO-labeled leukocytes and imaging quality was evaluated.

Results: The pH range of Tc-99m-HMPAO was 6-8 and the radiochemical purity was 90±2.04% (n=30), the radiochemical yield of Tc-99m-HMPAO-labeled leukocytes was 51±2.18% (n=30), the radiolabeling yield of Tc-99m-HMPAO-labeled leukocyte increased as the amount of white blood cell in the blood increased and whether the patients used any antibiotic, blood thinners, insulin and blood pressure medications did not affect the radiolabeling yield of Tc-99m-HMPAO-labeled leukocytes. The number of erythrocytes were removed at a rate of >99% in LPR by starch solution (6% HES; in the hemocytometric examination of Tc-99m-HMPAO-labeled leukocytes performed zeroth and 4th h, living/dead cell ratio was found 97.5% and the product was sterile.

Conclusion: Tc-99m-HMPAO was labeled with leukocytes successfully, and Tc-99m-HMPAO-labeled leukocytes was safely injected to the patients as sterile without loss of vitality and aggregation.

Amaç: Bu çalışmada; Tc-99m-heksametilpropilenaminoksim (HMPAO) ile işaretli lökositlerin radyokimyasal, biyokimyasal ve mikrobiyolojik açıdan kalite kontrollerinin incelenmesi ve hasta kanının ve lökosit süspansiyonunun ihtiva ettiği lökosit miktarı ile hastaların kullandıkları bazı ilaçların Tc-99m-HMPAO ile lökositlerin radyoişaretleme verimine etkisinin incelenmesi amaçlanmıştır.

Yöntem: Çalışmaya İstanbul Üniversitesi-Cerahhapaşa, Cerrahpaşa Tıp Fakültesi, Nükleer Tıp Anabilim Dalı’na Tc-99m-HMPAO ile işaretli lökosit sintigrafisi için başvuran 30 hasta dahil edildi. Radyoişaretleme sırasında kullandığımız alet ve kimyasallar literatürde belirtilenlerle diğer örneklerle karşılaştırıldı. Hazırlanan radyofarmasötiğin kalite kontrolleri radyokimyasal, biyokimyasal ve mikrobiyolojik açıdan incelendi. Hasta kanının ve lökosit süspansiyonunun ihtiva ettiği lökosit miktarları ile hastaların kullandıkları antibiyotik, kan sulandırıcı, insülin ve tansiyon ilaçlarının Tc-99m-HMPAO ile lökositlerin radyoişaretleme verimine etkisi SPSS-20 programı ile istatistiksel olarak değerlendirildi.

Bulgular: Tc-99m-HMPAO radyofarmasötiğinin pH aralığının 6-8 ve radyokimyasal saflığının %90±2,04 (n=30), Tc-99m-HMPAO ile işaretli lökositlerin radyokimyasal veriminin %51±2,18 (n=30), hastaların antibiyotik, kan sulandırıcı, insülin ve tansiyon ilacı kullanma durumunun Tc-99m-HMPAO ile işaretli lökositlerin radyokimyasal verimine etki etmediği, hasta kanında ve lökosit süspansiyonunda bulunan lökosit miktarı arttıkça Tc-99m-HMPAO ile işaretli lökositlerin radyokimyasal veriminin de arttığı, kullanılan nişasta çözeltisinin (%6 HES) kırmızı kan hücrelerinin %99’dan fazlasını ortamdan uzaklaştırdığı, işaretli lökositlerin hemositometrik yöntemle 0 ve 4. saatte yapılan analizleri sonucu lökositlerin %97,5 oranında canlılığını koruduğu ve son ürünün steril olduğu tespit edildi.

Sonuç: Tc-99m-HMPAO ile lökositler başarılı bir şekilde işaretlenmiş ve hastalara steril, canlılığını kaybetmemiş ve pıhtılaşma olmayan Tc-99m-HMPAO ile işaretli lökositlerin güvenle uygulanabileceği sonucuna varılmıştır.

Keywords: Tc-99m-HMPAO; Tc-99mHMPAO-labeled leukocytes; infection imaging.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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