Technetium (Sup99m/Suptc) Bicisate

What it is and how it works

Technetium-99m bicisate is a lipophilic, neutral complex that crosses the intact blood–brain barrier and is trapped in brain cells after enzymatic de-esterification to a polar metabolite. Its regional brain uptake is proportional to cerebral blood flow, allowing SPECT imaging of cerebral perfusion.

Indications

Single-photon emission computed tomography (SPECT) of regional cerebral perfusion, e.g. localisation of stroke, evaluation of dementia and localisation of epileptogenic foci.

Dosage and administration (summary)

Dosing (administered activity) is individualised according to protocol by the nuclear medicine specialist, in line with diagnostic reference levels and patient weight or age; given by intravenous injection after radiolabelling of the kit with sodium pertechnetate (99mTc).

Contraindications

Hypersensitivity to the active substance or any kit component.

Warnings and precautions

Radiolabelling and quality control (radiochemical purity) must follow the product instructions in an authorised radiopharmacy, and radiation exposure should be kept as low as reasonably achievable. Patients should be well hydrated and void frequently after the study to reduce bladder radiation dose.

Pregnancy

Diagnostic radiopharmaceuticals should be avoided in pregnancy unless clearly necessary; exclude pregnancy before administration in women of childbearing potential.

Storage and supply

Store the unlabelled kit according to the manufacturer (typically below 25 °C or at 2–8 °C); after labelling, keep the preparation in lead shielding and use within the time stated in the product information.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.