Technetium (Sup99m/Suptc) Macrosalb

What it is and how it works

Technetium-99m macrosalb consists of macroaggregated human albumin particles (mostly 10–90 micrometres) labelled with technetium-99m. After intravenous injection the particles are trapped temporarily in pulmonary capillaries in proportion to regional pulmonary blood flow, allowing perfusion imaging.

Indications

Lung perfusion scintigraphy (e.g. diagnosis of pulmonary embolism, with ventilation imaging); assessment of right-to-left shunts; intra-arterial use to assess lung shunting before selective internal radiation therapy of liver tumours, and venography, according to licence.

Dosage and administration (summary)

Dosing (administered activity and particle number) is individualised according to protocol by the nuclear medicine specialist; given by slow intravenous injection after radiolabelling of the kit with sodium pertechnetate (99mTc), with a reduced particle number in children and pulmonary hypertension.

Contraindications

Hypersensitivity to human albumin or kit components; severe pulmonary hypertension (relative, reduce particle number).

Warnings and precautions

Use with caution and reduce the number of particles in severe pulmonary hypertension, reduced pulmonary vascular bed and right-to-left shunts. Do not draw blood into the syringe, as clot formation may occur; shake gently before injection, and as a human-plasma-derived product, infection transmission cannot be totally excluded.

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.