4. Image acquisition Brain perfusion SPECT Imaging should be delayed 30-90 min after injection for best image quality. g. g. 120 projections, 60 projections per head, 30 s/projection). Imaging should be completed within 4 hours post injection.
Labeled leukocyte scintigraphy A large-field-of-view gamma camera with a low-energy high-resolution collimator is usually preferred. Early imaging of the pelvis and abdomen is essential (bowel activity is seen in 20%– 30% of children by 1 h and 2%–6% of adults by 3–4 h after injection).
Images of the limbs should be acquired for 10 min/view at 4–8 h and at least 15 min/view at 16–24 h (particularly for osteomyelitis). SPECT images of the chest, abdomen/pelvis,or spine may be helpful. 1 or to any of the components of the labelled radiopharmaceutical.
4 Special warnings and precautions for use Potential for hypersensitivity or anaphylactic reactions If hypersensitivity or anaphylactic reactions occurs, the administration of the medicinal product must be discontinued immediately and intravenous treatment initiated, if necessary.
To enable immediate action in emergencies, the necessary medicinal products and equipment such as endotracheal tube and ventilator must be immediately available. Individual benefit/risk justification For each patient, the radiation exposure must be justifiable by the likely benefit.
The activity administered should in every case be as low as reasonably achievable to obtain the required diagnostic information. Renal or Hepatic impairment Careful consideration of the benefit risk ratio in these patients is required since an increased radiation exposure is possible.
2. Careful consideration of the indication is required since the effective dose per MBq is higher than in adults (see section 11). Patient preparation The patient should be well hydrated before the start of the examination and urged to void as often as possible during the first hours after the examination in order to reduce radiation.
Brain perfusion SPECT Patients should preferably avoid excessive stimulants (such as caffeine, cola, and energy drinks), alcohol, smoking, and any drugs known to affect cerebral blood flow prior to imaging. After the procedure Close contact with infants and pregnant women should be restricted during the initial 12 hours following the injection.
e. essentially ‘sodium- free’. Depending on the time when you administer the injection, the content of sodium given to the patient may in some cases be greater than 1 mmol. This should be taken into account in patient on low sodium diet.
The preparation without reconstitution with sodium 99mTc-pertechnetate must not be administered to patients. Reinjected Medi –exametazime labelled leukocytes only When preparing technetium (99mTc)-labelled leukocytes, it is essential that cells are washed free of sedimentation agents before they are re-injected into the patient as materials used in cell separation may cause hypersensitivity reactions.
Manipulation of human cells (labelling of leucocytes) carries the risk of potential transmission of infections (HBV, HIV, etc). 6.