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A study of technetium-99m wastage in selected private sector nuclear medicine imaging departments.

Mathurine G, Bresser P, Teixeira N - Nucl Med Commun (2013)

Bottom Line: The purpose of the study was to interrogate the unconfirmed reports of 99mTc radiopharmaceutical wastage.It was identified that:(1) a total of 83.2% of ordered packages and 35.1% of standard packages of preprepared syringes were utilized;(2) a total of 36% of ordered packages and 22.6% of standard packages of bulk 99mTc were utilized; and (3) a total of 70.6% of the total quantity of radiopharmaceuticals was returned to the radiopharmaceutical laboratory.The total wastage represented 45.5% of the ordered packages and 75.8% of the standard packages.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Radiography, Faculty of Health Sciences, University of Pretoria bDepartment of Nuclear Medicine, Little Company of Mary Hospital, Pretoria, South Africa.

ABSTRACT

Background: South African nuclear medicine imaging departments have been fortunate in being able to receive an uninterrupted supply of molybdenum-99 (99Mo)/technetium-99m (99mTc) generators. Nuclear medicine radiographers practising in private sector services in the northern Gauteng region indicated a possible problem with the quantities of wasted and unused 99mTc radiopharmaceuticals returned to the radiopharmaceutical supply laboratory. Daily radiopharmaceutical deliveries are a combination of ordered packages and standard packages. The purpose of the standard package is to accommodate emergency and after-hours nuclear medicine services. The purpose of the study was to interrogate the unconfirmed reports of 99mTc radiopharmaceutical wastage.

Methods: A descriptive quantitative research design was conducted in six private sector nuclear medicine imaging practices in the northern Gauteng region. Overt observations of the quantities of radiopharmaceutical supply, usage and wastage were conducted over 2 days in each of these practices.

Results: Ordered packages comprised 14% of the total 99mTc radiopharmaceutical deliveries to these six nuclear medicine imaging departments. It was identified that:(1) a total of 83.2% of ordered packages and 35.1% of standard packages of preprepared syringes were utilized;(2) a total of 36% of ordered packages and 22.6% of standard packages of bulk 99mTc were utilized; and (3) a total of 70.6% of the total quantity of radiopharmaceuticals was returned to the radiopharmaceutical laboratory. The total wastage represented 45.5% of the ordered packages and 75.8% of the standard packages.

Conclusion: Wastage of 74 GBq of 99mTc from six sites over 12 days should raise concerns for the nuclear medicine industry. A review of the system framework that supports communication between the radiopharmaceutical supplier/s and the nuclear medicine imaging practices is recommended.

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Related in: MedlinePlus

Flow diagram of the radiopharmaceutical supply and return system in central and northern Gauteng private sector nuclear medicine imaging departments. 99Mo, molybdenum-99; 99mTc, technetium-99m. NTP, Nuclear Technology Products Radioisotopes (Pty) Ltd; AXIM, Africa X-Ray Industrial Medical.
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Figure 1: Flow diagram of the radiopharmaceutical supply and return system in central and northern Gauteng private sector nuclear medicine imaging departments. 99Mo, molybdenum-99; 99mTc, technetium-99m. NTP, Nuclear Technology Products Radioisotopes (Pty) Ltd; AXIM, Africa X-Ray Industrial Medical.

Mentions: Between 1997 and 2009, numerous international disruptions in nuclear reactor production of molybdenum-99 (99Mo) were reported as adversely affecting nuclear medicine patient services in a number of countries 1,2. In 2009, the Pelindaba nuclear reactor in South Africa was reported as having the highest number of 99Mo production days compared with that of other main reactor international sites 1. Thus, an uninterrupted daily supply of technetium-99m (99mTc) through 99Mo generators and 99mTc radionuclide preprepared syringes and vials to nuclear medicine imaging departments in public and private sector hospitals in South Africa was sustained 3. Although the high flux reactor in Petten, the Netherlands, and the National Research Universal reactor in Chalk River, Canada, were restarted in 2010, the Radiological Society of North America expressed concern that ‘the world remains vulnerable to a future short-fall of Molybdenum-99’ 4. Figure 1 provides an overview of the 99Mo supply to the local radiopharmaceutical laboratory and the subsequent 99mTc supply to private nuclear medicine practices in the central and northern Gauteng region. The daily radiopharmaceutical deliveries consist of ordered packages (OPs) and standard packages (SPs).


A study of technetium-99m wastage in selected private sector nuclear medicine imaging departments.

Mathurine G, Bresser P, Teixeira N - Nucl Med Commun (2013)

Flow diagram of the radiopharmaceutical supply and return system in central and northern Gauteng private sector nuclear medicine imaging departments. 99Mo, molybdenum-99; 99mTc, technetium-99m. NTP, Nuclear Technology Products Radioisotopes (Pty) Ltd; AXIM, Africa X-Ray Industrial Medical.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3815205&req=5

Figure 1: Flow diagram of the radiopharmaceutical supply and return system in central and northern Gauteng private sector nuclear medicine imaging departments. 99Mo, molybdenum-99; 99mTc, technetium-99m. NTP, Nuclear Technology Products Radioisotopes (Pty) Ltd; AXIM, Africa X-Ray Industrial Medical.
Mentions: Between 1997 and 2009, numerous international disruptions in nuclear reactor production of molybdenum-99 (99Mo) were reported as adversely affecting nuclear medicine patient services in a number of countries 1,2. In 2009, the Pelindaba nuclear reactor in South Africa was reported as having the highest number of 99Mo production days compared with that of other main reactor international sites 1. Thus, an uninterrupted daily supply of technetium-99m (99mTc) through 99Mo generators and 99mTc radionuclide preprepared syringes and vials to nuclear medicine imaging departments in public and private sector hospitals in South Africa was sustained 3. Although the high flux reactor in Petten, the Netherlands, and the National Research Universal reactor in Chalk River, Canada, were restarted in 2010, the Radiological Society of North America expressed concern that ‘the world remains vulnerable to a future short-fall of Molybdenum-99’ 4. Figure 1 provides an overview of the 99Mo supply to the local radiopharmaceutical laboratory and the subsequent 99mTc supply to private nuclear medicine practices in the central and northern Gauteng region. The daily radiopharmaceutical deliveries consist of ordered packages (OPs) and standard packages (SPs).

Bottom Line: The purpose of the study was to interrogate the unconfirmed reports of 99mTc radiopharmaceutical wastage.It was identified that:(1) a total of 83.2% of ordered packages and 35.1% of standard packages of preprepared syringes were utilized;(2) a total of 36% of ordered packages and 22.6% of standard packages of bulk 99mTc were utilized; and (3) a total of 70.6% of the total quantity of radiopharmaceuticals was returned to the radiopharmaceutical laboratory.The total wastage represented 45.5% of the ordered packages and 75.8% of the standard packages.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Radiography, Faculty of Health Sciences, University of Pretoria bDepartment of Nuclear Medicine, Little Company of Mary Hospital, Pretoria, South Africa.

ABSTRACT

Background: South African nuclear medicine imaging departments have been fortunate in being able to receive an uninterrupted supply of molybdenum-99 (99Mo)/technetium-99m (99mTc) generators. Nuclear medicine radiographers practising in private sector services in the northern Gauteng region indicated a possible problem with the quantities of wasted and unused 99mTc radiopharmaceuticals returned to the radiopharmaceutical supply laboratory. Daily radiopharmaceutical deliveries are a combination of ordered packages and standard packages. The purpose of the standard package is to accommodate emergency and after-hours nuclear medicine services. The purpose of the study was to interrogate the unconfirmed reports of 99mTc radiopharmaceutical wastage.

Methods: A descriptive quantitative research design was conducted in six private sector nuclear medicine imaging practices in the northern Gauteng region. Overt observations of the quantities of radiopharmaceutical supply, usage and wastage were conducted over 2 days in each of these practices.

Results: Ordered packages comprised 14% of the total 99mTc radiopharmaceutical deliveries to these six nuclear medicine imaging departments. It was identified that:(1) a total of 83.2% of ordered packages and 35.1% of standard packages of preprepared syringes were utilized;(2) a total of 36% of ordered packages and 22.6% of standard packages of bulk 99mTc were utilized; and (3) a total of 70.6% of the total quantity of radiopharmaceuticals was returned to the radiopharmaceutical laboratory. The total wastage represented 45.5% of the ordered packages and 75.8% of the standard packages.

Conclusion: Wastage of 74 GBq of 99mTc from six sites over 12 days should raise concerns for the nuclear medicine industry. A review of the system framework that supports communication between the radiopharmaceutical supplier/s and the nuclear medicine imaging practices is recommended.

Show MeSH
Related in: MedlinePlus