COVID-19 in the Nuclear Medicine Department, be prepared for ventilation scans as well!

Zuckier, Lionel S.; Gordon, Sharon

doi:10.1097/mnm.0000000000001196

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…However, if ventilation scan is deemed absolutely indicated, it should only be performed if CT pulmonary angiogram (CTPA) is contraindicated and in exceptional circumstances in COVID-19 confirmed or suspected cases. The number of the personnel in the unit should be minimized when dealing with an individual suspected to have COVID-19 pneumonia [12,16], the personnel must follow the recommended protective personal protective equipment (PPE) for COVID-19, which includes masks (such as, FFP3 or N95), apron, gown, gloves and eye protection [14,15] and ventilation should preferably be performed in negative pressure rooms [2,17,18], which are unfortunately not readily available. Some centres opted to request COVID-19 PCR swab testing prior to ventilation scan if perfusion scan is abnormal [17].…”

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confidence: 99%

Single photon emission computed tomography lung perfusion imaging during the COVID-19 pandemic: does nuclear medicine need to reconsider its guidelines?

Vöö

Dizdarevic

2020

Nuclear Medicine Communications

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We read with a great interest the British Society of Nuclear Medicine (BNMS) consensus document by Buscombe et al. [1] on behalf of the BNMS Council covering the comprehensive range of nuclear medicine practice, elaborated as coronavirus disease 2019 (COVID-19): guidance for infection prevention and control in nuclear medicine. We fully support the need to address the importance of adapting nuclear medicine and radiology practice in light of the COVID-19 pandemic [2] as we aim to move forward to find efficient diagnostic approaches in the near post first peak COVID-19 era.

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confidence: 99%

Single photon emission computed tomography lung perfusion imaging during the COVID-19 pandemic: does nuclear medicine need to reconsider its guidelines?

Vöö

Dizdarevic

2020

Nuclear Medicine Communications

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“…A similar phenomenon has also been noted with the newest ventilation radiopharmaceutical, 99m Tc-labeled carbon particles (Technegas), where activity was noted to persist in the imaging room air for over one hour following administration ( 31 , 32 ). Patient coughing ( 5 ), poor mouth seal ( 32 ), and incomplete nose closure ( 32 , 33 ) have all been considered possible avenues of dispersal of patient secretions into the air.…”

Section: Challenge To Performing Ventilation During Covid-19 Pandemicmentioning

confidence: 99%

“…As the COVID-19 pandemic evolved, and populations across the world were successively overrun by the virus, practitioners struggled to maintain healthcare in a manner safe for patients and medical workers alike ( 1 , 2 , 3 ). In the realm of nuclear medicine, one area that raised concern was performance of ventilation scintigraphy, an integral component of standard nuclear medicine protocols for the determination of pulmonary embolism, due to concern regarding spread of contaminated secretions into the ambient air ( 4 , 5 ). Nonetheless, the need for a diagnostic test to exclude pulmonary embolism (PE) remained acute both because symptoms of PE and COVID-19 pneumonia overlap ( 6 , 7 , 8 ), and because of an association between COVID-19 infection and thromboembolic disease ( 9 , 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Safe Pulmonary Scintigraphy in the Era of COVID-19

Zuckier

2022

Seminars in Nuclear Medicine

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One of the major effects of the COVID-19 pandemic within nuclear medicine was to halt performance of lung ventilation studies, due to concern regarding spread of contaminated secretions into the ambient air. A number of variant protocols for performing lung scintigraphy emerged in the medical literature which minimized or eliminated ventilation scintigraphy, due to the persistent need to provide this critical diagnostic service without compromising the safety of staff and patients. We have summarized and reviewed these protocols, many of which are based on concepts developed earlier in the history of lung scintigraphy. It is possible that some of these interim remedies may gain traction and earn a more permanent place in the ongoing practice of nuclear medicine.

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“…11 Although nuclear medicine societies have addressed the COVID-19 pandemic in several guidelines, they mostly covered the protection of the patients and personnel against COVID-19 infection. [12][13][14][15] In the current study, we reported our experience on sentinel node mapping of breast cancer patients during the extreme shortage of Mo99-Tc99m generators using Tc-99m phytate.…”

Section: Introductionmentioning

confidence: 99%

Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping

Sadri

Dabbagh

Forghani

et al. 2021

Lymphatic Research and Biology

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Background: In the current study, we reported our experience on sentinel node mapping of breast cancer patients during the extreme shortage of Mo99-Tc99m generators using Tc-99m phytate. Methods and Results: During the period from March 7, 2019, to April 18, 2020, due to disruption of molybdenum supply chain, we used low specific activity Tc-99m pertechnetate elute (0.5-2 mCi of 99m TcO 4 in 5 mL) for each kit preparation. Two or three intradermal periareolar injections were done for each patient (0.02-0.1 mCi/0.2 mL for each injection). Immediately following injection, dynamic lymphoscintigraphy was done. Surgery was done the same day of injection and the axillary sentinel node was sought using a gamma probe. Overall, 35 patients were included in the study. The specific activity of the Tc-99m elute (in 5 mL) used for kit preparation was 2 mCi/10 mg in four, 1.5 mCi/10 mg in eight, 1.25 mCi/10 mg in eight, 1 mCi/10 mg in three, 0.75 mCi/10 mg in five, and 0.5 mCi/10 mg of 99m Tc-Phytate in seven patients. For the first four groups of patients, we used two 0.2 mL injections, while in the latter two groups, three 0.2 mL injections were used. At least one sentinel node was detected in all patients but three in whom axilla was involved. Conclusion: Sentinel node biopsy can be achieved with low specific activity of Tc-99m elute at the time of Mo99-Tc-99m generator shortage. If special personal protection is used, sentinel node mapping can be done in nuclear medicine departments with excellent results despite the COVID-19 pandemic and disruption of generator shipment.

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COVID-19 in the Nuclear Medicine Department, be prepared for ventilation scans as well!

Cited by 11 publications

References 10 publications

Single photon emission computed tomography lung perfusion imaging during the COVID-19 pandemic: does nuclear medicine need to reconsider its guidelines?

Single photon emission computed tomography lung perfusion imaging during the COVID-19 pandemic: does nuclear medicine need to reconsider its guidelines?

Safe Pulmonary Scintigraphy in the Era of COVID-19

Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping

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