Last update: May 28, 2019

Tc 99m Pertechnetate

High Risk for breastfeeding


Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives).
Read the Comment.

The metastable Technetium 99 (Tc-99m) is a radioactive isotope that emits gamma radiation. Its half-life of radioactive decay is 6.0 hours.
After radioactive labeling with a sodium pertechnetate (99mTc) solution, the technetium pertechnetate solution (99mTc) obtained is used in thyroid, salivary, cerebral, cardiac, vascular, lacrimal scintigraphy and ectopic gastric mucosa localization (obscure gastrointestinal bleeding).

Between 0.82% (Tc 99m pertechnetate blocked, with a T½ of 5.2 hours) and 10% (Tc-99m pertechnetate not blocked, with a T½ of 3.4 hours) of the administered dose is excreted in breastmilk (Leide 2016, Liepe 2016).

Breastfeeding interruption periods or avoiding close contact are calculated so that the infant is not exposed to more than 1 millisievert (1 mSv = 0.1 rem) of radiation (ARSAC 2019, US.NCR 2016, ICRP 2008, Stabin 2000 ).
An adult receives between 5 and 10 mSv annually from environmental radiation.

Breastfeeding should be discontinued after the test for a period that depends on the dose administered: 30 hours for doses ≤ 80 MBq and 57 hours for ≥ 800 MBq according to ARSAC 2019 p51.
Other autors and agencies (Mitchell 2019, USNRC 2016 Tabl U.3) give shorter interruption times: a maximum of 24 hours for ≥1,100 MBq.
In the meantime, milk should be expressed and, instead, milk previously expressed and refrigerated before the test can be given.

Milk expressed after the test can be frozen and used after 10 radioactive half-lives: 10 x 6.0 = 60 hours = 3 days (Hale 2017, page 2019).

It is not necessary to avoid close contact with the infant (Mountford 1999).

Alternatives

We do not have alternatives for Tc 99m Pertechnetate.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Tc 99m Pertechnetate is also known as Technetium 99m Pertechnetate. Here it is a list of alternative known names::


Tc 99m Pertechnetate in other languages or writings:

Group

Tc 99m Pertechnetate belongs to this group or family:

Pharmacokinetics

Variable Value Unit
T1/2 3,4 - 5,2 hours

References

  1. ARSAC: Administration of Radioactive Substances Advisory Committee. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. Section 7 Conception, Pregnancy and Breastfeeding, p. 47-53. ARSAC Support Unit. Centre for Radiation, Chemical and Environmental Hazards. Public Health England. 2019 Abstract Full text (link to original source) Full text (in our servers)
  2. Mitchell KB, Fleming MM, Anderson PO, Giesbrandt JG; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #30: Radiology and Nuclear Medicine Studies in Lactating Women. Breastfeed Med. 2019 Jun;14(5):290-294. Abstract
  3. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  4. Leide-Svegborn S, Ahlgren L, Johansson L, Mattsson S. Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption. Eur J Nucl Med Mol Imaging. 2016 Abstract
  5. Liepe K, Becker A. Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption. Eur J Nucl Med Mol Imaging. 2016 Abstract Full text (in our servers)
  6. US.NRC - Nuclear Regulatory Commission Office of Nuclear Material Safety and Safeguards. Apéndice U, Tabla U.3. Consolidated guidance about materials licenses. Program-specific guidance about medical use licenses. Draft Report for Comment. Appendix U, Table U.3. NUREG-1556. Vol.9, Rev 3. 2016 Full text (link to original source) Full text (in our servers)
  7. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008 Abstract Full text (link to original source) Full text (in our servers)
  8. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  9. Mountford PJ, O'Doherty MJ. Exposure of critical groups to nuclear medicine patients. Appl Radiat Isot. 1999 Abstract

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