Dear Radiopharmacy Customer,

Below is updated, and hopefully more easily understandable, forecast of the Technetium-99m (Tc-99m) supply for the next three months.  Please keep in mind that the above are only estimates that we have received from our suppliers.  Their estimates in the past have not always been accurate, and the weekly situations can change for the better or worse.  We will continue to keep you informed as we receive updated information.

May 2010

June 2010

Tc99m Ceretec WBC Whole Body Scan.  Normal.

• The blood clearance half-life of 99mTc-leukocytes is about 4 h, and delayed images (longer than 4 h) may be preferred for detection of vascular graft or dialysis shunt infection. 111In-leukocytes may be preferred for detection of vascular graft or dialysis shunt infection, because blood pool activity is much lower relative to sites of abnormal localization (especially on 18-24-h delayed images)

• Bowel activity secondary to secretion of 99mTc complexes is seen in 20%-30% of children by 1 h but is usually not seen in adults before 4 h. In adults, physiologic bowel activity is usually faint if seen at 4 h and is usually seen in the terminal ileum or right colon, increasing over time.

• Renal and bladder activity is seen by 15-30 min in all patients with normal renal function. The patient should try to empty his/her bladder before pelvic imaging.

• Uniform physiologic gallbladder activity can be seen in 4% of patients by 2-4-h and up to 10% of patients by 24 h. A curvilinear pattern at the margin is suspicious for inflammation of the gallbladder wall.

• The spleen, liver, bone marrow, kidneys, bowel, bladder, and major blood vessels will normally be visualized.

• Abnormal bowel localization may be seen by 15-30 min and usually increases in intensity over the next 2-3 h.

• The degree and extent of bowel disease is usually demonstrated by 1-2 h.

• Shifting patterns of bowel activity on later images usually indicates distal transit of labeled granulocytes or, at times, bleeding within the bowel lumen.

• Lung activity usually clears by 4 h, unless there is pulmonary edema, diffuse inflammatory lung disease, atelectasis, renal failure, sepsis, or adult respiratory distress syndrome.

• Focal abdominal activity outside the liver and bowel is likely to indicate infection/ inflammation but can vary greatly in intensity depending on the degree of inflammation.

• Caution should be used in interpretation of a focal site of abnormal localization, as indicating a drainable abscess and correlation with other imaging modalities is recommended.

• Infection involving the spine may present as areas of increased or decreased activity compared with normal bone marrow localization.

• Photopenic or "cold" defects may indicate osteomyelitis, but other causes, such as compression fracture, neoplasm, postirradiation changes, or postsurgical or anatomic deformities, should also be considered.   

Saturday, May 22, 2010 - ISRT One Day Educational Seminar
St. Mary's Medical Center
Evansville, Indiana

• 6:45 - 7:45 a.m. Registration, St. Mary's Hospital Amphitheater
  

• 7:45 a.m. Opening Remarks and Instructions, Attendees must be seated in the Amphitheater at this time
  

• 8:00 - 9:00 a.m. What Does The CT Show Us? Jeffrey Hemmerlein M.D.

• 9:15 - 10:15 a.m. Review of Thyroid Anatomy & Pathology for the imaging professional, Claudine Fairchild M.S., RDMS, RT(R)(M)

• 10:30 - 11:30 a.m. MRI 3 T: Safety and Pathology Chris Schmidt B.S., RT(R), CT(R), MR(R)

• 11:40 - 12:40 p.m. Lunch

• 12:45 - 1:45 p.m. Radiologist Assistants: Facts, Frustrations, and the Future, Tracy Ferrara RRA, RT(R)

• 2:00 - 3:00 p.m. Mo-99 Supply Update: What Happened & What to Expect, Timothy Quinton B.C.N.P., Pharm D, M.S.

• 3:15 - 4:15 p.m. Advances in Computed Tomography: Existing and Upcoming Procedures, Chad Bayer B.S., R.T. (R)(CT)