Clinical Application of On-site Prepared Technetinum-99m Human Serum Albumin for Scintigraphic Detecting of Protein-losing Enteropathy

Abstract

Background: Abdominal scintigraphy performed with technetium-99m ((superscript 99 m) Tc)-labeled human serum albumin (HSA) provides direct evidence of protein-losing enteropathy (PLE). However, because of transfusioninduced infections, the safety of serum products is a major concern. We previously developed an on-site preparation of (superscript 99 m) Tc-HSA using domestic serum products, which showed good labeling efficiency, stability, and bioavailability. The purpose of this pilot study was to initially evaluate those preparations of (superscript 99 m) Tc-labeled HSA for clinical application. Methods: HSA was locally acquired and appropriately screened for infectious diseases. (superscript 99 m) Tc-HSA was prepared according to our previous protocol. It was intravenous administration to patients with clinically suspected PLE. Sequential abdominal images were acquired by a gamma camera. Sites of obvious PLE were localized after the radiolabeled HSA was administered. Patients were monitored for adverse events. Results: Five patients with clinical suspicious of PLE were enrolled in this pilot study. Areas of protein loss were demonstrated in two patients. Another three cases, the origin of diminished serum albumin levels remained undetermined. All patients tolerated with procedure well with no specific adverse effects or major complaints. Conclusion: Scintigraphy with (superscript 99 m) Tc-HSA is noninvasive and can be used to detect, localize, and follow up cases of occult or intermittent PLE. Our pilot study demonstrated that this on-site prepared (superscript 99 m) Tc-HSA was appropriate for clinical application. Procedure of on-site radiolabeling from the native serum product was easy to be performed and achieved good labeling efficiency and bioavailability. It might also reduce the incidence of transfusion-induced infections. This technique resulted in good image quality and improved patient safety.