Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review.
Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review.
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DOI：
10.1007/s00259-017-3675-7
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发表时间：
2017-07
影响因子：
9.1
通讯作者：
Mottaghy FM
中科院分区：
文献类型：
--
作者：
van der Pol J;Vöö S;Bucerius J;Mottaghy FM
放射性药物外渗可能会导致严重的软组织损伤，但对这些事件的发生率，医疗后果，可能的干预措施和有效性知之甚少。本研究的目的是估计诊断和治疗性放射性药物外渗的发生率，评价医疗后果，并评价随后对这些事件进行的医学治疗。在Embase和PubMed中使用关键词“给药不当”、“外渗”、“血管旁浸润”，结合“示踪剂”、“放射性核素”、“放射性药物”以及涉及临床使用的示踪剂（即“锝-99 m”、“钇-90”）的关键词列表，进行了一次敏感和详细的文献检索。提取并总结了关于放射性药物外渗和所应用干预措施的报告数据。37篇出版物报告了3016例诊断性放射性药物外渗，其中3例报告了外渗后的症状。8篇出版物报告了10例治疗性示踪剂渗漏病例。最严重的症状是溃疡。在文献中进行或提出了34种不同的干预和预防策略。诊断性放射性药物外渗是常见的。99 mTc、123 I、18F和68 Ga标记的示踪剂不需要特定干预。治疗性放射性药物的外渗可引起严重的软组织损伤。虽然没有证据，但应考虑手术干预。建议采取分散干预、剂量测定和随访。药物干预在放射性药物外渗的即时护理中还没有地位。
Radiopharmaceutical extravasation can potentially lead to severe soft tissue damage, but little is known about incidence, medical consequences, possible interventions, and effectiveness of these. The aims of this study are to estimate the incidence of extravasation of diagnostic and therapeutic radiopharmaceuticals, to evaluate medical consequences, and to evaluate medical treatment applied subsequently to those incidents. A sensitive and elaborate literature search was performed in Embase and PubMed using the keywords “misadministration”, “extravasation”, “paravascular infiltration”, combined with “tracer”, “radionuclide”, “radiopharmaceutical”, and a list of keywords referring to clinically used tracers (i.e. “Technetium-99m”, “Yttrium-90”). Reported data on radiopharmaceutical extravasation and applied interventions was extracted and summarised. Thirty-seven publications reported 3016 cases of diagnostic radiopharmaceutical extravasation, of which three cases reported symptoms after extravasation. Eight publications reported 10 cases of therapeutic tracer extravasation. The most severe symptom was ulceration. Thirty-four different intervention and prevention strategies were performed or proposed in literature. Extravasation of diagnostic radiopharmaceuticals is common. 99mTc, 123I, 18F, and 68Ga labelled tracers do not require specific intervention. Extravasation of therapeutic radiopharmaceuticals can give severe soft tissue lesions. Although not evidence based, surgical intervention should be considered. Furthermore, dispersive intervention, dosimetry and follow up is advised. Pharmaceutical intervention has no place yet in the immediate care of radiopharmaceutical extravasation.