Radiopharmaceutical factors in the variable quality of [99mTc]HM-PAO images of the brain.

Variability in the quality of [99mTc]HM-PAO images of the brain has been attributed to differences between kits and the addition of excessive amounts of pertechnetate to the kits. A retrospective study showed no significant differences between batches of kits with respect to radiochemical purity (RCP) or image quality. Up to 3000 MBq (81 mCi) pertechnetate could be added to the kit without adversely affecting RCP or image quality. It was shown that image quality was directly affected by RCP at time of injection and dropped sharply when RCP fell below 85%. Interstitial injection and mixing with blood prior to injection also resulted in poor image quality. Pretreatment with perchlorate reduced uptake of activity in the parotid glands; this improved image quality and reduced the influence of RCP.