PT - JOURNAL ARTICLE AU - Bonta, Dacian V. AU - Halkar, Raghuveer K. AU - Alazraki, Naomi TI - Extravasation of a Therapeutic Dose of <sup>131</sup>I-Metaiodobenzylguanidine: Prevention, Dosimetry, and Mitigation AID - 10.2967/jnumed.110.083725 DP - 2011 Sep 01 TA - Journal of Nuclear Medicine PG - 1418--1422 VI - 52 IP - 9 4099 - http://jnm.snmjournals.org/content/52/9/1418.short 4100 - http://jnm.snmjournals.org/content/52/9/1418.full SO - J Nucl Med2011 Sep 01; 52 AB - After the extravasation of a therapeutic dose of 131I-metaiodobenzylguanidine that produced a radiation burn to a patient's forearm, we instituted a catheter placement verification protocol. Methods: Before therapy infusion, proper placement is verified by administering 37 MBq of 99mTc-pertechnetate through the catheter, and monitoring activity at the administration site and on the contralateral extremity. A dosimetric model describing both high-rate and low-rate dose components was developed and predicted that the basal epidermal layer received a radiation dose consistent with the observed moist desquamation radiation skin toxicity. Results: No extravasation incidents have occurred since the verification procedure was instituted. Conclusion: To protect against radiation injury from extravasation of therapeutic radionuclides, test administration of a small 99mTc dose with probe monitoring of comparable sites in both upper extremities appears to be an effective preventive measure.