RT Journal Article SR Electronic T1 Extravasation of a Therapeutic Dose of 131I-Metaiodobenzylguanidine: Prevention, Dosimetry, and Mitigation JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1418 OP 1422 DO 10.2967/jnumed.110.083725 VO 52 IS 9 A1 Dacian V. Bonta A1 Raghuveer K. Halkar A1 Naomi Alazraki YR 2011 UL http://jnm.snmjournals.org/content/52/9/1418.abstract 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.