Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 4. P. 48–55

DOI: 10.12737/article_5d110f04375033.57581297

B.Ya. Narkevich1,2, S.V. Shiryaev2, I.V. Lagutina1,2, Yu.V. Buydenok2, T.K. Kharatishvili2, N.S. Petrochenko2

Leakage Radiometric Control of Chemical Drugs with Regional Perfusion of Surgical Isolated Limbs

1. Association of Medical Physicists of Russia, Moscow, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. ;
2. N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia

B.Ya. Narkevich – President of the AMPR, Leading Researcher, Dr. Sci. Tech., Prof., Academician of International Academy of Engineering;
S.V. Shiryaev – Head of Lab., Dr. Sci. Med., Prof., Member of the European Association of Nuclear Medicine and Molecular Imaging, Member of the American College of Nuclear Medicine and Molecular Imaging, Member of the Society of Nuclear Medicine and Molecular Imaging;
I.V. Lagutina – Medical Physicist;
Yu.V. Buydenok – Perfusiologist, Leading Researcher, Dr. Sci. Med.;
T.K. Kharatishvili – Surgeon, Leading Researcher, Dr. Sci. Med., Prof.;
N.S. Petrochenko – Surgeon, PhD Med.


Purpose: Modernization and evaluation of the clinical effectiveness of the technology of continuous radiometric monitoring carried out during high-dose chemotherapy of a surgically isolated limb with tumor foci.

Material and methods: A modernized radiometric control technology for regional limb perfusion is proposed. It is based on in vivo labeling of erythrocytes with 99mTc eluate followed by continuous monitoring of the activity of labeled erythrocytes as a simulator of a chemotherapy drug over the heart region. Its distinctive features are intravenous injection of a pyrfotech slice after giving inhalation anesthesia to ensure a sufficient level of red blood cell chelation, as well as using 99mTc activity less than its minimum significant level, which allows working with an open source of ionizing radiation without violating the requirements of radiation safety regulations.

Results: The developed technology was successfully used with 106 regional perfusion of the upper and lower extremities in patients with melanoma or sarcoma of soft tissues. In 4 cases, according to the results of radiometric control, the intervention of the surgical team was required to reduce the chemical preparation leakage that was occurring.

Conclusion: The technology upgraded by us is characterized by ease of implementation, the ability to take timely measures to prevent or reduce the leakage of a chemotherapy drug from an isolated limb according to the results of continuous in vivo radiometric monitoring of 99mTc-labeled red blood cells over the heart, as well as low radiation load on the patient and staff.

Key words: high-dose chemotherapy, surgically isolated limb, regional perfusion, chemotherapy leaks, radiometric monitoring


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For citation: Narkevich BYa, Shiryaev SV, Lagutina IV, Buydenok YuV, Kharatishvili TK, Petrochenko NS. Leakage Radiometric Control of Chemical Drugs with Regional Perfusion of Surgical Isolated Limbs. Medical Radiology and Radiation Safety. 2019;64(4):48–55. (Russian).

DOI: 10.12737/article_5d110f04375033.57581297

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