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Nuclear Pharmacy

Evaluation of Labeling and Stability of Novel Tc-99m-Sulfur Colloid Labeled Egg-Free Alternatives to the Recommended, Standardized Egg White-Based Meal for Gastric Emptying Scintigraphy

(1190) Evaluation of Labeling and Stability of Novel tc-99m-sulfur Colloid Labeled Egg-free Alternatives to the Recommended, Standardized Egg White-based Meal for Gastric Emptying Scintigraphy

Saturday, March 23, 2024
12:30 PM – 2:30 PM East Coast USA Time

    Primary (first) Author(s)

  • Spencer T. Smith, PharmD

    Academic Nuclear Pharmacy Fellow
    Purdue University
    West Lafayette, Indiana, United States

    • Presenting Author(s)

  • Spencer T. Smith, PharmD

    Academic Nuclear Pharmacy Fellow
    Purdue University
    West Lafayette, Indiana, United States

    • Co-Author(s)

  • CS

    Craig Shaffer

    PharmD Student
    Purdue University, United States

    • Faculty Advisor/Preceptor(s)

  • KW

    Kara Weatherman

    Clinical Professor
    Purdue University
    West Lafayette, Indiana, United States

Disclosure(s):
Spencer T. Smith, PharmD: No financial relationships to disclose


Objectives: To present alternatives to the recommended, standardized egg white-based meal for gastric emptying scintigraphy studies that may be acceptable for patients with a contraindication or dietary aversion to egg products.

Methods: The current standard for adult solid meal gastric emptying studies, Tc-99m-Sulfur Colloid (SC) in liquid egg whites, will be prepared according to current SNMMI procedure guidelines for adult solid meal gastric emptying studies and will serve as the control for our experiments. Four additional food items will be prepared and compared to the guideline standard for both radiopharmaceutical uniformity as well as overall stability of the radiolabel in a simulated gastric environment. Alternate food items that will be tested are: 1) instant rice and quinoa; 2) vegan egg substitute; 3) vegan waffle prepared from mix; and 4) chia seed and vegan protein shake pudding. Each food item will be prepared following product-specific preparation recommendations, with the addition of Tc-99m-SC during one of the product mixing steps to maximize uniformity. After radiolabeling, each food item will be divided into approximately equal portions. Each portion will be placed in a capped scintillation tube. To evaluate uniformity, total activity per weight will be obtained for each portion. Following this, simulated gastric fluid (SGF) will be added to the scintillation tubes. Samples will be divided into four groups, labeled for either 1-, 2-, 3-, or 4-hour testing, and placed on a shaker at 37 degrees Celsius for the duration of the designated testing period. At each specified time interval, the respective scintillation tubes will undergo centrifugation to separate the food item and SGF. The resulting supernatant will be drawn off, and the food item will be assayed and corrected for radioactive decay to determine the amount of Tc-99m-SC activity retained in the food item. Uniformity data will be evaluated to determine if any of the food items exhibit unusual radiolabel distribution. Stability data will be evaluated to determine radiolabel stability over time.

Results: Research is in progress.

Conclusions: Research is in progress.