A study of technetium-99m wastage in selected private sector nuclear medicine imaging departments

BACKGROUND South African nuclear medicine imaging departments have been fortunate in being able to receive an uninterrupted supply of molybdenum-99 (99Mo)/technetium-99m (99mTc) generators. Nuclear medicine radiographers practising in private sector services in the northern Gauteng region indicated a possible problem with the quantities of wasted and unused 99mTc radiopharmaceuticals returned to the radiopharmaceutical supply laboratory. Daily radiopharmaceutical deliveries are a combination of ordered packages and standard packages. The purpose of the standard package is to accommodate emergency and after-hours nuclear medicine services. The purpose of the study was to interrogate the unconfirmed reports of 99mTc radiopharmaceutical wastage. METHODS A descriptive quantitative research design was conducted in six private sector nuclear medicine imaging practices in the northern Gauteng region. Overt observations of the quantities of radiopharmaceutical supply, usage and wastage were conducted over 2 days in each of these practices. RESULTS Ordered packages comprised 14% of the total 99mTc radiopharmaceutical deliveries to these six nuclear medicine imaging departments. It was identified that:(1) a total of 83.2% of ordered packages and 35.1% of standard packages of preprepared syringes were utilized;(2) a total of 36% of ordered packages and 22.6% of standard packages of bulk 99mTc were utilized; and (3) a total of 70.6% of the total quantity of radiopharmaceuticals was returned to the radiopharmaceutical laboratory. The total wastage represented 45.5% of the ordered packages and 75.8% of the standard packages. CONCLUSION Wastage of 74 GBq of 99mTc from six sites over 12 days should raise concerns for the nuclear medicine industry. A review of the system framework that supports communication between the radiopharmaceutical supplier/s and the nuclear medicine imaging practices is recommended.