Norlyn Odchigue

BSRT 3-1
RADIOPHARMACY
Radionuclide
• 57Co t1/2:
270 days
Energies: 122 keV
Type: EC, y, accelerator
Radiopharmaceutical
• 57Co- cyanocobalamin (vitamin B-12)
Adult Dose Range
• .3-1 μCi (11.1-37 kBq)
Method of Administration
• Oral (PO); Intramuscular (IM)
• Intrinsic factor (IF)- Substance secreted by the stomach
which enables the body to absorb vitamin B12
INDICATIONS
Diagnosis of
- Type of anemia that
causes unusually red
blood cells, which
Macrocytic means red blood cells
Anemia have low hemoglobin

- Condition in which body

can’t make enough
healthy red blood cells
because it doesn’t have
enough vitamin B12
Evaluation of
Gastrointestinal absorption of B-12 or
low B-12
Small intestinal malabsorption
CONTRAINDICATIONS
• Pregnant women or nursing mothers.
PATIENT PREPARATION
Instruct the patient to;
• Be NPO at least 4 hours before test and continue to do so
for 2 hours after ingestion of radiotracer.
• Discontinue parenteral B-12 for 3 or more days before test.
• Collect all urine in container during the 24-hour period after
ingestion of radiotracer.
• Drink only water for liquid.
• Have no other tests, enemas, or laxatives for the duration of
this test
EQUIPMENT
DETECTOR
• Well Counter- Device used for measuring radioactivity in
small samples
COLLIMATOR
• N/A
COMPUTER SET-UP
• Energy window set at 114-144 keV. Count for 5-10 minutes
per sample (count all the same way)
PROCEDURE (Time: 30 Minutes)
Before Dosing Patient
• Obtain kit supplied by radiopharmacy.
• Assay patient and standard dose record.
• Label paperwork, collection container, and doses.
• Collect a predose urine sample from patient if background
test tube is indicated. Label and store for 24- hour count;
also needed if patient had recent nuclear scan.
Stage 1: Without Intrinsic Factor
• Instruct patient to empty bladder. Collect some urine for testing
for radioactivity if previous nuclear medicine tests have been
performed.
• Instruct patient to ingest capsule containing 57Co-labeled B-12.
Note time on paperwork.
• Patient is given 24-hour urine collection container to begin
collection, patient is still fasting.
• Instruct patient to return in 1-2 hours for IM ‘flushing dose’ of
1000 μg of cold B-12 was absorbed from intestine is excreted
in the urine.
• Instruct patient to return in 24 hours with collection container.
Some collector for 48 hours if serum creatinine levels are more
than 2.5 mg/dL. Record total amount of urine brought in.
Stage 2: With Intrinsic Factor
• Instruct patient to return in 5 days.
• Same test is repeated with patient receiving a capsule
containing intrinsic factor (30 mg) along with the 57Co-labeled
B-12 capsule.
Stage 3: After Antibiotic Treatment
• Physician prescribes antibiotic therapy to patient.
• Instruct patient to return in 5 days.
• Same test as in Stage 2
Stage 4: With Pancreatic Enzymes
• Instruct patient to return in 5 days.
• Same test is repeated with patient receiving a pancreatic
Enzymes
NORMAL RESULTS
• >10% or >7% of dose excreted in urine at 24 hours. Less than
7% is abnormal, indicating failure to absorb B-12.
• Others: >10% excreted at 24 hours (10-40%) is normal; 5-
9.9% indeterminate. Less than 5% is abnormal, indicating
failure to absorb B-12.
ABNORMAL RESULTS
• Stage 1: <10 % of dose excreted in urine at 24 hours. Deficient
absorption because of either intrinsic factor or intestinal deficiency
• Stage 2: >10 % of dose excreted in urine at 24 hours indicates
malabsorption due to intrinsic factor deficiency.
• Stage 3: >10 % indicates malabsorption caused by bacterial
overgrowth
<10 % indicates pancreatic insufficiency