Identification

Summary

Technetium Tc-99m sulfur colloid is a radiopharmaceutical diagnostic agent used for the localization of lymph nodes, evaluation of peritoneovenous (LeVeen) shunt patency, imaging areas of functioning reticuloendothelial cells, and gastrointestinal imaging.

Generic Name
Technetium Tc-99m sulfur colloid
DrugBank Accession Number
DB09397
Background

Technetium 99m sulfur colloid is a radiopharmaceutical diagnostic agent used in the evaluation of various conditions including lymph node metastases in breast cancer, detection of shunt patency, imaging of reticuloendothelial cells for assessment of liver function, and studies of esophageal transit and gastroesophageal reflux. Following injection or oral administration, single photon emission computer tomography (SPECT) imaging is performed using a gamma camera to detect technetium-99m decay. This is possible as Technetium-99m decays by isomeric transition to technetium-99 through the release of a gamma ray. Depending on site of administration and intended usage, Technetium 99m sulfur colloid enters the capillaries and is transported to the lymph nodes (subcutaneous injection), mixes with peritoneal fluid (intraperitoneal injection), is taken up by reticulocytes (intravenous injection), or enters the gastroesphageal tract (oral administration).

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 355.39
Monoisotopic: 354.682823946
Chemical Formula
S8Tc
Synonyms
  • Technetium (99mTc) sulfur colloid
  • Technetium 99m sulfur colloid
  • Technetium Tc 99m sulfur colloid
  • Technetium Tc-99m Sulfur Colloid

Pharmacology

Indication

Technetium 99m sulfur colloid is indicated as a diagnostic agent in adults for the following tests: localization of lymph nodes draining a primary tumor in patients with breast cancer or malignant melanoma; and evaluation of peritoneo-venous (LeVeen) shunt patency. It is indicated in both adult and pediatric patients for: imaging areas of functioning reticuloendothelial cells in the liver, spleen and bone marrow; and studies of esophageal transit and gastroesophageal reflux, and detection of pulmonary aspiration of gastric contents.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Not Available

Mechanism of action

Following injection or oral administration, single photon emission computer tomography (SPECT) imaging is performed using a gamma camera to detect technetium-99m decay. This is possible as Technetium-99m decays by isomeric transition to technetium-99 through the release of a gamma ray.

Absorption

When administered subcutaneously, Technetium Tc 99m Sulfur Colloid enters the lymphatic capillaries and is transported with lymph to lymph nodes where it can be used to detect drainage of primary tumours. When administered by intraperitoneal injection, Technetium Tc 99m Sulfur Colloid mixes with the peritoneal fluid where the rate of clearance from the cavity allows assessment of shunt patency. When administered by intravenous injection, Technetium Tc 99m Sulfur Colloid is taken up by the reticuloendothelial system (RES), allowing RES rich structures to be imaged. Uptake of the radioactive colloid by organs of the RES is dependent upon both their relative blood flow rates and the functional capacity of the phagocytic cells. When administered orally, Technetium Tc 99m sulfur colloid can be used in esophageal transit studies, gastroesophageal reflux scintigraphy, and for the detection of pulmonary aspiration of gastric contents. This is possible as the active substance is not absorbed from the GI tract.

Volume of distribution

Following oral ingestion, Technetium Tc 99m Sulfur Colloid is distributed primarily through the gastrointestinal tract.

Protein binding

Not Available

Metabolism

In the average patient 80 to 90% of the injected collodial particles are phagocytized by the Kupffer cells of the liver, 5 to 10% by the spleen and the balance by the bone marrow.

Route of elimination

Following oral ingestion, elimination is primarily through the feces.

Half-life

Technetium Tc 99m decays by isomeric transition with a physical half-life of 6.02 hours. Following intravenous administration, Technetium Tc 99m Sulfur Colloid Injection is rapidly cleared from the blood by the reticuloendothelial system with a nominal half-life of approximately 2 1/2 minutes.

Clearance

Not Available

Adverse Effects
Adverseeffects
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Toxicity

The most frequently reported adverse reactions, across all categories of use and routes of administration, include rash, allergic reaction, urticaria, anaphylaxis/anaphylactic shock, and hypotension. Less frequently reported adverse reactions are fatal cardiopulmonary arrest, seizures, dyspnea, bronchospasm, abdominal pain, flushing, nausea, vomiting, itching, fever, chills, perspiration, numbness, and dizziness. Local injection site reactions, including burning, blanching, erythema, sclerosis, swelling, eschar, and scarring, have also been reported. Anaphylactic reactions including rare fatalities have occurred following intravenously administered Technetium Tc 99m Sulfur Colloid. Radiation-emitting products, including Technetium Tc 99m Sulfur Colloid Injection, may increase the risk for cancer, especially in pediatric patients. Use the smallest dose necessary for imaging and ensure safe handling to protect the patient and health care worker.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Not Available
Food Interactions
  • Take with food. For pediatric patients, orally administered Technetium Tc-99m sulfur colloid should be given with milk, or if administered by nasogastric tube, it should be given with milk or dextrose.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Kit for the Prepartion of Technetium Tc99m Sulfur ColloidKit18.1 mg/10mLIntravenous; Oral; SubcutaneousSun Pharmaceutical Industries, Inc.1978-04-19Not applicableUS flag

Categories

ATC Codes
V09DB05 — Technetium (99mtc) sulfur colloid
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as organic transition metal salts. These are organic salt compounds containing a transition metal atom in its ionic form.
Kingdom
Organic compounds
Super Class
Organic salts
Class
Organic metal salts
Sub Class
Organic transition metal salts
Direct Parent
Organic transition metal salts
Alternative Parents
Not Available
Substituents
Organic transition metal salt
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
Not Available

Chemical Identifiers

UNII
556Q0P6PB1
CAS number
Not Available
InChI Key
FJTPHHNWVXNMEK-NLQOEHMXSA-N
InChI
InChI=1S/S8.Tc/c1-2-4-6-8-7-5-3-1;/i;1+2
IUPAC Name
octathiocane (99Tc)technetium
SMILES
[99Tc].S1SSSSSSS1

References

General References
  1. Giovinazzo H, Kumar P, Sheikh A, Brooks KM, Ivanovic M, Walsh M, Caron WP, Kowalsky RJ, Song G, Whitlow A, Clarke-Pearson DL, Brewster WR, Van Le L, Zamboni BA, Bae-Jump V, Gehrig PA, Zamboni WC: Technetium Tc 99m sulfur colloid phenotypic probe for the pharmacokinetics and pharmacodynamics of PEGylated liposomal doxorubicin in women with ovarian cancer. Cancer Chemother Pharmacol. 2016 Mar;77(3):565-73. doi: 10.1007/s00280-015-2945-y. Epub 2016 Jan 28. [Article]
  2. Shih WJ, Domstad PA, Friedman B, DeLand FH: Intrathoracic abnormalities demonstrated by technetium-99m sulfur colloid imaging. Clin Nucl Med. 1986 Nov;11(11):792-6. [Article]
  3. Bowen SR, Chapman TR, Borgman J, Miyaoka RS, Kinahan PE, Liou IW, Sandison GA, Vesselle HJ, Nyflot MJ, Apisarnthanarax S: Measuring total liver function on sulfur colloid SPECT/CT for improved risk stratification and outcome prediction of hepatocellular carcinoma patients. EJNMMI Res. 2016 Dec;6(1):57. doi: 10.1186/s13550-016-0212-9. Epub 2016 Jun 27. [Article]
  4. Zuckerman E, Slobodin G, Sabo E, Yeshurun D, Naschitz JE, Groshar D: Quantitative liver-spleen scan using single photon emission computerized tomography (SPECT) for assessment of hepatic function in cirrhotic patients. J Hepatol. 2003 Sep;39(3):326-32. [Article]
KEGG Drug
D06048
PubChem Compound
76957057
PubChem Substance
347827842
RxNav
1423270
ChEMBL
CHEMBL1201529
FDA label
Download (4.69 MB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
2CompletedDiagnosticDyspeptic Subjects1
2RecruitingDiagnosticEyelid Sebaceous Gland Carcinoma1
Not AvailableRecruitingDiagnosticHepatocellular Carcinoma / Intrahepatic Cholangiocarcinoma / Stage IV Liver Cancer / Stage IVA Liver Cancer / Stage IVB Liver Cancer / Vascular Thrombosis1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
KitIntravenous; Oral; Subcutaneous18.1 mg/10mL
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.608 mg/mLALOGPS
logP0.82ALOGPS
logP4.76ChemAxon
logS-2.6ALOGPS
Physiological Charge0ChemAxon
Hydrogen Acceptor Count0ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area0 Å2ChemAxon
Rotatable Bond Count0ChemAxon
Refractivity46.05 m3·mol-1ChemAxon
Polarizability20.4 Å3ChemAxon
Number of Rings1ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Drug created at November 30, 2015 19:10 / Updated at October 09, 2021 02:48