Excretion of radionuclides in human breast milk after nuclear medicine examinations. Biokinetic and dosimetric data and recommendations on breastfeeding interruption
2016 (English)In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 43, no 5, 808-821 p.Article in journal (Refereed) PublishedText
Purpose To review early recommendations and propose guidelines for breastfeeding interruption after administration of radiopharmaceuticals, based on additional biokinetic and dosimetric data.
Methods Activity concentrations in breast milk from 53 breastfeeding patients were determined. The milk was collected at various times after administration of 16 different radiopharmaceuticals. The fraction of the activity administered to the mother excreted in the breast milk, the absorbed doses to various organs and tissues and the effective dose to the infant were estimated.
Results The fraction of the administered activity excreted per millilitre of milk varied widely from 10(-10) to 10(-3) MBq/MBq administered. For Tc-99m-labelled radiopharmaceuticals, the total fraction of the administered activity excreted in the milk varied from 0.0057 % for Tc-99m-labelled red blood cells (RBC) to 19 % for Tc-99m-pertechnetate. The effective dose to an infant per unit activity administered to the mother ranged from 6.7 x 10(-6) mSv/MBq for Tc-99m-labelled RBC to 3.6 x 10(-2) mSv/MBq for Tc-99m-pertechnetate. For the other radiopharmaceuticals, the total fraction of administered activity excreted in the milk varied from 0.018 % (Cr-51-EDTA) to 48 % (I-131-NaI). The effective dose ranged from 5.6 x 10(-5) mSv(infant)/MBq(mother) (Cr-51-EDTA) to 106 mSv(infant)/MBq(mother) (I-131-NaI).
Conclusions Based on an effective dose limit of 1 mSv to the infant and a typical administered activity, we recommend cessation of breastfeeding for I-131-NaI and interruption of feeding for 12 h for I-125-iodohippurate, I-131-iodohippurate, Tc-99m-pertechnetate and Tc-99m-MAA. During this 12-h period all breast milk should be expressed at least three times and discarded. For the other radiopharmaceuticals included in this study, no interruption of breastfeeding is necessary.
Place, publisher, year, edition, pages
2016. Vol. 43, no 5, 808-821 p.
Absorbed dose, Breastfeeding, Breast milk, Nuclear medicine, Radiopharmaceutical
Radiology, Nuclear Medicine and Medical Imaging
IdentifiersURN: urn:nbn:se:umu:diva-120610DOI: 10.1007/s00259-015-3286-0ISI: 000373306800002PubMedID: 26732471OAI: oai:DiVA.org:umu-120610DiVA: diva2:951879