Ceretec

Ceretec is a radiopharmaceutical used in nuclear medicine for brain perfusion imaging. It refers to technetium-99m labeled hexamethylpropyleneamine oxime (Tc-99m exametazime, commonly known as HMPAO). The kit is reconstituted with Tc-99m to produce the imaging agent and is administered intravenously.

Pharmacology and mechanism: The compound is lipophilic and crosses the blood-brain barrier. After injection, Tc-99m exametazime distributes in brain tissue in relation to regional cerebral blood flow and becomes trapped within cells, allowing single-photon emission computed tomography (SPECT) to visualize cerebral perfusion patterns.

Clinical uses: Ceretec is used to evaluate cerebral perfusion in suspected stroke or other cerebrovascular disease, and to aid in the assessment of certain cognitive disorders such as dementia. It can also be employed in epilepsy workups and, in some centers, as an adjunct in brain death assessment when perfusion imaging is indicated.

Procedure and imaging: Following intravenous administration, patients undergo SPECT imaging. The acquisition is performed after a short interval, with timing depending on the protocol and clinical indication. The resulting perfusion maps are interpreted in the context of the patient’s clinical presentation and other imaging findings.

Safety and regulation: Ceretec is a radiopharmaceutical, and its use involves exposure to ionizing radiation. Adverse reactions are rare. Contraindications include pregnancy and lactation, and it should be used only in facilities equipped for radiopharmaceutical handling under appropriate radiation safety procedures.