Enhancing the Affordability and Accessibility of Methylene Diphosphonate Radiopharmaceutical through Optimization in Low Resource Oncology Settings

Purpose of Study: Methylene diphosphonate (MDP) radiolabeled with Technetium-99m (^99mTc-MDP) is among the most widely used radiopharmaceuticals in oncology, primarily for the detection of skeletal metastases in patients with breast, prostate, and lung cancers. However, high costs, wastage of multidose kits, and dependency on cold-chain infrastructure hinder accessibility in low-resource oncology centers. This study assessed the stability and radiochemical purity (RCP) of fractionated MDP aliquots stored under ambient conditions, with the goal of establishing cost-effective strategies for sustainable nuclear oncology services.

 

Materials and Methods: A prospective experimental laboratory-based study design was applied at the University Teaching Adult Hospital Nuclear Medicine Hot Laboratory, Zambia. Forty MDP aliquots prepared from kit fractionation were stored at ambient (15–32 °C), refrigerated (2–8 °C), and frozen (–23 °C) conditions. Aliquots were labeled with ^99mTc and tested for RCP using instant thin-layer chromatography. Data were analyzed with Stata 14.

 

Results: Ambient-stored MDP aliquots retained RCP values of 98–99% over 18 days, exceeding the WHO acceptance threshold of 90%. Refrigerated and frozen aliquots-maintained RCP values of 99–100% for 28 days. Statistical analysis using Pearson chi-square tests demonstrated significant differences in radiochemical purity with a p value of < 0.05.

 

Conclusion: In oncology practice, where bone scintigraphy is indispensable for staging and therapy monitoring, ambient storage of fractionated MDP offers substantial cost saving mechanisms and practical solution in low-resource settings. This method reduces radiopharmaceutical wastage, mitigates reliance on cold-chain logistics, and enhances access to essential cancer diagnostics.

 

Keywords: Technetium-99m, Methylene Diphosphonate, Radiochemical Purity, Bone Scintigraphy, Cancer Diagnosis, Radiopharmaceuticals