Last update Feb. 14, 2024

Rubidium-82, 82RB

Compatible

Safe substance and/or breastfeeding is the best option.

A positron emission tomography (PET) scan is an imaging study that helps reveal the metabolic or biochemical function of tissues and organs by means of a radiotracer or radionuclide (radioactive element) that is injected into a vein and accumulates in the diseased areas that will be detected by a CT or MRI scan.

The radiation received in a PET scan is not higher than that of an abdominal CT scan. The most commonly used markers for PET are Carbon-11 (11C), Fluorine-18 (18F), Nitrogen-13 (13N), Oxygen-15 (15O) and Rubidium-82 (82Rb).

The low quantity and short half-life of the radionuclides used makes it possible to breastfeed soon after the scan (ACMUI 2019, Mitchell 2019).Discontinuing breastfeeding for the time of 5 isotope half-lives removes all traces of radioactivity, but radiation of less than 1mSv (which is safe) is achieved without the need to discontinue breastfeeding with these radionuclides:

 Radionuclide       Half-life                         Interruption of breastfeeding 

  • 18F:                    110 minutes                       No or 4 hours (avoid contact first 12 hours) 
  • 11C:                     20 minutes                        No
  • 68Ga:                     68 minutes                        4 hours
  • 13N:                     10 minutes                        No
  • 15O:                       2 minutes                        No
  • 82Rb:                  1,3 minutes                        No

Most agencies and expert authors consider that, due to their short physical half-life, no interruption of lactation is required after PET with 18F, 11C, 13N, 15O or 82Rb. (Mattsson 2021, Mitchell 2019, IAEA 2018 p283, ICRP 2015 p320-21, Jamar 2013, Leide 2010, IRCP 2008 p164, Moses 2005)

Nuclear medicine services can measure the radioactivity of milk so that breastfeeding can be safely resumed. (Stabin 2000)

Breastfeeding can lead to excessive uptake of 18FDG diffusely in the breast, sometimes unilaterally, depending on the breastfeeding practice, which can lead to misdiagnoses of breast cancer or lymphoma or mastitis. (Ko 2013, Abhyankar 2012, Hendler 2010, Hicks 2001)


See below the information of these related products:

  • Fluorine-18 (18F) (Safe substance and/or breastfeeding is the best option.)
  • Gallium-68 (68Ga) (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Magnetic Resonance Imaging (Safe substance and/or breastfeeding is the best option.)
  • Raclopride 11C (Safe substance and/or breastfeeding is the best option.)
  • X-Ray (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Rubidium-82, 82RB is also known as Positron Emission Tomography (Scan PET). Here it is a list of alternative known names::


References

  1. Mattsson S, Leide-Svegborn S, Andersson M. X-RAY AND MOLECULAR IMAGING DURING PREGNANCY AND BREASTFEEDING-WHEN SHOULD WE BE WORRIED? Radiat Prot Dosimetry. 2021 Oct 12;195(3-4):339-348. Abstract Full text (link to original source)
  2. ACMUI: Advisory Committee on Medical Uses of Isotopes. Sub-Committee on Nursing Mother Guidelines for the Medical Administration of Radioactive Materials. Final Report Submitted: January 31, 2019 Full text (link to original source)
  3. Mitchell KB, Fleming MM, Anderson PO, Giesbrandt JG; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #30: Radiology and Nuclear Medicine Studies in Lactating Women. Breastfeed Med. 2019 Jun;14(5):290-294. Abstract
  4. IAEA - International Atomic Energy Agency. Radiation Protection and Safety in Medical Uses of Ionizing Radiation IAEA Safety Standards Series No. SSG-46, 2018 Abstract Full text (link to original source)
  5. ICRP 2015: Mattsson S, Johansson L, Leide Svegborn S, Liniecki J, Noßke D, Riklund KÅ, Stabin M, Taylor D, Bolch W, Carlsson S, Eckerman K, Giussani A, Söderberg L, Valind S; ICRP.. Radiation Dose to Patients from Radiopharmaceuticals: a Compendium of Current Information Related to Frequently Used Substances. ANNEX D. RECOMMENDATIONS ON BREAST-FEEDING INTERRUPTIONS. ICRP Publication 128. Ann. ICRP 44(2S). 2015. Table D1 p320-21. Abstract Full text (link to original source)
  6. Ko KH, Jung HK, Jeon TJ. Diffuse intense 18F-FDG uptake at PET in unilateral breast related to breastfeeding practice. Korean J Radiol. 2013 Abstract Full text (in our servers)
  7. Jamar F, Buscombe J, Chiti A, Christian PE, Delbeke D, Donohoe KJ, Israel O, Martin-Comin J, Signore A. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. Abhyankar A, Joshi J, Basu S. FDG uptake in unilateral breast related to breastfeeding practice in a patient of pulmonary hydatid cyst. Clin Nucl Med. 2012 Abstract
  9. Hendler D, Stemmer SM. Uncommon reason for high fluorodeoxyglucose positron emission tomography uptake. J Clin Oncol. 2010 Abstract Full text (in our servers)
  10. Leide-Svegborn S. Radiation exposure of patients and personnel from a PET/CT procedure with 18F-FDG. Radiat Prot Dosimetry. 2010 Abstract
  11. ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Annex D. Recommendations on breast-feeding interruptions, p. 163-165. Ann ICRP. 2008 Abstract Full text (link to original source) Full text (in our servers)
  12. Moses-Kolko EL, Meltzer CC, Helsel JC, Sheetz M, Mathis C, Ruszkiewicz J, Bogen D, Confer AL, Wisner KL. No interruption of lactation is needed after (11)C-WAY 100635 or (11)C-raclopride PET. J Nucl Med. 2005 Abstract Full text (in our servers)
  13. Hicks RJ, Binns D, Stabin MG. Pattern of uptake and excretion of (18)F-FDG in the lactating breast. J Nucl Med. 2001 Abstract Full text (in our servers)
  14. Stabin MG, Breitz HB. Breast milk excretion of radiopharmaceuticals: mechanisms, findings, and radiation dosimetry. J Nucl Med. 2000 Abstract Full text (link to original source) Full text (in our servers)

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