Validation of radiochemical purity analysis methods used in two tertiary public hospitals in South Africa

Date
2016-03
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Radiopharmaceutical kits are supplied by manufacturers with package inserts containing information about the kit including validated methods of preparation and radiochemical purity (RCP) analysis. Validated analytical methods are also described in pharmacopoeial monographs. However the information provided is not always complete or practical and in a hospital setting it can be difficult to select and perform adequate RCP testing on the prepared radiopharmaceuticals. This situation has led to modifications or substitution for much quicker, simplified, safe or cost-effective analytical procedures. A number of these procedures have been proposed in published literature and have been incorporated in some hospital settings including radio pharmacies in Africa. Since the responsibility of any method that deviates from the official pharmacopoeial or manufacturer’s method rests with the end user, this study was aimed to determine whether appropriate validation procedures based on the Q2A and Q2B guidelines of the International Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) are feasible for use in a resource limited environment, which pertains in most hospital radio pharmacy settings in Southern Africa. A further aim was to develop a prototype protocol for validation of analytical procedures in a hospital radio pharmacy setting. In an attempt to undertake a full analytical method validation, eight validation parameters described in the ICH guidelines were selected for the current study namely specificity, accuracy, precision (repeatability and intermediate precision), linearity, range, limit of detection, limit of quantitation and robustness. To undertake the validation exercise, fast RCP test methods for Tc-99m sestamibi involving the use of Whatman 31ET and Schleicher and Schuell chromatography paper were used. Locally procured Macherey-Nagel (MN) Alox N aluminium oxide TLC strips were intended as control method as the Baker-Flex aluminium oxide TLC strips described in the manufacturer’s instructions could not be sourced. All the tests were performed in triplicate and results were compared. A limited number of tests was also performed on Baker-Flex TLC strips to compare with the results of the substitute MN Alox method. The radiochemical components namely Tc-99m sestamibi, Tc-99m colloid and pertechnetate that were prepared in house and were assumed to be 100 % pure, were each tested on the chromatography strips. Samples containing mixtures of varying concentrations of the radiochemical components were also tested on all the strips. Radiochemical purity test results of sestamibi samples without any added impurities were 99.8 % ± 0.0 % for Macherey-Nagel Alox TLC, 99.5 % ± 0.1 % for Whatman 31ET paper and 99.3 % ± 0.2 % for Schleicher and Schuell paper chromatography strips. When Tc-99m pertechnetate and Tc-99m colloid were added to Tc-99m sestamibi as impurities after completion of kit reconstitution, the values for sestamibi were in all cases higher than the calculated RCP. These higher results could have been due to binding of the added technetium to the sestamibi. Another possibility would be that another technetium compound was formed after mixing the already prepared radiochemical components. This new impurity then co-migrated with the Tc-99m sestamibi on the chromatography strips. The unknown impurity could not be isolated or quantified. This impurity could not be proved to be Tc-99m pentamibi, as it was not possible to prepare this radiochemical component in-house and hence all the analytical methods lacked specificity. The MN Alox test method showed exceptionally high values for sestamibi due to co-elution of the free pertechnetate with sestamibi in addition to the unknown impurity. As a result, the MN Alox RCP test method could not be used as a reference standard. The poor agreement between the nominal (calculated) and observed results had a negative effect on the accuracy and linearity over the range that was selected of all the three analytical procedures. Apart from meeting the acceptance criteria for repeatability and intermediate precision, all three analytical methods were also noted to be robust. For the radiochromatogram scanner, the limit of detection was 59 counts while the limit of quantitation was 177 counts for the scanning speed and distance used. In conclusion, all the eight ICH validation parameters are essential when validating a RCP test method. Also, validating an analytical procedure in a hospital setting is possible once some important prerequisites are met, such as availability of staff trained in radiopharmacy or radiochemistry, availability of specified materials for the reference procedure or control experiments, in house preparation of reference standards, and a template validation protocol for thin layer chromatography (TLC) and paper chromatography. Availability of specialized equipment such as a high performance liquid chromatography (HPLC)system for radiopharmaceuticals that have impurities other than free pertechnetate and colloid, is also a requirement, but HPLC is not currently available in public sector Radiopharmacies in South Africa.
AFRIKAANSE OPSOMMING : Radiofarmaseutiese kitsstelle word deur vervaardigers met voubiljette wat inligting oor die kitsstel bevat, voorsien. Dit sluit bereidingsmetodes en analisemetodes om radiochemiese suiwerheid te bepaal, in. Gevalideerde analitiese metodes word ook in monografieë in farmakopieë beskryf. Die inligting wat voorsien word, is egter nie altyd volledig of prakties nie en in ʼn hospitaalopset kan dit moeilik wees om geskikte radiochemiese analise van die bereide radiofarmaseutika te doen. Hierdie situasie het tot aanpassings van metodes of vervanging met vinniger, vereenvoudigde, veilige of koste-effektiewe analitiese prosedures gelei. ʼn Aantal van die prosedures is gepubliseer en word in hospitaal radiofarmasiepraktyk, ook in Afrika, toegepas. Die verantwoordelikheid vir enige metode wat van die amptelike farmakopieë of vervaardiger sʼn afwyk, lê by die eindgebruiker daarvan. Hierdie studie het daarom ten doel gehad om te bepaal of toepaslike validasieprosedures gebaseer op die ICH (International Conference on Harmonisation) se Q2A en Q2B riglyne uitvoerbaar is in omgewings met beperkte hulpbronne, soos in hospitaal radiofarmasiepraktyke in suidelike Afrika. ʼn Verdere doelstelling was om ʼn prototipe protokol vir die validering van analitiese prosedures in hospitaalradiofarmasie te ontwikkel. In ʼn poging om ʼn volle analitiese validering volgens ICH riglyne te doen, is agt validasie parameters, naamlik spesifisiteit, akkuraatheid, presisie (herhaalbaarheid en intermediêre presisie), lineariteit, reikwydte, perk van opsporing, perk van kwantifisering en robuustheid, vir hierdie studie gekies. Vinnige radiochemiese analisemetodes vir die evaluering vanTc-99m sestamibi is gebruik om die valideringsproses te toets. Whatman 31ET en Schleicher en Schuell chromatografie papier is gebruik. Plaaslik verkrygbare Macherey-Nagel (MN) Alox N aluminiumoksied dunlaagstrokies was aanvanklik die keuse van kontrolemetode, aangesien die Baker-Flex aluminiumoksied strokies wat die kitsstelvervaardiger se aanwysings voorskryf, nie verkry kon word nie. Alle toetse is in drievoud gedoen en resultate is vergelyk. ʼn Beperkte aantal toetse is aan die einde van die studietydperk met Baker-Flex TLC strokies uitgevoer om dit met die plaasvervangende MN Alox aluminiumoksied te vergelyk. Die radiochemiese komponente, naamlik Tc-99m sestamibi, Tc-99m kolloïed en vry pertegnetaat is intern berei met veronderstelde suiwerheid van 100 %. Al drie komponente is individueel op die chromatografiestrokies getoets, asook mengsels met wisselende konsentrasies van die drie vorms van Tc-99m. Die gemete radiochemiese suiwerheid van sestamibi monsters sonder enige bygevoegde onsuiwerhede was 99.8 % ± 0.0 % vir Macherey-Nagel Alox strokies, 99.5 % ± 0.1 % vir Whatman 31ET papier en 99.3 % ± 0.2 % vir Schleicher en Schuell papier chromatografie strokies. Toe Tc-99m pertegnetaat en Tc-99m kolloïed as onsuiwerhede na kitsstelbereiding by Tc-99m sestamibi gevoeg is, was die waardes vir sestamibi in alle gevalle hoër as die berekende radiochemiese suiwerheid. Hierdie hoër waardes mag moontlik te wyte wees aan binding van die bygevoegde tegnesium aan die sestamibi. Nog ʼn moontlikheid mag wees dat ʼn ander tegnesium verbinding na vermenging van die verskillende radiochemiese komponente gevorm is. Die nuwe onsuiwerheid het dan saam met sestamibi op die chromatografie strokies migreer. Die onbekende onsuiwerheid kon nie geïsoleer of kwantifiseer word nie. Dit kon ook nie aangetoon word of dit Tc-99m pentamibi was nie, aangesien dit nie moontlik was om hierdie radiochemiese spesie plaaslik te berei nie. Al die analitiese metodes was dus nie spesifiek genoeg nie. Die MN Alox metode het buitengewoon hoë waardes vir sestamibi getoon as gevolg van ko-migrasie van vry pertegnetaat met sestamibi bykomend tot bogenoemde onbekende onsuiwerheid. Die MN Alox radiochemiese analisemetode was dus nie as verwysingsmetode geskik nie. Die swak korrelasie tussen die teoretiese (berekende) en gemete resultate het die akkuraatheid en lineariteit oor die gekose reikwydte vir al drie analisemetodes negatief beïnvloed. Al drie metodes het aan die kriteria vir herhaalbaarheid en intermediêre presisie voldoen en was robuus. Daar is getoon dat die radiochromatogram skandeerder se perk van opsporing (limit of detection) 59 tellings en perk van kwantifisering (limit of quantitation) 177 tellings vir die gebruikte skandeerspoed en lengte was. Die gevolgtrekking van hierdie studie is dat al agt ICH valideringsparameters noodsaaklik is wanneer ʼn analisemetode vir radiochemiese suiwerheid evalueer word. Validering van ʼn analitiese metode in ʼn hospitaalopset is moontlik, mits aan ʼn paar belangrike vereistes voldoen kan word. Voorbeelde hiervan is beskikbaarheid van personeel wat in radiofarmasie of radiochemie opgelei is, beskikbaarheid van die gespesifiseerde materiaal vir die verwysingsmetode of kontrole eksperimente, die moontlikheid om verwysingstandaarde te berei, asook beskikbaarheid van ʼn templaat valideringsprotokol vir dunlaag- en papierchromatografie. Beskikbaarheid van gespesialiseerde apparaat soos ʼn HPLC sisteem vir radiofarmaseutiese produkte met ander onsuiwerhede as vry pertegnetaat en kolloïed, is ook ʼn vereiste, maar HPLC is oor die algemeen nie in hospitaalradiofarmasiepraktyke in Suid-Afrika beskikbaar nie.
Description
Thesis (MSc)--Stellenbosch University, 2016.
Keywords
Radiochemical analysis, Radioisotopes in pharmacology, Sestamibi, Thin layer chromatography, UCTD
Citation