Comparison of radionuclide estimation of glomerular filtration rate using technetium 99m diethylenetriaminepentaacetic acid and chromium 51 ethylenediaminetetraacetic acid (original) (raw)
Related papers
European Journal of Nuclear Medicine, 1995
Simultaneous measurements of the clearance rate of chromium-51 ethylene diamine tetra-acetic acid (51Cr-EDTA) and technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA) were performed in 54 patients with a range of function between 9 and 176 ml/min. Using multiple blood samples the two clearance values correlated well (r = 0.97, SEE 8.6 ml/min) and DTPA clearance was higher by 2.9%. For each radiopharmaceutical the plasma clearance rates obtained using multiple blood samples were compared with those obtained with simplified methods, i.e., the 60-180 rain two-sample method of Russell and the mono-exponential method with the Brochner-Mortensen correction. For both radiopharmaceuticals the clearance values correlated well with the Russell method (r = 0.99, SEE = 4.1 ml/min for EDTA; r-0.99, SEE 4.9 ml/min for DTPA) and the mono-exponential method (r = 0.99, SEE 3,6 ml/min for EDTA; r = 0.99, SEE 3.9 ml/min for DTPA). The mean plasma clearance obtained using multiple blood samples did not differ significantly from that obtained with the Russell method, either in patients with a glomerular filtration rate (GFR)<30 ml/min or in patients with GFR> 30 ml/min. The mean plasma clearance obtained using multiple blood samples differed significantly from that obtained with the mono-exponential method because of the great difference observed in patients with GFR_>30 ml/min. It is concluded that the Russell two-sample method after injection of 99mTc-DTPA is accurate enough for routine clinical use.
2016
BACKGROUND: Conflicting results have been published con-cerning the reproducibility of Tc-99m MAG3 clearance. The aim of the study was to reevaluate again this reproducibi-lity on a large prospective series of healthy volunteers. MATERIAL AND METHODS: Fifty subjects underwent three successive tests performed at 1-week interval. The physiological conditions were controlled as much as possible and all experi-mental measurements were rigorously double-checked. Renal clearances were calculated using single sample algorithms. RESULTS: Thin layer chromatography demonstrated a radio-chemical purity of more than 92 % (mean 93.8%; SD 1.6%; range 92.0–96.4%). The mean (and SD) of 44th minute plasma con-centrations for the three successive measurements were respec-tively 1.8 ± 0.4, 2.1 ± 0.4 and 1.9 ± 0.4 (%dose/liter). The mean changes (and S.D. of differences) between two tests were 0.26 ± ± 0.29, –0.08 ± 0.5 and 0.18 ± 0.30 respectively between tests 1 and 2, tests 1 and 3, and tests 2 and ...
Reassessment of the reproducibility of Technetium-99m mercaptoacetyltriglycine renal clearance
2005
BACKGROUND: Conflicting results have been published concerning the reproducibility of Tc-99m MAG3 clearance. The aim of the study was to reevaluate again this reproducibility on a large prospective series of healthy volunteers. MATERIAL AND METHODS: Fifty subjects underwent three successive tests performed at 1-week interval. The physiological conditions were controlled as much as possible and all experimental measurements were rigorously double-checked. Renal clearances were calculated using single sample algorithms. RESULTS: Thin layer chromatography demonstrated a radiochemical purity of more than 92% (mean 93.8%; SD 1.6%; range 92.0–96.4%). The mean (and SD) of 44th minute plasma concentrations for the three successive measurements were respectively 1.8 ± 0.4, 2.1 ± 0.4 and 1.9 ± 0.4 (%dose/liter). The mean changes (and S.D. of differences) between two tests were 0.26 ± ± 0.29, –0.08 ± 0.5 and 0.18 ± 0.30 respectively between tests 1 and 2, tests 1 and 3, and tests 2 and 3. Usin...
Simplified technetium-99m-EC clearance in adults from a single plasma sample
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1997
Technetium-99m-EC has recently been introduced as an alternative renal tubular agent to 131I-ortho iodohippurate (OIH). It has been shown that 99mTc-EC clearance shows strong correlation with OIH clearance and it is possible to estimate effective renal plasma flow. In routine clinical studies, it is practical to use one or two plasma sample methods instead of multiple plasma samples for clearance determination. An attempt was made to determine 99mTc-EC clearance with one sample method. Data from 72 subjects were collected. To increase the range of renal function, two anuric hemodialysis patients were also included. Clearances were determined by the open two-compartment model. The clearance range was 12 ml/min to 660 ml/min with a mean of 275 +/- 117 ml/min. Analysis of correlation was made by Tauxe's method. The least standard error of estimation (s.e.e. = 32.71 ml/min) and the best correlation (r = 0.97) between the theoretical volume distribution and the clearance estimations ...
Renal handling of technetium-99m DMSA: evidence for glomerular filtration and peritubular uptake
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1989
The finding of an enhanced excretion of [99mTc]dimercaptosuccinic acid (DMSA) in patients with tubular reabsorption disorders prompted us to investigate the role of filtration in the renal handling of [99mTc]DMSA. Our studies in human serum indicated that binding to serum proteins was approximately 90%. Chromatography of human urine and studies in rats showed that the complex was excreted unaltered into the urine. Renal extraction of [99mTc]DMSA in a human volunteer was 5.8%. Continuous infusion of [99mTc]DMSA in 13 individuals with normal renal function gave the following results (mean +/- s.d.): plasma clearance of [99mTc]DMSA 34 +/- 4 ml/min, urinary clearance of [99mTc]DMSA 12 +/- 3 ml/min. The calculated filtered load of [99mTc]DMSA closely resembled the urinary clearance, whereas the plasma clearance was about three times faster. This indicates that peritubular uptake accounts for approximately 65% and filtration for approximately 35% of the renal handling of [99mTc]DMSA.
Sao Paulo Medical Journal, 2008
CONTEXT AND OBJECTIVE: Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard. DESIGN AND SETTING: Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas. METHODS: Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in ...
Nuclear Medicine Communications, 2009
Objectives The single-sample 99m Tc-diethylenetriamine penta-acetate (DTPA) clearance method by Christensen and Groth is recommended by the Radionuclides in Nephrourology Committee on Renal Clearance for use in adults with an estimated glomerular filtration rate (GFR) Z 30 ml/min. The purpose of this study was to test a new 99m Tc-DTPA single-sample low clearance formula for GFR lesser than 30 ml/min. Methods Twenty-one adult patients (29 investigations) were included. Reference clearance was calculated with both 51 Cr-EDTA and 99m Tc-DTPA according to Brøchner-Mortensen with samples drawn between 3 and 24 h. Single-sample clearance was calculated from a 24 h sample using the low clearance formula Cl Sð24hÞ ¼ Àln CðtÞ ECV Q0 h i ECV t C(t) is the activity of the tracer in the plasma sample t minutes after the injection and Q 0 is the injected amount. ECV is the extracellular volume in ml defined as the distribution volume of the tracer. ECV is estimated from the body surface area as ECV = 8116.6 ¾ body surface area-28.2. Results The mean difference between reference and 99m Tc-DTPA single-sample clearance was-0.5 ml/min (SD 1.0 ml/min) for 99m Tc-DTPA and-0.8 ml/min (SD 1.2 ml/min) for 51 Cr-EDTA as reference clearance. Conclusion In adult patients it is possible, even with GFR lesser than 30 ml/min, to get an accurate determination of 99m Tc-DTPA plasma clearance from a single sample using the mean sojourn time approach. The blood sample should be obtained about 24 h after injection of the GFR tracer.
Evaluation of a Simplified Measurement for Low Glomerular Filtration Rates With lndium-111 DTPA
Henry Ford Hospital medical journal, 1979
A rapid new method for measuring glomerular filtration rates using "Vn diethylenetriamine pentaacetic acid CUnDTPA) was evaluated w i th 39 patients who showed marked impairment of renal function (creatinine clearance less than 20 ml/min). A simple, single compartment system was assumed. For comparison, parallel inulin and creatinine clearances were performed. High linear correlations (r = 0.96-0.97j were demonstrated when " V n DTPA clearances were compared with the standard nonisotopic tests. Initial data indicate that reliable isotopic clearance values could be obtained for low clearances by withdrawing only two blood samples for assay at 6 and 48 hours after isotope injection (without urine assay).
Clinical Physiology and Functional Imaging, 2013
Several single sample methods for determination of 99m Tc-mercaptoacetyltriglycine (MAG3) clearance are being used clinically. Kabasakal et al. proposed a similar formula for 99m Tc-ethylenedicysteine (EC). This study was performed to compare his method with Bubeck et al. formula for 99m Tc-MAG3 already in use. Twenty-eight subjects divided in two groups were registered which included 22 patients with various renal diseases (group-I) and six normal volunteers (group II). All subjects were studied twice using both the radiopharmaceuticals. The images and renogram parameters, that is T MAX and T 1/2 of both the agents, were similar in all the subjects. The clearance of the 99m Tc-EC was however considerably higher than 99m Tc-MAG3 in both the groups (mean AE SEM = 279 AE 14 ml min À1 /1Á73 m 2 versus 177 AE 15 ml min À1 /1Á73 m 2 in group-I and 377 AE 11Á90 ml min À1 /1Á73 m 2 versus 238 AE 8Á23 ml min À1 /1Á73 m 2 in group II). This difference was more pronounced in cases with reduced renal functions. Among the Effective Renal Plasma Flow (ERPF) values determined from EC and MAG3 clearances in six normal volunteers, four cases only in MAG3 had ERPF below the lower limit. This study has demonstrated superiority of single sample method for 99 m Tc-EC clearance over its analogous method for 99m Tc-MAG3.