Abstract
Technetium-99m-L,L-ethylenedicysteine (99mTc-L,L-EC), a new renal imaging agent, was introduced as an alternative to99mTc-mercaptoacetyltriglycine (MAG3). This radiopharmaceutical can be easily labelled at room temperature and has high radiochemical purity and long stability. The aim of this study was to gain clinical experience in using99mTc-L,L-EC in normal volunteers and patients. The clearance of this radiopharmaceutical was compared with that of iodine-131ortho-iodohippurate (OIH) in five healthy volunteers. In addition, conventional renogram and whole-body distribution of99mTc-L,L-EC (40 min and 3 h post-injection) were evaluated in these subjects. Subsequently, ten patients with suspected obstructive nephropathy, four with renovascular disorders and two in acute renal failure were imaged. In five patients with impaired renal function both99mTc-MAG3 and99mTc-L,L-EC studies were performed. In each case the scintigraphic images and time/activity curves were evaluated and various semiquantitative parameters calculated and compared. No adverse effects were noted during and after99mTc-L,L-EC scintigraphy. The mean clearance values for99mTc-L,L-EC and131I-OIH in volunteers were 504 and 663 ml/min respectively. The total plasma clearance of99mTc-L,L-EC was about 75.8% of the131I-0IH value. In volunteers the parenchymal transit time index, whole kidney transit time index and mean parenchymal transit time for99mTc-L,L-EC were 63 s, 124 s and 175 s respectively. The mean time to peak activity was 235 s and the time from peak to 50% of peak activity was 402 s. In all patients the results of scintigraphy were concordant with clinical findings and subsequently influenced patient management. Furthermore,99mTc-L,L-EC scintigraphy provided high-quality images similar to those obtained with99mTc-MAG3, even at low glomerular filtration rates (18 ml/min). It is concluded that99mTc-L,L-EC has excellent imaging characteristics similar to99mTc-MAG3 and excretion properties similar to OIH. This radiopharmaceutical can be used routinely to evaluate patients with renal disorders.
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Gupta, N.K., Bomanji, J.B., Waddington, W. et al. Technetium-99m-L,L-ethylenedicysteine scintigraphy in patients with renal disorders. Eur J Nucl Med 22, 617–624 (1995). https://doi.org/10.1007/BF01254562
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DOI: https://doi.org/10.1007/BF01254562