Reproducibility of a single-sample method for 99Tcm-MAG3 clearance under clinical conditions

Kotzerke, Jörg; Glatz, S.; Grillenberger, K.; Kleinschmidt, K.; Reske, S. N.

doi:10.1097/00006231-199704000-00175

Cited by 12 publications

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“…Kotzerke et al evaluated the reproducibility of the plasma sample 99m Tc-MAG3 clearance and concluded that it was not precise enough to evaluate a change in kidney function (i.e. after surgery or chemotherapy) (13). Piepsz et al also observed marked differences in repeat 99m Tc-MAG3 plasma clearance measurements and warned that changes in the 99m Tc-MAG3 plasma clearance should be interpreted with caution in general clinical practice (14).…”

Section: Introductionmentioning

confidence: 99%

^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

2010

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Studies in rats showed that the pharmacokinetics of the tricarbonyl core radiopharmaceutical 99m Tc(CO) 3 -nitrilotriacetic acid, 99m Tc(CO) 3 (NTA), were essentially identical to those of 131 I ortho-iodohippuran ( 131 I-OIH), the clinical gold standard for the measurement of effective renal plasma flow. Our objective was to compare the pharmacokinetics of these 2 tracers in healthy volunteers. Methods: 99m Tc(CO) 3 (NTA) was prepared with commercially available NTA and a commercially available kit and isolated by reversed-phase high-performance liquid chromatography. Approximately 74 MBq (2 mCi) of 99m Tc(CO) 3 (NTA) were coinjected with 9.25 MBq (250 mCi) of 131 I-OIH in 9 volunteers, and simultaneous imaging of each tracer was performed for 24 min. Plasma clearances were determined from 8 blood samples obtained 3-90 min after injection using the single-injection, 2-compartment model. Plasma protein binding, red cell uptake, and percentage injected dose in the urine at 30 and 180 min were determined. Results: There was no difference in the plasma clearances of 99m Tc(CO) 3 (NTA) and 131 I-OIH, 475 6 105 mL/min versus 472 6 108 mL/min, respectively. The plasma protein binding and red cell uptake of 99m Tc(CO) 3 (NTA) were 43% 6 5% and 9% 6 6%, respectively; both values were significantly lower (P , 0.001) than the plasma protein binding (75% 6 3%) and red cell uptake (17% 6 5%) of 131 I-OIH. There was no significant difference in the percentage injected dose recovered in the urine at 30 min and at 3 h; for comparison, the percentage dose in the urine at 3 h was 91% 6 4% for 99m Tc(CO) 3 (NTA) and 91% 6 6% for 131 I-OIH (P 5 0.96). Image quality with 99m Tc(CO) 3 (NTA) was excellent, and the renogram parameters were similar to those of 131 I-OIH. Conclusion: Preliminary results in healthy volunteers suggest that the pharmacokinetic behavior of 99m Tc(CO) 3 (NTA) is comparable to that of 131 I-OIH.Key Words: 99m Tc-tricarbonyl; renal radiopharmaceuticals; 99m Tc(CO) 3 (NTA); 131 I-ortho-iodohippuran ( 131 I-OIH); 99m Tc-mercaptoacetyltriglycine ( 99m

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Section: Introductionmentioning

confidence: 99%

^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

2010

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“…Inconsistent results of the reproducibility of 99m Tc-MAG3 clearance have been reported, ranging from 6.3 to 40.4% depending on the level of renal function, the clearance measurement technique applied and the time interval between the two studies [13][14][15][16][17][18][19]24]. However, in serial measurements of renal function, especially in patients with renal failure, good reproducibility of the test is vitally important for monitoring renal function and to ascertain whether changes in renal function are related to disease or to the limited reproducibility of the study.…”

Section: Discussionmentioning

confidence: 99%

“…However, in serial measurements of renal function, especially in patients with renal failure, good reproducibility of the test is vitally important for monitoring renal function and to ascertain whether changes in renal function are related to disease or to the limited reproducibility of the study. Only the results of three patients with a 99m Tc-MAG3 clearance lower than 100 ml/min/1.73 m 2 were reported and showed very high SDs (56, 68 and 100%) [14]. Furthermore, almost the same level of reproducibility with a relative SD of around 12% was accepted as adequate for monitoring renal function by Werner et al [15], Russell and Dubovsky [16] and Kanazawa et al [17], whereas it was found to be inadequate by Kotzerke et al [14], Moller and Widding [18] and Sadeleer [19].…”

Section: Discussionmentioning

confidence: 99%

“…The utility of 99m Tc-MAG3 clearance has been extensively investigated in several studies [4][5][6], and it has been shown that the clearance of 99m Tc-MAG3 is closely correlated with the clearance of [ 131 I]OIH [6][7][8][9]. However, it has generally been reported that, although 99m Tc-MAG3 has very good accuracy [7][8][9][10][11][12], the results in terms of reproducibility are still controversial [13][14][15][16][17][18][19]. The reproducibility of the study is especially important in patients with renal failure in order to determine whether changes in renal function in serial measurements are related to progression, regression, resolution of the disease or poor reproducibility of the test.…”

Section: Introductionmentioning

confidence: 99%

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Reproducibility of technetium-99m mercaptoacetyltriglycine clearance in patients with impaired renal function

Erdıl

Dede²,

Şen³

et al. 2006

Nuclear Medicine Communications

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Single-sample methods give very poor reproducibility and accuracy and should not be used in patients with poor renal function. The reproducibility of 99mTc-MAG3 clearance using the multi-sample method (90 min) in patients with impaired renal function is 12.6%, which is similar to that in patients with good renal function and that obtained with other tubular agents. Whether this level of reproducibility is satisfactory for documenting serial changes in an individual patient with a 99mTc-MAG3 clearance below 100 ml/min/1.73 m2 depends on the expectation of the clinician.

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“…The reproducibility of the 99m Tc-MAG3 clearance based on plasma sample measurements has also been questioned. Kotzerke et al presented data suggesting that 99m Tc-MAG3 clearance was not precise enough to evaluate a change in kidney function (12), and Piepsz et al have reported marked variations in repeated 99m Tc-MAG3 plasma clearance measurements and have warned that changes in the 99m Tc-MAG3 plasma clearance should be interpreted with caution (13). …”

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confidence: 99%

^99mTc(CO)₃(NTA) and ¹³¹I-OIH: Comparable Plasma Clearances in Patients with Chronic Kidney Disease

2013

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The pharmacokinetics of the tricarbonyl core radiopharmaceutical 99mTc(CO)3-nitrilotriacetic acid (99mTc(CO)3(NTA)) in rats and subjects with normal renal function are comparable to those of 131I-o-iodohippuran (131I-OIH), the radiopharmaceutical gold standard for the measurement of effective renal plasma flow. Our objective was to compare the pharmacokinetics of these 2 tracers in subjects with renal failure. Methods 99mTc (CO)3(NTA) was prepared with commercially available NTA and a commercially available labeling kit and isolated by reversed-phase high-performance liquid chromatography. Approximately 74 MBq (2.0 mCi) of 99mTc(CO)3(NTA) were coinjected with approximately 11.1 MBq (300 µCi) of 131I-OIH in 8 subjects with stage 3–4 renal failure; simultaneous images were obtained for 24 min, followed by an anterior image over the gallbladder and abdomen. Plasma clearances were determined from 10 blood samples obtained 3–180 min after injection using the single-injection, 2-compartment model. Plasma protein binding, red cell uptake, and percentage injected dose in the urine at 30 and 180 min were determined. Results There was no difference in the plasma clearances of 99mTc(CO)3(NTA) and 131I-OIH (177 ± 63 vs. 171 ± 66 mL/min/1.73 m2, respectively) (P = 0.41). The plasma protein binding and red cell uptake of 99mTc(CO)3(NTA) were 35% ± 7% and 6% ± 3%, respectively; both values were significantly lower than the plasma protein binding (71% ± 5%) and red cell uptake (16% ± 2%) of 131I-OIH (P < 0.001). There was no significant difference in the percentage injected dose in the urine at 30 min (P = 0.24) and at 3 h (P = 0.82); for comparison, the percentage dose in the urine at 3 h was 77% ± 9% for 99mTc(CO)3(NTA) and 78% ± 11% for 131I-OIH. Image quality with 99mTc(CO)3(NTA) was excellent and no activity was identified in the gallbladder or intestine. Conclusion Results in patients with renal failure show the clearance and rate of urine excretion of 99mTc(CO)3(NTA) to be equivalent to that of 131I-OIH.

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Reproducibility of a single-sample method for 99Tcm-MAG3 clearance under clinical conditions

Cited by 12 publications

References 0 publications

^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

Reproducibility of technetium-99m mercaptoacetyltriglycine clearance in patients with impaired renal function

^99mTc(CO)₃(NTA) and ¹³¹I-OIH: Comparable Plasma Clearances in Patients with Chronic Kidney Disease

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Reproducibility of a single-sample method for 99Tcm-MAG3 clearance under clinical conditions

Cited by 12 publications

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99mTc(CO)3(NTA): A 99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of 131I-OIH in Healthy Volunteers

99mTc(CO)3(NTA): A 99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of 131I-OIH in Healthy Volunteers

Reproducibility of technetium-99m mercaptoacetyltriglycine clearance in patients with impaired renal function

99mTc(CO)3(NTA) and 131I-OIH: Comparable Plasma Clearances in Patients with Chronic Kidney Disease

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^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

^99mTc(CO)₃(NTA): A ^99mTc Renal Tracer with Pharmacokinetic Properties Comparable to Those of ¹³¹I-OIH in Healthy Volunteers

^99mTc(CO)₃(NTA) and ¹³¹I-OIH: Comparable Plasma Clearances in Patients with Chronic Kidney Disease