Detecting deep venous thrombosis with technetium-99m-labeled synthetic peptide P280.
Scintigraphy, using small, thrombus-avid, synthetic peptides labeled with gamma-emitting nuclides is an innovative approach to the noninvasive detection of acute deep venous thrombosis (DVT). The goal of this study was to evaluate clinically 99mTc-P280 for imaging DVT. The peptide P280 is a 26 amino acid dimer that binds with high affinity to the GPIIb/IIIa receptor expressed on activated platelets and can be labeled with 99mTc.


METHODS
Scintigraphy with 99mTc-P280 (10-22 mCi) was performed in nine patients with clinical suspicion and diagnostic evidence of DVT. Planar and tomographic images of the legs, abdomen/pelvis, chest and head were obtained immediately, 1, 2, 4 and 24 hr after injection.


RESULTS
No adverse effects were noted after 99mTc-P280 administration in any patient. Positive visualization of thrombi occurred in eight of nine cases with confirmed DVT within 1 hr of tracer injection. The majority of the patients had recent onset of DVT symptoms (less than 3 wk), while the only negative case was diagnosed 42 days earlier and was likely related to an accident 7 mo earlier. Thrombi-to-background ratios were essentially constant over the study. Technetium-99m-P280 accumulation was also discernible in two patients with pulmonary embolism, while in a third patient the radiotracer concentrated in a cerebellar hemangioblastoma.


CONCLUSIONS
These human studies indicate that 99mTc-P280 is a potentially safe and sensitive procedure for diagnosing DVT and pulmonary embolism. It also may have substantial utility in monitoring active venous thrombosis.
Muto
P
P
Department of Nuclear Medicine, National Cancer Institute, Naples, Italy.
Lastoria
S
S
Varrella
P
P
Vergara
E
E
Salvatore
M
M
Morgano
G
G
Lister-James
J
J
Bernardy
J D
JD
Dean
R T
RT
Wencker
D
D
D000328:Adult; D000818:Animals; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D018325:Hemangioblastoma / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007553:Isotope Labeling; D008297:Male; D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011817:Rabbits; D051381:Rats; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000000981:diagnostic imaging*; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; C094919:technetium Tc 99m P280