title: Detecting deep venous thrombosis with technetium-99m-labeled synthetic peptide P280.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine, National Cancer Institute, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Muto
authors.forename: S
authors.initials: S
authors.lastname: Lastoria
authors.forename: P
authors.initials: P
authors.lastname: Varrella
authors.forename: E
authors.initials: E
authors.lastname: Vergara
authors.forename: M
authors.initials: M
authors.lastname: Salvatore
authors.forename: G
authors.initials: G
authors.lastname: Morgano
authors.forename: J
authors.initials: J
authors.lastname: Lister-James
authors.forename: J D
authors.initials: JD
authors.lastname: Bernardy
authors.forename: R T
authors.initials: RT
authors.lastname: Dean
authors.forename: D
authors.initials: D
authors.lastname: Wencker
mesh_terms: 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
chemical_list: D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; C094919:technetium Tc 99m P280