title: Comparison of technetium-99m-ll-EC isomers in rats and humans.
abstract: Technetium-99m-L,L-ethylenedicysteine (99mTc-LL-EC) is a new renal imaging agent with pharmacokinetic properties reported to be slightly superior to those of 99mTc-mercaptoacetyltriglycine (99mTc-MAG3); however, to better define the potential of the enantiomer 99mTc-DD-EC and the diastereomer 99mTc-DL-EC as renal imaging agents, we compared the three EC stereoisomers with 131I-orthoiodohippurate (OIH) in a series of rats and humans.
  
  
  METHODS
  Each 99mTc-EC stereoisomer was coinjected with OIH in six Sprague-Dawley rats for measurements of clearance and extraction fraction. Each stereoisomer was also coinjected with OIH in three human volunteers followed by sequential imaging, plasma clearance measurements and timed urine collections.
  
  
  RESULTS
  Technetium-99m-DD-EC had the highest clearance and extraction efficiency in rats (p < or = 0.02). In humans, image quality was good with all three agents. The clearance ratio (EC/OIH) was 82% +/- 8% for 99mTc-DD-EC compared to 70% +/- 3% and 40% +/- 5% for 99mTc-LL-EC and 99mTc-DL-EC, respectively. Technetium-99m-DD and 99mTc-LL-EC were excreted more rapidly than 99mTc-DL-EC.
  
  
  CONCLUSIONS
  Technetium-99m-DD-EC has excellent imaging properties and the data suggest that its clearance may approach that of OIH more closely than any other 99mTc renal agent. A potential limitation is the fact that both 99mTc-DD and LL-EC exist in dianionic (80%) and monoanionic (20%) forms at physiological pH and it is unlikely that these two forms have the same clearance or protein binding affinity.
authors.affiliation: Department of Radiology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: A
authors.initials: A
authors.lastname: Taylor
authors.forename: L
authors.initials: L
authors.lastname: Hansen
authors.forename: D
authors.initials: D
authors.lastname: Eshima
authors.forename: E
authors.initials: E
authors.lastname: Malveaux
authors.forename: R
authors.initials: R
authors.lastname: Folks
authors.forename: L
authors.initials: L
authors.lastname: Shattuck
authors.forename: M
authors.initials: M
authors.lastname: Lipowska
authors.forename: L G
authors.initials: LG
authors.lastname: Marzilli
mesh_terms: D000818:Animals; D003287:Contrast Media; D003545:Cysteine / Q000031:analogs & derivatives*; D006801:Humans; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D015609:Organotechnetium Compounds / Q000737:chemistry; D011866:Radioisotope Renography; D051381:Rats; D017207:Rats, Sprague-Dawley; D013237:Stereoisomerism; D013329:Structure-Activity Relationship; D014018:Tissue Distribution
chemical_list: D003287:Contrast Media; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D007465:Iodohippuric Acid; C059659:technetium Tc 99m bicisate; D003545:Cysteine