Clinical evaluation of technetium-99m-L,L-ethylenedicysteine in patients with chronic renal failure.
Technetium-99m-L,L-ethylenedicysteine (99mTc-L,L-EC), a new renal radiopharmaceutical, has been shown to have similar excretion characteristics but a higher plasma clearance than 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) in normal volunteers and patients with obstructive nephropathy. This study evaluated 99mTc-L,L-EC in patients with chronic renal failure.


METHODS
The clearance of 99mTc-L,L-EC was compared with that of 125l-hippuran in 26 patients with varying degrees of chronic renal impairment (serum creatine 168-1163 mumol/liter). All 26 patients also were imaged with 99mTc-L,L-EC (70-80 MBq). Fifteen patients had further imaging with 99mTc-MAG3 (100 MBq) the following day.


RESULTS
A subjective analysis of the 99mTc-L,L-EC images revealed that all were of acceptable quality regardless of creatinine level. In the 15 patients who were imaged with both 99mTc-L,L-EC and 99mTc-MAG3, general image quality and target-to-background ratios were similar. Time-activity curves and mean parenchymal transit times obtained with the two agents were almost identical. Plasma clearance values (mean +/- s.d.) of 99mTc-L,L-EC and 125l-hippuran were 81 +/- 68 ml/min and 114 +/- 104 ml/min, respectively. Mean 99mTc-L,L-EC clearance was 71% of the mean 125l-hippuran value.


CONCLUSIONS
Technetium-99m-L,L-EC provides equally high-quality images to 99mTc-MAG3 in patients with chronic renal failure. Technetium-99m-L,L-EC clearance more closely resembles that of hippuran than does 99mTc-MAG3 clearance. These features together with its ease of preparation make 99mTc-L,L-EC an attractive alternative to 99mTc-MAG3 in patients with chronic renal failure.
Prvulovich
E M
EM
Institute of Nuclear Medicine, University College London Medical School, United Kingdom.
Bomanji
J B
JB
Waddington
W A
WA
Rudrasingham
P
P
Verbruggen
A M
AM
Ell
P J
PJ
D003287:Contrast Media; D003545:Cysteine / Q000031:analogs & derivatives*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011866:Radioisotope Renography; D017263:Technetium Tc 99m Mertiatide
D003287:Contrast Media; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D007465:Iodohippuric Acid; D017263:Technetium Tc 99m Mertiatide; C059659:technetium Tc 99m bicisate; D003545:Cysteine