title: 99mTc-MAG3: Image Wisely.
abstract: Purpose To determine if commonly administered doses of technetium 99m (99mTc) mertiatide (MAG3) in the range of 300-370 MBq (approximately 8-10 mCi) contribute to image interpretation and justify the resulting radiation exposure. Materials and Methods The respective institutional review boards approved this HIPAA-compliant study and waived informed consent. Baseline and furosemide99mTc-MAG3imaging examinations in 50 patients suspected of having renal obstruction and 48 patients suspected of having renovascular hypertension (RVH) were randomly selected from archived databases and were independently scored by three experienced readers without access to 2-second flow images. Readers were blinded to their original scores, and then they rescored each examination with access to high-activity 2-second flow images. Relative renal function was determined after a low activity (62.9 MBq ± 40.7) baseline acquisition for RVH and a high activity (303.4 MBq ± 48.1) acquisition after administration of enalaprilat. Data were analyzed by using random effects analysis of variance and mean and standard error of the mean for the difference between sets of scores and the difference between relative function measurements. Results There was no significant difference in the scores without flow images compared with blinded scores with high-activity flow images for patients suspected of having obstruction (P = .80) or RVH (P = .24). Moreover, there was no significant difference in the relative uptake measurements after administration of low and high activities (P > .99). Conclusion Administered doses of99mTc-MAG3in the range of 300-370 MBq (approximately 8-10 mCi) do not affect the relative function measurements or contribute to interpretation of images in patients suspected of having RVH or obstruction compared with administration of lower doses; unnecessary radiation exposure can be avoided by administering doses in the range of 37-185 MBq as recommended incurrent guidelines.©RSNA, 2017.
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Taylor
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Russell D
authors.initials: RD
authors.lastname: Folks
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: A K M Fazlur
authors.initials: AKMF
authors.lastname: Rahman
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Aruna
authors.initials: A
authors.lastname: Polsani
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Eva V
authors.initials: EV
authors.lastname: Dubovsky
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Halkar
authors.affiliation: From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.
authors.forename: Amita
authors.initials: A
authors.lastname: Manatunga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011866:Radioisotope Renography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017263:Technetium Tc 99m Mertiatide / Q000008:administration & dosage*
chemical_list: D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide