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Comparison of ^99mTc-Polyophosphate and ¹⁸F. I. Kinetics

VA Wadsworth Hospital Center and UCLA School of Medicine, Los Angeles, California

Correspondence: For reprints contact: G. T. Krishnamurthy, Nuclear Medicine Service, VA Wadsworth Hospital Center, Los Angeles, Calif. 90073.

ABSTRACT

In 12 patients with suspected bone lesions, the kinetics of intravenously injected ^99mTc-polyphosphate (Tc-PP) were compared with those of ¹⁸F. Both radiopharmaceuticals showed biexponential clearance from blood. With both agents, Exponent I clearance half-time is relatively shorter and represents uptake by bone. Exponent II clearance half-time is longer and represents mainly renal clearance. Both Exponent I and II clearances are longer with Tc-PP than with ¹⁸F. The relatively slower blood clearance with Tc-PP is due to two major causes. The first is the relatively higher plasma protein binding associated with Tc-PP. About 80% of plasma radioactivity is protein-bound with Tc-PP, and only about 15% with ¹⁸F. About 20% of total protein-bound Tc-PP radioactivity is bound to albumin; the remaining 80% is bound mainly to globulin fractions and, to a minor extent, to fibrinogen. Tc-PP protein binding is loose and seems to dissociate easily in vivo. The second major cause of slower Tc-PP blood clearance is red blood cell binding, which is firm and is not washed off completely with normal saline. About 28.2% of the injected dose of Tc-PP is excreted in urine in 4 hr. The genitourinary system is the major nonosseous structure to accumulate injected Tc-PP.

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