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Comparison of Iodine-131 OIH and Technetium-99m MAG₃ Renal Imaging in Volunteers

Department of Nuclear Medicine, University of Utah School of Medicine; and Veterans Administration Medical Center Salt Lake City, Utah

Correspondence: For reprints contact: Andrew Taylor, Jr., MD, Director of Nuclear Medicine, University of Utah School of Medicine, 50 North Medical Dr., Salt Lake City, UT 84132.

ABSTRACT

Animal studies have suggested that the nonisomeric N₃S triamide mercaptide ligand, ^99mTc mercaptoacetyltriglycine (MAG₃), may provide a satisfactory ^99mTc-labeled replacement for ¹³¹I hippurate (OIH). Sequential 30-min [^99mTc]MAG₃ (5–10 mCi) and [¹³¹I]OIH (300 µCi) imaging studies were performed in ten normal volunteers in order to compare the image quality, renal excretion, blood clearance, and time to peak height of the renogram curve. In addition, [^99mTc] MAG₃ (5 mCi) and [¹³¹l]OIH (150 µCi) were administered simultaneously in eight volunteers for comparison of 180-min blood and plasma clearances and urine excretion. In the sequential imaging studies, the blood clearance of [^99mTc]MAG₃ was more rapid than [¹³¹I]OIH with a mean clearance of 1.30 l/min compared with 0.88 l/min for [¹³¹I]OIH (p < 0.05). Seventy-three percent of the injected dose of the MAG₃ was excreted by 30 min compared with 66.8% for [¹³¹I]OIH. Whole kidney and cortical renogram curves showed no significant difference in the time to peak height for MAG₃ and [¹³¹I]OIH. In all subjects, the quality of the [^99mTc]MAG₃ images were clearly superior to [¹³¹I]OIH. Following simultaneous injection, blood and plasma clearances for [¹³¹I]OIH were more rapid than MAG₃ when determined for multiple time intervals from 0–30 to 0–180 min (p 0.05). The 0–30-min clearances of MAG₃ and [¹³¹I]OIH were only slightly greater than the 0–180-min clearances and can be used to obtain valid comparisons of the two agents. As in the sequential study, 30-min urine excretion was greater for MAG₃ than [¹³¹I]OIH (73.1 compared with 69.6%) but the difference was not statistically significant. Although the differences in the MAG₃ clearances following sequential and simultaneous administration are not satisfactorily explained, the fact that both clearances were rapid, the MAG₃ and OIH renogram curves were quite similar, and 30-min urine excretions of MAG₃ and OIH were essentially identical suggests that MAG₃ may become a ^99mTc replacement for [¹³¹I]OIH and further clinical evaluation is warranted.

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