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Aluminemic Disturbance of Technetium-99m DTPA Renal Function Measurement

Nuclear Medicine and Biochemistry Divisions, Department of Clinical Pathology, Oregon Health Sciences University, Portland, Oregon

Correspondence: For reprints contact: H. David Specht, MD, Nuclear Medicine Division, Dept. of Clinical Pathology, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97201.

ABSTRACT

During follow-up study of a patient with surgically corrected unilateral renal ischemia, using computer image generated [^99mTc]diethylenethiaminepentaacetic acid (DTPA) glomerular filtration rate (GFR) and [¹³¹I]orthoiodohippurate estimated renal plasma flow (ERPF), we observed prominent gastric and intestinal uptake of ^99mTc. Profound alteration in the GFR results, but not the ERPF results, was also observed. Radiopharmaceutical breakdown was suspected and shown to be endogenous and due to hyperaluminemia at 28 ng/ml. These case findings add DTPA to the list of ^99mTc radiopharmaceuticals that have previously been reported to have altered biodistribution when hyperaluminemia is present. The case findings also reaffirm the benefits of obtaining images to corroborate the validity of quantitative data and demonstrate that quantitative radionuclide renal function data are not independent of renal chemical handling.