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Biodistribution, Dosimetry, and Clinical Evaluation of Technetium-99m Ethyl Cysteinate Dimer in Normal Subjects and in Patients with Chronic Cerebral Infarction

Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
Medical College of Wisconsin, Milwaukee, Wisconsin
Mt. Sinai Medical Center, New York, New York
Harbor-UCLA Medical Center, Torrance, California
Hotel Dieu de Montreal, Montreal, Canada
Istituto Scientifico,, S. Raffaele, Milano, Italy
Hospital Avicenne, Bobigny, France
Centre Hospitalier Universitaire Vaudois, School of Medicine, Lausanne, Switzerland
New England Deaconess Hospital, Boston, Massachusetts
Hopital de Baviere, Liege, Belgium
St. Vincents Hospital, New York, New York
University College and Middlesex School of Medicine, London, England
Abteilung Nulkearmedizin, Technical University of Aachen, West Germany
Universitaire Ziekenhuizen, Gasthuisberg, Leuven, Belgium
Dupont Company, North Billerica, Massachusetts

Correspondence: For reprints contact: B. Leonard Holman, MD, Dept. of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.

ABSTRACT

Technetium-99m ethyl cysteinate dimer (ECD) has high initial cerebral uptake with slow clearance in nonhuman primates suggesting ideal characteristics for single photon emission computer tomography (SPECT) imaging. We evaluated the biodistribution, dosimetry and scintigraphic pattern of [^99mTc]ECD in normal subjects and the accuracy of SPECT imaging in patients with chronic cerebral infarction. Sixteen normal subjects were injected with 10 mCi of [^99mTc]ECD. Anterior and posterior single-pass whole-body images were obtained at multiple times after injection. Blood clearance of the radiotracer was rapid, falling to 10.0 ± 6.6% and 4.9 ± 1.1% of the injected dose at 2 and60 min, respectively. Brain uptake was 6.4 ± 2.1% of the injected dose 5 min after injection. The critical organ was the urinary bladder. Technetium-99m ECD SPECT was performed with a rotating gamma camera in ten of the 16 normal subjects and 34 patients with clinical and CT evidence of chronic stroke. Thirty-three of the thirty-four patients had focal [^99mTc]ECD abnormalities on SPECT (97.1%) based on visual inspection of the SPECT images. In summary, we obtained high quality SPECT images as a result of the optimal physical and biologic characteristics of the tracer. Technetium-99m ECD SPECT shows promise for the evaluation of patients with stroke.

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