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Kit Preparation of Technetium-99m-Mercaptoacetyltriglycine: Analysis, Biodistribution and Comparison with Technetium-99m-DTPA in Patients with Impaired Renal Function

Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, South Australia

Correspondence: For reprints contact: Dr. Kym M. Bannister, Department of Nuclear Medicine and Renal Unit, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000.

ABSTRACT

Technetium-99m-mercaptoacetyltriglycine (^99mTc-MAG₃) was prepared by a frozen solution method, enabling the preparation of kits yielding a product substantially free of lipophilic impurities (96% ^99mTc-MAG₃). However, biliary activity was not completely eliminated as HPLC-purified ^99mTc-MAG₃ was also excreted by that route. Sequential ^99mTc-DTPA and ^99mTc-MAG₃ renal scans were performed in 15 patients with renal dysfunction, including renal transplant recipients. In all cases, the ^99mTc-MAG₃ kit preparation provided superior images to ^99mTc-DTPA at all levels of renal function due to a higher target-to-background ratio and a plasma clearance twice as fast as ^99mTc-DTPA. Interpretation of delayed ^99mTc-MAG₃ images, however, was complicated by biliary excretion which will limit quantitative estimates of renal clearance. A ^99mTc-MAG₃ kit is likely to be of value in renal transplant assessment and in cases of significant renal impairment but would not appear to offer major advantages over ^99mTc-DTPA in routine renal imaging.