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Intrasubject Comparison Between Technetium-99m-ECD and Technetium-99m-HMPAO in Healthy Human Subjects

Médecine Nucléaire, Hotel-Dieu de Montréal, Montréal, Canada
Nucleaire Geneeskunde, St. Elisabeth Ziekenhuis, Zottegem, Belgium
Medical Research, The Du Pont Merck Pharmaceutical Company, N. Billerica, Massachusetts

Correspondence: For reprints contact: Jean Léveillé, MD, FRCP(C), ABNM, Chef Médecine Nucléaire, Hotel-Dieu de Montreal, 3840, rue St-Urbain, Montreal, Quebec H2W 1T8 Canada.

ABSTRACT

The pharmacokinetics and quality of planar and SPECT brain imaging of two ^99mTc-labeled brain perfusion agents, d,I-hexamethyl propylene amine oxime (HMPAO) and ethyl cysteinate dimer (ECD), were compared in seven healthy, normal subjects. Both radiopharmaceuticals showed rapid brain uptake and had a net brain washout of less than 5% during the first 20 min after drug administration. However, during the same time period, ^99mTc-ECD images of the head showed significantly less background facial uptake and retention when compared to ^99mTc-HMPAO images. The brain-to-background contrast ratio of ^99mTc-ECD (brain/neck) continued to improve over time and by 5 hr postadministration was 17 to 1 versus 2 to 1 for ^99mTc-HMPAO. SPECT brain images of both agents show gray/white matter ratios that were unchanged over time and an intracerebral distribution consistent with blood flow. A blind read of these SPECT images also shows ^99mTc-ECD to produce images that were "easier to interpret" with less extracerebral activity as compared to ^99mTc-HMPAO. Repeat, whole-body planar spot imaging suggests that ^99mTc-ECD was cleared more rapidly from the body than was ^99mTc-HMPAO.

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