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Scintigraphic Evaluation of Pancreatic Transplants Using Technetium-99m-Sestamibi

Division of Nuclear Medicine, Departments of Radiology and Surgery, University of Cincinnati Hospital, Cincinnati, Ohio

Correspondence: For correspondence or reprints contact: Abdelhamid H. Elgazzar, MD, Division of Nuclear Medicine, Department of Radiology, Mt. Sinai School of Medicine, One Custave Levy Pl., New York, NY 10029-6574.

ABSTRACT

The purpose of this study was to evaluate the feasibility of using ^99mTc-sestamibi in the assessment of pancreatic transplant. Methods: Ten transplant recipients with a history of insulin-dependent diabetes mellitus were studied. Fourteen ^99mTc-sestamibi studies were performed. Each patient was injected intravenously with 10 mCi of ^99mTc-sestamibi. Two-second frames were obtained for 1 min, followed by serial dynamic and static images every 5 min for 30 min. Technetium-99m sestamibi studies, read by two nuclear medicine physicians, were correlated with clinicopathologic findings and compared to the ten ²⁰¹Tl studies obtained in seven of these patients. Results: On ^99mTc-sestamibi images, normally functioning grafts showed adequate perfusion on the angiogram and good uptake followed by clearance on static images. Time-activity curves showed an initial upslope followed by a downslope after the initial uptake peak. The quality of ^99mTc-sestamibi images was superior to those of ²⁰¹Tl in five, similar in four and marginally inferior in one paired study. Technetium-99m-sestamibi was used for both flow and static images, whereas a ^99mTc radiotracer angiogram was needed to accompany the ²⁰¹Tl study. Conclusion: Our preliminary experience indicates that ^99mTc-sestamibi helps evaluate pancreatic transplants and provides high count statistics, which result in better image quality and diagnostic detail. Extensive quantitative studies are being performed to further evaluate this agent's role in the clinical management of pancreatic transplant patients.

Key Words: pancreatic transplantation • scintigraphy • technetium-99m-sestamibi • thallium-201