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Prospective Validation of Single Plasma Sample ^99mTc-Ethylenedicysteine Clearance in Adults

Levent Kabasakal, Metin Halaç, A. Fuat Yapar, Ebru Alkan, Bedii Kanmaz, Çetin Önsel, Kerim Sönmezolu, Meltem Ayaz, Betül Kalender, Haluk B. Sayman and lhami Uslu

Department of Nuclear Medicine, Cerrahpaa Medical Faculty, stanbul, Turkey

Correspondence: For correspondence or reprints contact: Levent Kabasakal, MD, Cerrahpaa Tip Fakültesi, Nükleer Tip Anabilim Dali, Aksaray, stanbul, TR-34303, Turkey.

ABSTRACT

^99mTc-L,L-ethylene, L, dicysteine (EC) clearance shows strong correlation with orthoiodohippurate clearance, and it is possible to estimate effective renal plasma flow from ^99mTc-EC clearance. In routine clinical studies, it is practical to use the one or two plasma sample method instead of multiple plasma samples for clearance determination. A single-sample technique was developed for ^99mTc-EC, and a regression formula was generated. A prospective study tested the validity of this regression formula. Methods: The study population was composed of 26 patients with a wide range of renal function. Multiple plasma sample ^99mTc-EC clearances were calculated from all patients using the open two-compartment model. Single plasma sample clearances were also determined from the 54-min plasma sample using the regression formula published previously. Results: The multiple-sample plasma clearance of ^99mTc-EC ranged from 46 to 668 mL/min with a mean of 300.76 ± 150.73 mL/min. The clearances obtained from the 54-min plasma sample ranged from 49 to 699 mL/min, with a mean of 297.39 ± 152.23 mL/min. There was an excellent correlation between the clearances obtained by the two techniques (r= 0.99, slope = 0.9911). The standard error of estimation was found to be 25.9 mL/min. Conclusion: This study suggests that ^99mTc-EC clearance can be estimated from 54-min plasma samples with an acceptable error of estimation for most routine clinical studies.

Key Words: ^99mTc-L,L-ethylene, L, dicysteine • radionuclide renography • effective renal plasma flow • renal function