HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Taillefer, R. Articles by Lister-James, J. Search for Related Content PubMed PubMed Citation Articles by Taillefer, R. Articles by Lister-James, J.

Acute Thromboscintigraphy with ^99mTc-Apcitide: Results of the Phase 3 Multicenter Clinical Trial Comparing ^99mTc-Apcitide Scintigraphy with Contrast Venography for Imaging Acute DVT

Hotel-Dieu, Montreal, Quebec
Royal Columbian Hospital, Delta, British Columbia, Canada
Delaware SPECT Imaging Center, Newark, Delaware
Diatide, Inc., Londonderry, New Hampshire

Correspondence: For correspondence or reprints contact: Raymond Taillefer, MD, Department of Nuclear Medicine, Center Hospitalier de l'Universite de Montreal, Pavilion Hotel-Dieu, 3840 St-Urbain, Montreal H2W 1T8, Canada.

ABSTRACT

^99mTc-apcitide (formerly known as ^99mTc-P280) is a radiolabeled peptide that binds with high affinity and specificity to the glycoprotein IIb/IIIa receptors expressed on the activated platelets that are involved in acute thrombosis. The purpose of the phase 3 multicenter clinical trials was to compare ^99mTc-apcitide scintigraphy with contrast venography for imaging acute deep venous thrombosis (DVT). Methods: A total of 280 patients were enrolled in 2 clinical trials conducted in North America and Europe. Patients were to be within 10 d of onset of signs and symptoms of acute DVT or within 10 d of surgery associated with a high risk of DVT. ^99mTc-apcitide scintigraphy and contrast venography were to be performed within 36 h. Planar scintigraphic images were obtained at 10, 60, and 120–180 min after injection. ^99mTc-apcitide scintigrams and contrast venograms were read with masking and also by the institutional investigators. Results: Of a total of 243 patients who were evaluable, 61.7% were receiving heparin at the time of imaging. Masked reading of ^99mTc-apcitide scintigraphy, compared with masked reading of contrast venography, had a sensitivity, specificity, and agreement of 73.4%, 67.5%, and 69.1%, respectively, which met the prospectively defined target efficacy endpoint in both trials. Institutional reading of ^99mTc-apcitide scintigraphy, compared with institutional reading of contrast venography, had a sensitivity, specificity, and agreement of 75.5%, 72.8%, and 74.0%, respectively. However, the entire trial population included patients with a history of DVT who may have had old, nonacute venous thrombi that could confound the venography results. Therefore, data from patients having no history of DVT or pulmonary embolism and who presented within 3 d of onset of signs and symptoms (n - 63), i.e., patients for whom a venogram would be expected to be positive only if acute DVT were present, also were analyzed as a subset. In these patients, institutional reading of ^99mTc-apcitide scintigraphy, compared with institutional reading of contrast venography, had a sensitivity, specificity, and agreement of 90.6%, 83.9%, and 87.3%, respectively. Conclusion: ^99mTc-apcitide scintigraphy is a new diagnostic modality that is highly sensitive for imaging acute DVT.

Key Words: ^99mTc-apcitide • acute deep venous thrombosis • scintigraphy • venography

This article has been cited by other articles:

				J. M. Davison, R. Bridwell, J. L. Montilla, E. Jackson, and L. K. Moores A Novel Diagnostic Method for Acute Pulmonary Embolism: Technetium-99m Apcitide Scintigraphy Ann Intern Med, June 1, 2004; 140(11): 936 - 939. [Full Text] [PDF]

				S. M. Bates, J. Lister-James, J. A. Julian, R. Taillefer, B. R. Moyer, and J. S. Ginsberg Imaging Characteristics of a Novel Technetium Tc 99m-Labeled Platelet Glycoprotein IIb/IIIa Receptor Antagonist in Patients With Acute Deep Vein Thrombosis or a History of Deep Vein Thrombosis Arch Intern Med, February 24, 2003; 163(4): 452 - 456. [Abstract] [Full Text] [PDF]