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A Bayesian 3-Compartment Model for ^99mTc-MAG3 Clearance

Division of Nuclear Medicine, University of Alabama Hospital, Birmingham, Alabama

Because recent reports have questioned the traditional 2-compartment model for calculating tracer clearance after a single intravenous injection, a 3-compartment model was evaluated in this study. Methods: Bayesian statistics were used, which facilitated curve fitting by treating all subjects simultaneously. ^99mTc-Mercaptoacetyltriglycine clearance data from 154 adults and 109 children were measured at several centers, typically 6–9 plasma samples spanning 5–90 min, and fitted by 2- and 3-compartment Bayesian models. Results: Clearance estimates were found to be systematically lower for the 3-compartment model than for the 2-compartment model. A single-sample procedure based on the 3-compartment model was found to eliminate most of the known discrepancy between formulas based on single-injection and continuous-infusion reference methods. Conclusion: A 3-compartment model led to lower and probably more accurate clearance estimates than the conventional 2-compartment model. A new single-sample method is presented, based on the 3-compartment model as reference standard.

Key Words: kidney function • MAG3 • renal clearance • compartmental model