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Validation of a Blood-Sampling Method for the Measurement of 99mTc-Methylene Diphosphonate Skeletal Plasma Clearance

Amelia E.B. Moore, PhD, Glen M. Blake, PhD and Ignac Fogelman, MD

School of Medicine, King's College London, London, United Kingdom


Figure 1
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  		FIGURE 1.  Compartmental model describing whole-body kinetics of 99mTc-MDP. Total plasma clearance is sum of Kbone and Krenal.

 

Figure 2
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  		FIGURE 2.  (A) Nominal percentage of 99mTc-MDP in soft tissue plotted against AUC. Ktotal is estimated by extrapolating straight line fitted to 1-, 2-, 3-, and 4-h points to find terminal value of AUC1. Note that 15-min point lies below straight line because equilibration between tracer in blood and tracer in soft tissue is not reached at this early time. (B) {gamma}-Camera measurements of whole-body retention (WBR) plotted against AUC. Renal clearance of free 99mTc-MDP was determined by extrapolating straight-line fit to find AUC2. (C) Measurement of 99mTc-MDP Kbone using Patlak plot. Kbone is determined from slope of straight line fitted to 2-, 3-, and 4-h time points.

 

Figure 3
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  		FIGURE 3.  Scatter plot (A) and Bland–Altman plot (B) of values of GFR determined using 51Cr-EDTA, compared with equivalent values from whole-body retention measurements obtained using {gamma}-camera in subset of 10 patients who participated in GFR investigation. Solid lines represent line of identity, and dashed lines represent mean and 95% CI.

 

Figure 4
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  		FIGURE 4.  Least-squares fit to 1-, 2-, 3-, and 4-h soft-tissue data from first 22 patients to determine value of k4. Minimum value of {chi}2 was 0.64 at k4 = 0.0003 min–1; 95% CI (–0.0002 < k4 < 0.0008 min–1) was determined by adding 95% upper limit of {chi}2 for 1 degree of freedom (3.84) to Formula 7

 

Figure 5
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  		FIGURE 5.  Scatter plot (A) and Bland–Altman plot (B) of values of Ktotal determined using Brenner method vs. values of Ktotal determined using AUC.

 

Figure 6
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  		FIGURE 6.  Scatter plot (A) and Bland–Altman plot (B) of values of Kbone determined using AUC vs. values of Kbone determined using Patlak plot, and scatter plot (C) and Bland–Altman plot (D) of values of Kbone determined using AUC vs. values of Kbone determined using Brenner method. Solid lines represent line of identity, and dashed lines represent mean and 95% CI.

 




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