The radiation exposure resulting from medical imaging is a topic of some concern. Nuclear medicine provides potentially life-saving information regarding physiological processes, and is of particular value in children where the rapid and unequivocal diagnosis of pathological concerns is essential for the health of these patients. The overall objective of this investigation is to optimize pediatric patient absorbed dose by keeping it as low as possible while maintaining excellent diagnostic quality of nuclear medicine images. This is particularly important since children are at increased risk due to the enhanced radiosensitivity of their tissues and the longer time-period over which radiation effects may manifest. Current dosimetric estimations in children are based on either animal biokinetic or pharmacokinetic data from adults due to paucity of data that exists for children. This situation will be improved through the following specific aims:
Collect image-based pharmacokinetic (PK) data from patient volunteers in different age groups scheduled for routine nuclear medicine studies for Tc-99m mercaptoacetyltriglycine (MAG3), a radiopharmaceutical commonly used in pediatric nuclear medicine
Pool and analyze the data for different age groups for each radiopharmaceuticals and
Generate biokinetic models to be used in subsequent dosimetric models for the optimization of pediatric nuclear medicine procedures.
Since inadequate pharmacokinetic data currently exist in these patients, the investigators will use the data acquired in this study to establish PK models applicable to different age categories. Data on the pharmacokinetics of agents used in pediatric nuclear medicine are almost completely lacking. Internationally adopted dose coefficients (mSv/MBq) for pediatric nuclear medicine make age-dependent adjustments only for patient size and anatomical differences, while time-dependent kinetics from adult PK models are assumed due to the lack of kinetic data for children. The data obtained from this study will make it possible for the first time to determine how the PK in pediatric patients differs from adults. This will be done for Tc-99m MAG3, a radiopharmaceutical commonly used for pediatric nuclear medicine imaging. The overall hope is that results will allow the molecular imaging community to implement pediatric dose-reduction approaches that substantially improve upon current guidelines pointing to future technological advances that could yield even greater dose-reduction while simultaneously improving diagnostic image quality.

开始日期2018-01-02

申办/合作机构

The Children's Hospital Corp.

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100 项与锝[99mTc]巯替肽相关的临床结果

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100 项与锝[99mTc]巯替肽相关的转化医学

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100 项与锝[99mTc]巯替肽相关的专利（医药）

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138

项与锝[99mTc]巯替肽相关的文献（医药）

2024-09-01·Journal of Ultrasound in Medicine

Doppler Ultrasound and Resistive Indices in the Diagnosis of Ureteropelvic Junction Obstruction in the Pediatric Population

Article

作者: Vemulakonda, Vijaya M ; Sevick, Carter ; Walker, Jonathan ; Meyers, Mariana L ; Beltran, Gemma G

ObjectivesMercapto acetyl tri‐glycine renogram (MAG3) scan has been the gold standard assessment of pediatric ureteropelvic junction obstruction (UPJO) but requires intravenous access and radiation exposure. While Doppler ultrasound measurements of resistive indices (RI) of the arcuate arteries have been proposed as an alternative assessment of obstruction, they have not been widely adopted in the pediatric population. We hypothesized that RI of the main renal artery (RA) is more strongly correlated with MAG3 findings than arcuate RI.MethodsPediatric patients with unilateral Society for Fetal Urology grade 3–4 hydronephrosis undergoing concomitant RUS and MAG3 were recruited. Doppler ultrasound peak systolic velocity (PSV); RI of bilateral RA at the origin, middle, and hilum; and RI of the superior, middle, and lower pole arcuate arteries were obtained. MAG3 differential renal function (DRF) and T½ were recorded. Differences in RI measurements (DRI) between the affected and normal kidney were calculated and compared with DRF and T½.Results31 patients (median 4.6‐month‐old) were enrolled. Only RA RI at the origin differed between affected and normal kidneys (p < .001). DRI RA at the origin showed weak evidence for an association with MAG3 DRF < 40% (p .07). DRI was not associated with T½ > 20 minutes.ConclusionThere was weak evidence for an association between RA DRI at the origin and DRF but not with T½. These findings suggest that RA DRI may provide additional data in the evaluation of patients with UPJO to tailor the use of MAG3 and associated risk of radiation exposure to those patients most at risk for concomitant renal function impairment.

2024-06-01·Radiological Physics and Technology

Feasibility study of radioactivity estimation of 99mTc and 123I-labeled radiopharmaceuticals using shielded syringes

Article

作者: Yasuno, Narumi ; Nakamura, Yuto

This study investigates the feasibility of estimating the radioactivity of radiopharmaceuticals using shielded syringes. The radioactivities of ^99mTc-MDP, ^99mTc-HMDP, ^99mTc-ECD, ^99mTc-MAG₃, and ¹²³I-IMP were measured using a dose calibrator. Correlation coefficients and regression equations were obtained from the radioactivity in the shielded and unshielded syringes. ^99mTc-MDP was also measured for residual radioactivity after the administration. The correlation coefficients of ^99mTc-MDP, ^99mTc-HMDP, ^99mTc-ECD, ^99mTc-MAG₃, and ¹²³I-IMP were r_s = 0.9998, r_s = 0.9997, r_s = 0.9999, r_s = 0.9998, and r_s = 0.9888, respectively. The regression equations were y = 0.0364x + 0.0913, y = 0.0349x + 0.0273, y = 0.0343x - 0.0018, y = 0.0522x + 0.1215, and y = 0.0383x + 0.0058, respectively. The correlation coefficient for the residual radioactivity of ^99mTc-MDP was r_s = 0.9887 and the regression equation was y = 0.1505x + 0.0853. The radioactivity of ^99mTc- and ¹²³I-labeled radiopharmaceuticals in shielded syringes was accurately measured. It was suggested that the measuring shielded syringes could provide an estimate of the actual radioactivity.

2023-06-01·Nuclear Medicine Communications

Computer assisted interpretation of Tc-99m mercaptoacetyltriglycine diuretic scintigraphy enhances resident performance

Article

作者: Halkar, Raghuveer K. ; Fazlur Rahman, A.K.M. ; Plaxton, Nicholas ; Manatunga, Amita ; Taylor, Andrew T. ; Garcia, Ernest V. ; Polsani, Aruna ; Folks, Russell D. ; Dubovsky, Eva V. ; Savir-Baruch, Bital ; Moncayo, Valeria

ObjectiveiRENEX is a software module that incorporates scintigraphic and clinical data to interpret 99mTc- mercaptoacetyltriglycine (MAG3) diuretic studies and provide reasons for their conclusions. Our objectives were to compare iRENEX interpretations with those of expert physicians, use iRENEX to evaluate resident performance and determine if iRENEX could improve the diagnostic accuracy of experienced residents.MethodsBaseline and furosemide 99mTc-MAG3 acquisitions of 50 patients with suspected obstruction (mean age ± SD, 58.7 ± 15.8 years, 60% female) were randomly selected from an archived database and independently interpreted by iRENEX, three expert readers and four nuclear medicine residents with one full year of residency. All raters had access to scintigraphic data and a text file containing clinical information and scored each kidney on a scale from +1.0 to −1.0. Scores ≥0.20 represented obstruction with higher scores indicating greater confidence. Scores +0.19 to −0.19 were indeterminate; scores ≤−0.20 indicated no obstruction. Several months later, residents reinterpreted the studies with access to iRENEX. Receiver operating characteristic (ROC) analysis and concordance correlation coefficient (CCC) quantified agreement.ResultsThe CCC among experts was higher than that among residents, 0.84, versus 0.39, respectively, P < 0.001. When residents reinterpreted the studies with iRENEX, their CCC improved from 0.39 to 0.73, P < 0.001. ROC analysis showed significant improvement in the ability of residents to distinguish between obstructed and non-obstructed kidneys using iRENEX (P = 0.036).ConclusioniRENEX interpretations were comparable to those of experts. iRENEX reduced interobserver variability among experienced residents and led to better agreement between resident and expert interpretations.

100 项与锝[99mTc]巯替肽相关的药物交易

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适应症	国家/地区	公司	日期
诊断试剂	美国	Curium US Holdings LLC	1990-06-15

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


SNMMI2020	N/A	-	-	Tc-99m MAG3	構鹹醖觸廠願範餘壓構(簾壓衊夢鬱簾顧獵憲獵) = 顧餘淵壓鑰鬱夢膚繭淵簾齋願餘艱製膚繭鹹鬱 (餘鹽簾鬱廠鬱鑰繭觸衊 )	-	2020-05-15
				Furosemide (Lasix)	構鹹醖觸廠願範餘壓構(簾壓衊夢鬱簾顧獵憲獵) = 鏇獵餘繭窪願選鹹廠願簾齋願餘艱製膚繭鹹鬱 (餘鹽簾鬱廠鬱鑰繭觸衊 )