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PubMed2006

Technetium complexes with triazacyclononane.

[NBu4][TcOCl4] reacts with ethylene glycol and 1,4,7-triazacyclononane (tacn) in MeOH under the formation of the deep-blue oxotechnetium(V) cation [TcO(OC2H4O)(tacn)]+, which can readily be oxidized by air to give the stable technetium(VII) compound [TcO3(tacn)]+. The reaction with aqueous HCl results in reduction and the formation of the cationic technetium(III) complex [TcCl2(OH2)(tacn)]Cl. The products were isolated in crystalline form and studied spectroscopically and by X-ray diffraction.

Journal Article↗
PubMed1996

Metal-Metal Multiply Bonded Complexes of Technetium. 5.(1) Tris and Tetrakis(formamidinato) Complexes of Ditechnetium.

Compounds of the type Tc(2)Cl(4)(PR(3))(4) (PR(3) = PEt(3), PMe(2)Ph, PMePh(2)) react with the molten formamidines HDPhF (HDPhF = diphenylformamidine) and HDTolF (HDTolF = di-p-tolylformamidine) to produce mixtures of tris- and tetrakis-bridged formamidinate complexes of ditechnetium. The displacement of chloride and phosphine by [DPhF](-) was accompanied by the oxidation of the dimetal core to produce the mixed-valent complexes Tc(2)(DPhF)(3)Cl(2) (1) and Tc(2)(DPhF)(4)Cl (2) in modest yield. The solid-state structures of the di-p-tolyl analog of 1, Tc(2)(DTolF)(3)Cl(2) (1a), and Tc(2)(DPhF)(4)Cl.C(7)H(8) (2.C(7)H(8)) have been determined by single crystal X-ray diffraction studies and are described in detail. The structure of 1a consists of three formamidinate ligands spanning the two technetium atoms. The two chloride ligands, which complete the coordination sphere, are bound equatorially at distances of 2.357(1) and 2.346(2) Å from the metals. Though possessing no crystallographic symmetry, 1a approximates C(2)(v)() symmetry. The metal-metal bond length of 2.0937(6) Å ranks among the shortest reported for technetium and is indicative of a Tc-Tc multiple bond. Compound 2 crystallizes with the Tc atoms colinear with a crystallographic 4-fold axis. The four bridging formamidinate ligands are arranged in a lantern geometry about the dimetal unit. The chloride is bonded in an axial position at a distance of 2.450(4) Å. The Tc-Tc bond length of 2.119(2) Å is also consistent with the presence of a high order Tc-Tc bond. The electronic structures of 1 and 2 were investigated by means of SCF-Xalpha-SW molecular orbital calculations using the model compounds Tc(2)(HNCHNH)(3)Cl(2) and Tc(2)(HNCHNH)(4)Cl. The results support the presence of a sigma(2)pi(4)delta(2)delta ground state configuration giving rise to a formal bond order of 3.5. The LUMO in both cases is a low-lying pi orbital. The formamidinate complexes 1 and 2 have been further characterized by IR spectroscopy and cyclic voltammetry. The crystallographic parameters for 1a and 2.C(7)H(8) are as follows: Tc(2)(DTolF)(3)Cl(2) (1a), monoclinic space group P2(1)/n (No. 14) with a = 16.185(2) Å, b = 15.637(2) Å, c = 17.812(1) Å, beta = 110.142(5) degrees, V = 4232.3(6) Å(3) and Z = 4; Tc(2)(DPhF)(4)Cl.C(7)H(8) (2.C(7)H(8)), tetragonal space group P4/ncc (No. 130) with a = 15.245(2) Å, c = 21.832(3) Å, V = 5074.1(9) Å(3) and Z = 4.

Journal Article↗
PubMed1999

Technetium Complexes of a Hydrazinonicotinamide-Conjugated Cyclic Peptide and 2-Hydrazinopyridine: Synthesis and Characterization.

Ternary ligand technetium complexes of a hydrazinonicotinamide-conjugated cyclic peptide (HYNICtide: cyclo(D-Val-NMeArg-Gly-Asp-Mamb(5-(6-(6-hydrazinonicotinamido)hexanamide)))) and 2-hydrazinopyridine (HYPY) were prepared and characterized by various spectroscopic methods. The HPLC concordance experiments for (99m)Tc and (99)Tc analogues show clearly that the same complexes are prepared on the no-carrier-added ((99m)Tc) and the carrier-added ((99)Tc) levels. Using a chirality experiment, it was demonstrated that the presence of two radiometric peaks in the HPLC chromatograms of RP444, RP445, and RP446 is due to the resolution of diastereomers, which result from the presence of chiral cyclic peptide and the formation of two enantiomers of the technetium chelate. In a ligand challenge experiment, we found that the high solution stability of these ternary ligand [(99m)Tc]HYNICtide complexes is due to their kinetic inertness. The 1:1:1:1 composition for Tc:HYNICtide:L:tricine (L = TPPTS, TPPDS, and TPPMS) in these ternary ligand [(99)Tc]HYNICtide complexes is confirmed by (1)H NMR and FAB mass spectral data and is completely consistent with that determined on the tracer ((99m)Tc) level. In addition, the IC(50) values of RP444, RP445, and RP446 and the two isomeric forms of RP444 were determined using a platelet IIb/IIIa binding assay. Both isomeric forms of RP444 were found to have the same binding affinity (IC(50) = 13 +/- 2 nM). Complexes [(99)Tc(HYPY)(PPh(3))(2)Cl(2)] and [(99)Tc(HYPY)(PPh(3))(tricine)] were isolated from the reaction of HYPY with [n-Bu(4)N][TcOCl(4)(-)] in the presence of excess tricine and triphenylphosphine. [(99)Tc(HYPY)(PPh(3))(tricine)] serves as a model for ternary ligand [(99m)Tc]HYNICtide complexes. Both complexes have been characterized by HPLC, spectroscopic (IR, NMR, and FAB-MS) methods, and elemental analysis. The HPLC concordance for complexes [(99m)Tc(HYPY)(PPh(3))(tricine)] and [(99)Tc(HYPY)(PPh(3))(tricine)] shows that the two complexes are identical. The NMR ((1)H and (13)C) data suggests that the complex [(99)Tc(HYPY)(PPh(3))(tricine)] have an octahedral coordination geometry with a monodentate diazenido HYPY, a tetradentate tricine, and a monodentate triphenylphosphine coligand.

Journal Article↗
PubMed2001

Synthesis and biodistribution of a new oxo-technetium-99m bis(aminothiol) complex as a potential melanoma tracer.

[123I]-N-(2-Diethylaminoethyl)-4-iodobenzamide (123I-BZA) has been the best scintigraphic agent described so far for malignant melanoma and ocular melanoma diagnosis. We replaced 123I by the more convenient radioisotope 99mTc and synthesized four bis(aminoethanethiol) derivatives. We describe the synthesis of a new oxo-technetium complex (TcO-Cf), prepared in very high yield (radiochemical yield > 95%), that exhibits an affinity for the pigmented tumor cells. This complex was evaluated in vivo in mice bearing C57Bl6 murine melanoma. After injection, a rapid decrease in the radioactivity levels was noted for all tissues and organs except for eyes (1.26 %ID/g at 1 h and 2.69 %ID/g at 24 h postinjection) and the tumor (1.19 %ID/g at 1 h and 0.80 %ID/g at 24 h postinjection), suggesting a specific in vivo binding of this complex to the pigmented cells. These results were compared with those already published for three other technetium-99m bis(aminothiol) complexes with benzamide derivatives.

Animals↗
PubMed2003

A second-generation 99m technetium single photon emission computed tomography agent that provides in vivo images of the dopamine transporter in primate brain.

The dopamine transporter (DAT), located presynaptically on dopamine neurons, provides a marker for Parkinson's disease (Pd) and attention deficit hyperactivity disorder (ADHD). In ADHD, DAT density levels are elevated, while in Pd these levels are depleted. The depletion of DAT levels also corresponds with the loss of dopamine. We now describe the design, synthesis, biology, and SPECT imaging in nonhuman primates of second-generation (99m)technetium-based tropane ligands that bind potently and selectively to the DAT. We demonstrate that improved selectivity and biological stability allows sufficient agent to enter the brain and label the DAT in vivo to provide a quantitative measure of DAT density in nonhuman primates. We introduce FLUORATEC (N-[(2-((3'-N'-propyl-(1"R)-3"alpha-(4-fluorophenyl)tropane-2"beta-1-propanoyl)(2-mercaptoethyl)amino)acetyl)-2-aminoethanethiolato]technetium(V) oxide), a DAT imaging agent that has emerged from these studies and is now in phase 1 clinical trials in the U.S.

Animals↗
PubMed2001

Detection of caustic oesophageal injury with technetium 99m-labelled sucralfate.

BACKGROUND/PURPOSE: Radiolabelled sucralfate has been used to show the extent and severity of reflux oesophagitis, peptic ulceration, and inflammatory bowel disease. Endoscopy under general anaesthetic has been the preferred method to assess the injury after caustic ingestion. The aim of this study was to assess whether sucralfate has an affinity for the chemically injured oesophageal mucosa and, if so, to assess the accuracy of radiolabeled sucralfate as an indicator of presence and extent of oesophageal injury. METHODS: A prospective study was conducted of 22 patients with mean age of 30 months (range, 13 to 90) admitted consecutively with a history of caustic ingestion between January 1998 and January 2000. A sucralfate-labelled scan followed by endoscopic assessment of upper gastrointestinal tract with documentation of extent and grade of injury was performed in all patients within 24 hours of admission except the first 6 who underwent scan after the endoscopy. The sucralfate was labelled by the direct stannous reduction method. Oesophageal transit was studied by recording 120 images (64 x 64 matrix size) at 1 image per second while the child swallowed 5 mL of labelled sucralfate containing 2 to 3 MBq Technetium 99m. Retention of radiolabelled oesophageal activity was considered abnormal. RESULTS: The caustic substances ingested were household cleaners in 18, potassium permanganate in 3, and pool chlorine in 1. There were 11 scans that showed residual activity in the oesophagus, which correlated exactly with endoscopic findings. The other 11 patients had normal oesophageal mucosa, but 2 were found to be falsely positive on scanning. In 2 cases repeat sucralfate scan results correlated well with the healing process assessed endoscopically. CONCLUSIONS: The results indicate that technetium 99m sucralfate swallow is an accurate technique for assessing oesophageal injury after ingestion of caustic substances. In addition, it may be used to document healing.

Burns, Chemical↗
PubMedDate not supplied

Myocardial ischemia in Kawasaki disease: evaluation with dipyridamole stress technetium 99m tetrofosmin scintigraphy.

BACKGROUND: The coronary artery abnormalities in Kawasaki disease (KD) often cause myocardial ischemia. Previous publications have described the use of thallium 201 myocardial perfusion imaging to determine the extent of ischemia in patients with KD. The technetium perfusion agents offer better resolution and may offer additional information about ventricular function in these patients. This study was performed to evaluate myocardial perfusion in patients with KD through use of technetium 99m tetrofosmin (TF) in conjunction with dipyridamole vasodilator stress. METHODS AND RESULTS: Eighty-six patients with KD aged 11.5 +/- 6.4 years and 20 age-matched control patients without heart disease were studied. Among 86 patients with KD, significant coronary artery stenosis (>or=75%) was observed in 20, coronary aneurysm without stenosis in 37, and no coronary lesions in 29. After administration of high-dose dipyridamole infusion (0.70 mg/kg), 74 to 370 MBq TF was injected and 148 to 740 MBq TF was injected at rest 4 hours later. Single photon emission computed tomography images were obtained more than 30 minutes after TF injection. Regional myocardial hypoperfusion was observed in 18 patients who had coronary artery stenosis of 75% or greater (sensitivity, 90%, and specificity, 100%). Two patients did not demonstrate ischemic changes in coronary artery stenosis in group I; one had good collateral flow. There were no TF injection-related complications. CONCLUSIONS: Tetrofosmin myocardial perfusion imaging can detect regional hypoperfusion in children with KD.

Adolescent↗
PubMed1996

Tomographic myocardial imaging with technetium-99m tetrofosmin. Comparison with tetrofosmin and thallium planar imaging and with angiography.

Technetium-99m tetrofosmin is a new myocardial imaging agent with improved handling and kinetic characteristics. The purpose of this study was to compare the ability of planar and SPECT Tc-99m tetrofosmin imaging with Thallium-201 planar data to detect coronary artery disease and individual vessel lesions ( > 50% diameter stenosis). Seventy-two patients with definite or suspected coronary artery disease were included. Sixty-three had angiographic evidence of coronary artery disease, among whom 42 had had a previous myocardial infarction, while 21 had not. The total number of diseased arteries was 111. Patients underwent symptom-limited treadmill or bicycle exercise to similar endpoints. Thallium and tetrofosmin images were analysed separately by consensus reading. Interpretation was made for five standard anatomical regions (anterior, septal, inferior, lateral and apex), classified into four categories (normal, reversible, fixed and mixed defects). Sensitivity and specificity to detect coronary artery disease were 71% and 78% for Thallium-201 vs 68% and 78% for tetrofosmin by planar imaging, and 87% and 89% for tetrofosmin by SPECT. The improved sensitivity of SPECT was confirmed both in patients with and without previous myocardial infarction. The sensitivity to detect individual vessel lesions was improved by SPECT (59% tetrofosmin SPECT vs 50% thallium planar and 51% tetrofosmin planar). Individual vessel lesion detection by SPECT was 50% for the left anterior descending coronary artery, 42% for the left circumflex and 86% for the right coronary artery. This study confirms the value of technetium-99m tetrofosmin as a myocardial imaging agent. Improvements in diagnosis and in evaluating extent of disease can be expected from using SPECT.

Adult↗
PubMed1990

One-dose technetium-99m pertechnetate imaging in acute testicular torsion followed by manual detorsion.

The role of technetium-99m pertechnetate imaging in acute testicular torsion is well appreciated. Manual testicular detorsion under local anesthesia may be performed in the nuclear medicine clinic by the urology service immediately following initial diagnostic scintigraphy. Following manual testicular detorsion, continued images of the testes are obtained up to 30 minutes without having to reinject the patient with technetium-99m pertechnetate. Reperfusion of the affected testicle will be dramatically noted if the manual detorsion is successful. Four cases are presented to illustrate this.

Acute Disease↗
PubMed2001

Compartmental modeling of technetium-99m-labeled teboroxime with dynamic single-photon emission computed tomography: comparison with static thallium-201 in a canine model.

UNLABELLED: Di Bella EVR, Ross SG, Kadrmas DJ, et al. Compartmental modeling of technetium-99m-labeled teboroxime with dynamic single-photon emission computed tomography: Comparison with static thallium-201 in a canine model. Invest Radiol 2001;36:178-185. RATIONALE AND OBJECTIVES: A compartmental modeling approach to deriving kinetic parameters from a time series of single-photon emission computed tomography (SPECT) images of technetium-99m-labeled (99mTc-) teboroxime may have value for semiquantitative assessment of myocardial perfusion. This study investigated the value of the kinetic parameters derived from a two-compartment model of 99mTc-teboroxime for measuring myocardial perfusion and compared it with static thallium-201 (201Tl) uptake and microsphere-measured blood flow in dogs. METHODS: Experiments were successfully conducted in 9 of 11 open-chest dogs. During adenosine stress, a single complete set of projections of 201Tl uptake was acquired. 99mTc-teboroxime was then injected during adenosine stress, and a complete set of projections was acquired every 5.7 seconds for 17 minutes. Resting studies were performed on 4 of the animals. All of the projection sets were reconstructed with an iterative algorithm and incorporated corrections for attenuation and the geometric response of the collimators. Regional kinetic parameters (washin and washout) were determined semiautomatically from the time series of reconstructed 99mTc-teboroxime images and registered with microsphere data. Regional washin estimates were compared with 201Tl intensities and myocardial blood flows determined from microspheres. RESULTS: Optimally scaled 99mTc-teboroxime washin parameters and 201Tl uptakes were correlated with microsphere-determined blood flows (r = 0.91, y = 0. 99x + 0.01, and r = 0.92, y = 0.88x + 0.28, respectively). In six of the studies, the left anterior descending coronary artery was occluded, and stress occluded-to-normal (O/N) ratios were calculated. The O/N ratios were 0.32 +/- 0.17 as determined from microspheres injected with 201Tl and 0.38 +/- 0.29 from microspheres injected with 99mTc-teboroxime (P = NS). The O/N ratios were 0.48 +/- 0.16 for static 201Tl uptake and 0.27 +/- 0.21 for 99mTc-teboroxime washin (P < 0.05). CONCLUSIONS: Both 201Tl uptake and 99mTc-teboroxime kinetic parameters were well correlated with flow. The 99mTc-teboroxime washin parameters offer semiquantitative flow values and provide greater defect contrast than can be obtained with 201Tl uptake values.

Animals↗
PubMed2003

Prediction of cardiac death in hypertensive patients with suspected or known coronary artery disease by stress technetium-99m tetrofosmin myocardial perfusion imaging.

BACKGROUND: There are currently insufficient data to indicate a role for stress myocardial perfusion imaging as a prognostic tool in hypertensive patients. OBJECTIVES: To assess the incremental value of stress myocardial perfusion imaging for the prediction of cardiac death in hypertensive patients relative to clinical data. PATIENTS: We studied 601 hypertensive patients (aged 59 +/- 10 years, 387 men) who underwent exercise bicycle or dobutamine (up to 40 microg/kg per min) stress technetium-99m tetrofosmin single photon emission computed tomography (SPECT) for evaluation of coronary artery disease. OUTCOME: Cardiac death during follow-up. RESULTS; An abnormal scan (reversible or fixed perfusion abnormalities) was detected in 293 (49%) patients (134 had reversible abnormalities). During a mean follow-up period of 3.1 +/- 1.3 years, 109 (18%) patients died; of whom, 42 patients (39%) died due to cardiac causes. Independent predictors of cardiac death were age [hazard ratio = 1.04, 95% confidence interval (CI) 1.01-1.08], history of previous myocardial infarction (hazard ratio = 2, CI 1.1-3.7), stress rate-pressure product (hazard ratio = 0.94, CI 0.87-0.98) and abnormal scan (hazard ratio = 4.7 CI 1.9-11.4). Both reversible and fixed abnormalities were predictive of death. The annual cardiac death rate was 5.3% in patients with an abnormal and 0.5% in patients with a normal perfusion scan. CONCLUSION: Stress technetium-99m tetrofosmin myocardial perfusion imaging provides prognostic information incremental to clinical data for the prediction of cardiac death in hypertensive patients with known or suspected coronary artery disease.

Adrenergic beta-Agonists↗
PubMed1990

Stable and lipophilic technetium-99m dithiosemicarbazone complexes with 5-6-5 membered chelate ring structure.

Modification of the chelate ring structure of technetium-99m (99mTc) dithiosemicarbazone (DTS) chelate was carried out in pursuit of a more stable and lipophilic compound. A new DTS chelating molecule, pentane-2,4-dione bis(N-methylthiosemicarbazone) (PETS), with a 5-6-5 membered chelate ring structure, was synthesized and labeled with 99mTc, PETS generated two 99mTc compounds as major products. Both had much higher stability and lipophilicity than a 5-5-5 membered 99mTc DTS compound, as well as great stability in plasma. Both 99mTc-PETS compounds were rapidly extracted by the brain and heart when injected into mice. Thus, the modified chelate ring structure afforded a preferable characteristics to DTS chelate as for the chelating site for technetium radiopharmaceuticals.

Animals↗
PubMed2003

Successful resection of localized intestinal lymphangiectasia post-Fontan: role of (99m)technetium-dextran scintigraphy.

Intestinal lymphangiectasia is a well-recognized complication of the Fontan procedure, occurring in up to 24% of patients. Because of the loss of chylous fluid into the gut lumen, protein-losing enteropathy results as well as lymphopenia and hypogammaglobulinaemia. In some cases, dilated lymphatics in the intestinal serosa or mesentery also rupture, causing chylous ascites. Standard medical and cardiac surgical interventions are generally ineffective and the condition is frequently lethal. We report a case of intractable and life-threatening chylous ascites and chylothorax in a 14-year-old girl, associated with intestinal lymphangiectasia and protein-losing enteropathy after a Fontan procedure for tricuspid atresia. The condition was refractory to all standard medical therapies, including dietary modifications, diuretics, corticosteroid therapy, albumin infusions, octreotide, heparin, bowel rest, and parenteral nutrition. Cardiac surgery to optimize her hemodynamic status was also ineffective and large volume pleural and ascitic fluid losses continued. Having exhausted all other therapeutic modalities, (99m)technetium-dextran scintigraphy was performed to assess the extent of intestinal protein loss and the potential for surgical intervention. Scintigraphy suggested localized protein loss from the proximal jejunum and subsequent segmental resection was effective. Postoperatively, ascites and pleural effusions resolved, and there was no evidence of short bowel syndrome. Growth has accelerated and the patient has entered puberty. There is mild persistent intestinal protein loss requiring diuretic therapy. Ascites or pleural effusions are absent, and the patient remains well >2 years after surgery. Intestinal lymphangiectasia post-Fontan procedures has traditionally been ascribed to hemodynamic factors such as raised systemic venous pressure, which would predispose to a generalized intestinal lesion. However, in this case, scintigraphy demonstrated a localized, surgically correctible lesion. To our knowledge, this is the first reported case of the use of (99m)technetium-dextran scintigraphy for this indication and of successful partial small bowel resection in such a case.

Adolescent↗
PubMedDate not supplied

[The ineffectiveness of Technetium-99m-sestamibi for the pre-operative localization of parathyroid glands in neonatal primary hyperparathyroidism: case report]

OBJECTIVE: To present the case of a child with neonatal primary hyperparathyroidism submitted to preoperative image studies that couldn't localize the parathyroid glands. METHODS: Report of clinical and laboratory evaluation of neonatal primary hyperparathyroidism in a two-and-a-half-monthold child submitted to preoperative cervical ultrasonography and parathyroid scintigraphy with Technetium-99m-Sestamibi, and subtotal parathyroidectomy at the age of four-and-a -half months. RESULTS: The preoperative images suggested an erroneous diagnosis of parathyroid adenoma. After surgery and pos-operative histopathological exams, hyperplasia of parathyroid glands was confirmed. After two years and a half the child has normal parathyroid function. CONCLUSIONS: The cervical ultrasonography and the parathyroid scintigraphy with Technetium-99m-Sestamibi were not useful for preoperative localization of hyperplasied parathyroid glands in the neonatal primary hyperparathyroidism in this case. The subtotal parathyroidectomy has been a successful method for the maintenance of normocalcemy in the patient.

Journal Article↗
PubMedDate not supplied

Parathyroid reoperation with use of technetium 99m sestamibi radiolocalization and an intraoperative gamma counter.

OBJECTIVE: To describe a new intraoperative technique for localization of abnormal parathyroid tissue. METHODS: We report a case and discuss the difficulties encountered in reexploration of the neck area. RESULTS: Parathyroid reoperation remains a formidable challenge to even the most experienced endocrine surgeon. Despite the advances in radiographic imaging and localization techniques, accurate intraoperative identification of abnormal parathyroid tissue in a scarred field with obliterated anatomic planes is frequently tedious and occasionally unsuccessful. In a 48-year-old woman with hyperparathyroidism, extensive exploration of the area identified (on the basis of preoperative magnetic resonance imaging and technetium 99m sestamibi scans) as suspicious for the presence of abnormal parathyroid tissue revealed only an aberrant vein. With use of a handheld gamma counter to provide intraoperative guidance during parathyroid reexploration after preoperative intravenous injection of technetium 99m sestamibi, quick identification of a small, intrathyroidal, fifth gland adenoma responsible for persistent primary hyperparathyroidism was facilitated. CONCLUSION: Because of suboptimal precision and specificity, current preoperative localization studies can occasionally provide misleading information. Particularly in difficult cases of parathyroid reexploration, an instrument capable of localizing abnormal parathyroid tissue, which can be used intraoperatively with ease, can be an invaluable tool to ensure a safe, expedient, and successful surgical outcome.

Journal Article↗
PubMed2001

[Renal scintigraphy using technetium Tc 99m-ethylenedicysteine or SPECT as a method for examining kidneys in children diagnosed with vesicoureteral reflux].

Vesicoureteral reflux (VUR) can lead to parenchymal lesions of the kidneys. Renal scarring is an important cause of chronic renal failure and hypertension in children. Effective prevention necessitates an early diagnosis of urinary tract pathology. The aim of this work was to examine renal morphology and function in VUR using radioisotope techniques and to compare the sensitivity of the planar technique and single photon emission computed tomography (SPECT) for detection of renal scarring. The following examinations were performed in 45 children with VUR: ultrasonography, renoscintigraphy with technetium-99m-etylenedicysteine (EC-Tc-99m) or technetium-99m-dimercaptosuccinic acid (DMSA-Tc-99m) in planar and SPECT modes. The stage of VUR correlated with cortical lesions as reflected by effective renal plasma flow (ERPF), and scarring as shown by static scintigraphy. The use of SPECT increased diagnostic sensitivity in the case of small and isolated scars. Thus, SPECT would be recommended in children at risk of renal scarring. The correlation between ERPF and DMSA scintigraphy findings supports the use of EC-Tc-99m renoscintigraphy to monitor the process of renal scarring.

Adolescent↗
PubMed2002

Gastrointestinal bleeding in adult patients with Meckel's diverticulum: the role of technetium 99m pertechnetate scan.

Obscure gastrointestinal (GI) bleeding is often challenging for the primary care physician, but with improved diagnostic testing the cause of this blood loss is determined in most patients. However, approximately 5% of the time no underlying cause is found. One common etiology in patients younger than 40 years of age is a Meckel's diverticulum. The technetium 99m pertechnetate scan is the standard test for making this diagnosis. However, the sensitivity of the scan is only 62% in the adult population. In this case report, a patient with profound, hemodynamically significant GI blood loss had multiple negative studies. Subsequently, an abnormal vascular lesion was detected and during exploratory laparotomy, a Meckel's diverticulum was found and removed. Although the technetium pertechnetate scan is falsely negative in a number of cases, there are ways to increase its sensitivity and possibly avoid repeated testing.

Adult↗