Ethylenedicysteine Versus Diethylenetriamine Pentaacetic Acid as the Carrier of Technetium Tc 99m in Diuretic Renography for Patients with Upper Urinary Tract Obstruction

• Main Authors: Hossein Shahrokh, Mansour Movahhed, Mohammad Ali Zargar Shoshtari, Amir Mohammad Orafa, Sepideh Hekmat
• Format: Article
• Language: English
• Published: Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences 2006-03-01
• Series: Urology Journal
• Online Access: http://www.urologyjournal.org/index.php/uj/article/view/203
• ISSN: 1735-1308; 1735-546X

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Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; text-align:right; mso-pagination:widow-orphan; direction:rtl; unicode-bidi:embed; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 72.0pt 72.0pt 72.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Introduction:</strong> L,L-ethylenedicysteine (EC) is a new carrier of technetium Tc 99m (<sup>99m</sup>Tc) with a lower affinity to plasma albumin in comparison with diethylenetriamine pentaacetic acid (DTPA). We compared<span> </span><sup>99m</sup>Tc-EC<sup> </sup>scan with <sup>99m</sup>Tc-DTPA scan in diuretic renography for patients with obstructive uropathy.</p> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Materials and Methods: </strong>Thirty-three patients with upper urinary tract obstruction were randomly selected and underwent diuretic renographies by <sup>99m</sup>Tc-EC and <sup>99m</sup>Tc-DTPA. The counts of radioisotope per pixel in the target (the kidney) and background tissues as well as the clearance half-life of these two radiopharmaceuticals were measured and compared.<span> </span></p> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Results</strong>: Mean counts of radioisotope per pixel in the target tissue was not different between <sup>99m</sup>Tc-EC and <sup>99m</sup>Tc-DTPA scans, but in the background tissue, it was less for <sup>99m</sup>Tc-EC (<em>P</em> = .003). Target-background ratio was higher for <sup>99m</sup>Tc-EC scan (3.80 ± 2.11 versus 2.48 ± 1.39; <em>P</em> < .001). Renal clearance half-life of radioisotope was shorter for <sup>99m</sup>Tc-EC scan than <sup>99m</sup>Tc-DTPA scan (58.15 ± 15.17 minutes versus 78.65 ± 19.99 minutes; <em>P</em> = .033). The results were similar for uremic patients (with a serum creatinine level > 2mg/dL).</p> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Conclusion</strong>: Target-background ratio of radiopharmaceutical uptake rates in diuretic renography was a good indicator of the higher resolution of <sup>99m</sup>Tc-EC than <sup>99m</sup>Tc-DTPA scan. We also demonstrated the faster clearance of <sup>99m</sup>Tc-EC than <sup>99m</sup>Tc-DTPA. This results in less radiation that is especially useful in children. To our opinion, <sup>99m</sup>Tc-EC can better depict the kidneys in comparison with <sup>99m</sup>Tc-DTPA.</p>