Noninvasive measurement of microvascular permeability to small solutes

Peters, A. M.; George, Penny

doi:10.1097/00006231-198907000-00012

Cited by 4 publications

(3 citation statements)

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“…The technical problems of measuring regional tissue clearance have been discussed elsewhere (Peters and George 1989;Peters and Myers 1989;Peters 1990). …”

Section: Discussionmentioning

confidence: 99%

“…The theory underlying the measurement of small solute clearance across the microvasculature has been described in detail elsewhere (Peters and George 1989;Peters and Myers 1989;Peters 1990). In principle, it is based on a widely accepted method for measuring individual kidney GFR at the time of 99~"Tc-DTPA gamma camera renography (Rehling et al 1985;Rutland 1985;Peters et al 1987Peters et al , 1988.…”

Section: Methodsmentioning

confidence: 99%

“…We recently described a non-invasive technique for measuring 99mTc-DTPA clearance from intravascular to extravascular spaces in a tissue region of interest in the lumbar region below the kidneys (Peters and George 1989;Peters and Myers 1989;Peters 1990). By combining this measurement of clearance with simultaneous measurement of solute extraction fraction in the same region, one can calculate the permeability surface area (PS) product, which is the conventional way to express endothelial permeability to small solutes.…”

Section: Introductionmentioning

confidence: 99%

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Bone marrow transplantation: effects of conditioning and cyclosporin prophylaxis on microvascular permeability to a small solute (technetium 99m diethylene triamine penta-acetic acid)

et al. 1991

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Microvascular permeability to small diffusible solutes has rarely been measured at a clinical level. We have developed a simple non-invasive technique for measuring the permeability surface area (PS) product, which is suitable for clinical use. We illustrate its potential value in six subjects who underwent bone marrow transplantation for chronic myeloid leukaemia. These patients received high-dose cyclosporin A (CyA) for prevention of graft versus host disease (GVHD) and sustained an easily measurable increase in microvascular permeability to technetium 99m diethyltriamine penta-acetic acid (99mTc-DTPA). This was measured as the PS product, which increased from 1.1 (SD 0.3) to 2.2 (0.4) ml/min per 100 ml tissue between baseline and treatment with CyA for prevention of GVHD (P less than 0.01). The increase broadly correlated with nephrotoxicity which was measured, from the plasma DTPA clearance, as global glomerular filtration rate (GFR). This decreased from 106 (11.1) to 49 (6.7) ml/min (P less than 0.001). These abnormalities, both in PS product and GFR, were sustained for several months, after which they tended to return towards baseline levels. We conclude firstly that this technique has a potential clinical role and secondly that endothelial abnormalities due to CyA deserve further study.

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“…The technical problems of measuring regional tissue clearance have been discussed elsewhere (Peters and George 1989;Peters and Myers 1989;Peters 1990). …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bone marrow transplantation: effects of conditioning and cyclosporin prophylaxis on microvascular permeability to a small solute (technetium 99m diethylene triamine penta-acetic acid)

et al. 1991

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Quantification of renal haemodynamics with radionuclides

Peters

1991

Eur J Nucl Med

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Non-invasive quantification of renal function with radionuclides is an important role of nuclear medicine. With modern commercial preparations of technetium-99m diethylene triamine penta-acetic acid (DTPA), glomerular filtration rate (GFR) can be measured accurately either from the rate of disappearance of the tracer from plasma or from its rate of uptake into the kidneys. Determination of the latter with the gamma camera allows measurement of individual kidney GFR. Renal blood flow (RBF) can be measured from plasma clearance of hippurate or from first-pass kinetics of intravenously injected tracer using the gamma camera. The filtration fraction can be obtained from separate measurement of GFR and RBF, either globally from plasma clearance studies or of each kidney from gamma camera studies. Because they are central to the understanding of plasma clearance studies, the effective distribution volumes of the various tracers used for renal function studies are also discussed in detail.

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Extravascular chest wall technetium 99m diethylene triamine penta-acetic acid: implications for the measurement of renal function during renography

Bell

Peters

1991

Eur J Nucl Med

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Measurement of individual kidney glomerular filtration rate (IKGFR) from the gamma-camera technetium 99m diethylene triamine penta-acetic acid (99mTc-DTPA) renogram requires a continuous measurement of arterial activity. This is usually based on a region of interest (ROI) placed over the cardiac blood pool on the posterior view, with the assumption of negligible contamination from activity in the extravascular space of the chest wall. By injecting a small dose of technetium 99m human serum albumin (HSA) before the 99mTc-DTPA in 12 patients undergoing routine renography, the contribution of extravascular activity to the total signal recorded over the cardiac blood pool was calculated to be 11.0% (SE 2.1%) 1.5 min after DTPA injection, rising to 35.1% (SE 2.5%) at 15 min. Subtraction of the time-activity curve recorded from a ROI of the same size over the right lung generated a "pure" blood signal as shown by almost identical HSA/DTPA signal ratios recorded in blood samples taken 5 min after HSA and 15 min after DTPA and from the gamma-camera at the corresponding times. The effect of using a cardiac blood pool time-activity curve uncorrected for extravascular activity was to overestimate IKGFR by an average factor of 1.17 (SE 0.03).

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Noninvasive measurement of microvascular permeability to small solutes

Cited by 4 publications

References 0 publications

Bone marrow transplantation: effects of conditioning and cyclosporin prophylaxis on microvascular permeability to a small solute (technetium 99m diethylene triamine penta-acetic acid)

Bone marrow transplantation: effects of conditioning and cyclosporin prophylaxis on microvascular permeability to a small solute (technetium 99m diethylene triamine penta-acetic acid)

Quantification of renal haemodynamics with radionuclides

Extravascular chest wall technetium 99m diethylene triamine penta-acetic acid: implications for the measurement of renal function during renography

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