Pertechnetate-99m Localization in Man with Applications to Thyroid Scanning and the Study of Thyroid Physiology

Andros, George; Harper, Paul V.; Lathrop, K.A.; McCardle, Robert J.

doi:10.1210/jcem-25-8-1067

Cited by 118 publications

(54 citation statements)

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“…2 Previously, Sorensen had counted 99mTc in humans injected with the parent isotope 99molybdenurn (O9Mo) . 8 The decay scheme for 99M0 is given in Fig 1. 4 Many clinical uses of 99mTc have been developed, including joint scans.6-7 A technic for the visualization of diseased joints using 9 s m T~ and a scintillation (Anger) camera is the subject of this report.…”

mentioning

confidence: 99%

^99mTechnetium scintiphotography in arthritis I. technic and interpretation

McCarty

Polcyn²,

Collins

et al. 1970

Arthritis & Rheumatism

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A technic for visualization of inflamed joints using intravenously injected technetium-99m as pertechnetate and an Anger (scintillation) camera for detection will be described. Contrast between inflamed and normal tissue was usually greatest in the first few minutes after isotope injection, presumably, at the time of maximal difference in concentration of 99mTc between blood and extravascular tissue. Inflamed joints with moderate to large effusions were often visualized best 1-2 hr after injection. The extensive binding of pertechnetate by plasma and joint fluid proteins found in equilibrium dialysis experiments was evoked as an explanation of this phenomenon.Technetium-99m ("9mTc) scheme for 99M0 is given in Fig 1.4 Many clinical uses of 99mTc have been developed, including joint scans.6-7 A technic for the visualization of diseased joints using 9 s m T~ and a scintillation (Anger) camera is the subject of this report. The data are interpreted in terms of isotope kinetics. MATERIALS AND METHODSSubjects. T h e optimal time of exposure was determined after scintiphotographs of the hands and wrists of 6 patients without joint disease had demonstrated a nearly uniform distribution of radioactivity (Fig 2). The "normals" were individuals receiving intravenous pertechnetate-99m for other diagnostic studies such as brain tumor localization. The hand, "wrist" and knee joints of patients with classical rheumatoid arthritis (RA) were then examined serially. Serial frontal images (ie, patella to collimator) were obtained of an inflamed knee containing a large effusion in patient E.M.Podtfonlng. Five mc lomTc, as sodium pertechnetate (NaTcO,) , were given intravenously. The

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confidence: 99%

^99mTechnetium scintiphotography in arthritis I. technic and interpretation

McCarty

Polcyn²,

Collins

et al. 1970

Arthritis & Rheumatism

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“…99m Tc-pertechnetate concentrates in the brain, thyroid, salivary glands, and gastric mucosa, mediated by plasma membrane glycoprotein sodium-iodine symporter (19,20). To avoid dissociated 99m Tc-pertechnetate, 99m Tc-MAA should be prepared under strict quality control assessments and scintigraphy should be performed within 1 h of 99m Tc-MAA injection.…”

Section: Discussionmentioning

confidence: 99%

Significance of Oral Administration of Sodium Perchlorate in Planning Liver-Directed Radioembolization

et al. 2011

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99m Tc-macroaggregated albumin ( 99m Tc-MAA) scanning precedes radioembolization of the liver to detect extrahepatic shunting to the lung or gastrointestinal tract. Despite strict preventive measures in the production of 99m Tc-MAA and in scanning protocols, the images frequently show a gastric concentration of free 99m Tc-pertechnetate, hindering accurate evaluation of the gastroduodenal region. Our aim was to evaluate whether oral administration of sodium perchlorate (NaClO 4 ) before 99m Tc-MAA scanning will improve its accuracy by blocking free 99m Tc-pertechnetate gastric uptake. Methods: In 144 patients, 171 diagnostic hepatic angiograms combined with a 99m Tc-MAA scan were performed; 86 angiograms were performed after oral administration of NaClO 4 , and 85 were performed without this premedication. Clinical follow-up, esophagogastroduodenoscopy, and angiography served as reference standards. Results: 99m Tc-MAA studies showed tracer uptake in the gastric region of 25 patients who did not receive NaClO 4 . The uptake was interpreted as a free 99m Tc-pertechnetate concentration in 21 studies and as a 99m Tc-MAA accumulation in 4 studies. In 5 patients with a free 99m Tc-pertechnetate concentration, aberrant vessels were detected in angiographic reexamination, and 3 patients developed gastrointestinal ulcer. In 7 studies, gastric findings viewed pretherapeutically as free 99m Tc-pertechnetate were retrospectively classified as equivocal. Of the patients receiving NaClO 4 , 2 showed gastric accumulation of 99m Tc-MAA but no equivocal or free 99m Tc-pertechnetate. Oral administration of NaClO 4 increased the negative predictive value and accuracy of the test concerning the detection of gastric perfusion from 68% and 69%, respectively, to 93% and 94%, respectively. Conclusion: Oral administration of NaClO 4 before the test angiogram with 99m Tc-MAA resulted in effective avoidance of free 99m Tc-pertechnetate concentration and, consequently, of equivocal findings in the gastroduodenal region. This technique increased test accuracy and reporter confidence, saved time in reviewing the angiograms, and can improve treatment planning and reduce therapeutic side effects. Scanni ng with 99m Tc-macroaggregated albumin ( 99m Tc-MAA) generally precedes radioembolization of the liver to detect extrahepatic shunting to the lung or gastrointestinal tract (1). To avoid dissociated 99m Tc-pertechnetate, 99m Tc-MAA should be prepared under strict quality control assessments (2-4) and scintigraphy should be performed within 1 h of the radiopharmaceutical injection. Despite the preventive measures, a gastric concentration of free 99m Tc-pertechnetate is frequently seen in 99m Tc-MAA images and can hinder the accurate evaluation of the gastroduodenal region. Sodium perchlorate (NaClO 4 ) has a great affinity for the sodium-iodine symporter and is safely used for prophylaxis of iodine-induced hyperthyroidism due to iodinated contrast agents (5-7). Our aim was to evaluate whether oral administration of NaClO 4 before 99m Tc-MAA sca...

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“…Analogous external structure and sizes of both anions seem to account for analogous behaviour. Both anions show common ways of transport and exhibit affinity to the same organs, like the thyroid, salivary glands and gastric mucosa [1,10,15]. This sim ilarity is also shown in the suppression action ofpertechnetates and thiocyanates on the thyroid uptake and gastric secretion of TcO and I-ions [4].…”

Section: Sw 28mentioning

confidence: 99%

“…Its short half-life (6 h) makes it also particularly safe in large doses, necessary in scintigraphy. The TcO , ion replaces the anions of the elements of the 7th group and, when introduced into the body, is accumulated mainly by the gastric mucosa and by the thyroid, salivary and lacrymal glands [1,7,10,15]. Although technetium -99m does not normally enter into the constituents of the body and its properties are not fully determ ined, owing to its special physical properties, it has found wide acceptance in the scanning of the thyroid, liver, brain and placenta.…”

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confidence: 99%

Scanning of the Stomach with <sup>99m</sup>Tc

Mikołajków¹,

Chomicki²

1970

Digestion

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Technetium-99m, after i. v. administration, is found to be localized in the gastric mucosa, and is subsequently excreted with the stomach juice. Owing to the favorable physical properties of ^99mTc, satisfactory scans of the stomach can be made. The presence of neoplasms is shown as areas of lower density of scans. No alcerations or inflammatory processes, however, can be visualized with this method. The technique of obtaining ^99mTc and the scanning procedure are presented.

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Pertechnetate-99m Localization in Man with Applications to Thyroid Scanning and the Study of Thyroid Physiology

Cited by 118 publications

References 3 publications

^99mTechnetium scintiphotography in arthritis I. technic and interpretation

^99mTechnetium scintiphotography in arthritis I. technic and interpretation

Significance of Oral Administration of Sodium Perchlorate in Planning Liver-Directed Radioembolization

Scanning of the Stomach with <sup>99m</sup>Tc

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