• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.270-276
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• 1993

$Technetium-^{99m}$ labeling method using bifunctional chelating agent cyclic DTPA has been evaluated with human polyclonal nonspecific IgG. IgG was conjugated with cyclic DTPA with various molar ratio. Reduction of $^{99m}Tc$ was done with $Na_2S_2O_4$ with various molar excess. Labeling efficiency and identification of polymer was confirmed with HPLC using TSK4000 SW column. Polymer was purified with 100 cm Sepharose 6LB column. Cultured $1{\times}10^9$ Staphylococcus aureus were injected into rat thigh 24 hours later labeled IgG was injected, and in vivo distribution was observed 4 and 24 hours thereafter. Reduction of $^{99m}Tc$ was optimal with the 10000-50000 times molar excess of $Na_2S_2O_4$. Polymer formation increased with increasing mloar excess of cyclic DTPA to IgG. Three step labeling-labeling DTPA conjugated IgG after reduction of $^{99m}Tc$-made more polymer than two two step labeling-simultaneous mixing DTPA conjugated IgG, $^{99m}Tc$ and $Na_2S_2O_4$. $^{99m}Tc$ blood clearance and lower uptake in the abscess and other organs. IgG conjugated with 200 times molar excess of cyclic DTPA showed slower blood clearance with 200 times molar excess of cyclic DTPA showed slower blood clearance than that of 200 times molar excess of cyclic DTPA showed slower blood clearance than that of 20 times molar excess. In the $^{99m}Tc$ labeling of IgG with cyclic DTPA for the immunoscintigraphy, obtimal labeling condition should be chosen, and effect of the $^{99m}Tc$ labeled IgG polymer should be considered.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.252-259
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• 2000

Purpose: The purpose of this study was to compare the radiation adaptive response (RAR) in peripheral lymphocytes (PL) of patients induced by Tc-99m MDP and Tc-99m DTPA scintigraphies. Materials and Methods: Lymphocytes from 45 patients (25 males, 20 females, mean age $44{\pm}18$ years) were collected before and after scintigraphies using 740 MBq Tc-99m MDP (n=22) or Tc-99m DTPA (n=23). Lymphocytes from 20 controls (12 males, 8 females, mean age $43{\pm}7$ years) were also collected. They were exposed to challenge dose of 2 Gy ${\gamma}-rays$ using a Cs-137 cell irradiator Number of ring-form (R) and dicentric (D) chromosomes was counted under the light microscope. From them a representative score, Ydr, was calculated as Ydr=(D+R)/cells. Adaptation index (AI) was defined as difference of Ydr between unconditioned and conditioned lymphocytes. Ydr was also measured after an administration of cycloheximide (CHM), a protein synthesis inhibitor, before challenge dose. Results: RAR was induced in both groups of patients. CHM abolished the adaptive response in both groups. AI of Tc-99m MDP group was significantly higher than that of Tc-99m BTPA group. Conclusion: Tc-99m MDP induced RAR was more prominent than those induced by Tc-99m DTPA.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.202-205
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• 2003

A 10 days old male infant with congenital megacalyces and megaureter, diagnosed by prenatal ultrasonographic screening, underwent Tc-99m DTPA renal scan for evaluation of urinary tract patency, Tc-99m DMSA scan for evaluation of renal cortical damage. He also underwent intravenous urography(IVU) and renal ultrasonography. Tc-99m DTPA renal scan demonstrates intense tracer accumulation in enlarged both renal pelvocalyses and ureters, which rapidly washout without diuretics administration. Tc-99m DMSA renal cortical scan shows no remarkable photon defect in both renal cortices and visible tracer uptake in both megaureter areas. Ultasonographic and IVU studios show enlarged both renal calyses and bullously dilated ureters, but no dilatation in renal pelvis. Follow up Tc-99m DTPA renal scan, peformed at one year later, also reveals intense tracer accumulation in enlarged both urinary tracts which rapidly washout without diuretics, and shows no significant change compare to the previous Tc-99m DTPA renal scan. Urinary tract obstruction and renal cortical damage can be easily evaluated with Tc-99m DTPA and Tc-99m DMSA scans in patiens with megacalyces and megaureter.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.313-316
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• 1994

Usually the persistence of ventricular activity in Tc-99m DTPA cisternography is deter mined using 24 hour images in our country. However, the 24 hour image is regarded as an in-sufficient data by many investigators. They prefer 48 hour image. The aim of the present study was to evaluate the feasibility and usefulness of 48 hour delayed imaging in Tc-99m DTPA cisternography. We performed 48 hour cisternography using Tc-99m DTPA in 38 patients with known hydrocephalus. 37-111 MBq (1-3mCi) of Tc-99m DTPA were injected by lumbar puncture. Anterior and both lateral Images were obtained at 2, 6, 24 and 48 hours. The classification of hydrocephalus was done at 24 and 48 hours by two independent nuclear medicine physicians. The 48 hour images were interpretable in all cases. In seven patients, the clearance of ventricular activity was noted only on 48 hours images. Therefore, their classification was changed from type W to type III. Sixteen of 38 patients were underwent shunt operations. Clinical improvement was noted in 13 patients(1/1 of type II, 3/6 of type III 8/9 of type IV). One case who showed a changing pattern from IV to IIIa showed no clinical improvement after shunt operation. In conclusion, the 48 hour delayed imaging was feasible and useful technique in Tc-99m DTPA cisternography.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.61-66
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• 2009

Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age $51.3{\pm}16.9$) with various renal function were examined. we compared the GFR using $^{99m}Tc$-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and $^{99m}Tc$-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with $3.0{\pm}3.1\;mg/dL$, In patients with normal renal function (Scr<1.5 mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5$^{99m}Tc$-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, $^{99m}Tc$-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.

• The Korean Journal of Nuclear Medicine
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• v.32 no.3
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• pp.266-275
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• 1998

Purpose: We measured pulmonary epithelial permeability by $^{99m}Tc-DTPA$ radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate $^{99m}Tc-DTPA$ radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. Materials and Methods: We performed $^{99m}Tc-DTPA$ radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) was calculated, then compared with the result of chest radiography and pulmonary function test. Results: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiopathy were significantly older (p<0.05). The $T_{1/2}$ of normal subjects and asymptomatic smokers were significantly different ($65.2{\pm}23.7min$ vs $39.6{\pm}9.8min$, p<0.05). For diabetic patients with microangiopathy, the $T_{1/2}$ was $90.5{\pm}46.5min$ and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the $T_{1/2}$ of diabetic patients without microangiopathy, $70.0{\pm}12.7min$, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the $T_{1/2}$ and spirometric parameters including DLco, FVC, $FEV_1,\;FEV_1/FVC$ (%) and $FEF_{25-75%}$ in all subjects, and between the $T_{1/2}$ and duration of diabetes ;in diabetic patients. Conclusion: Eventhough the influence of age can't be excluded, delayed $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.2
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• pp.35-40
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• 2021

Purpose Glomerular filtration rate(GFR) is an important indicator for the diagnosis, treatment, and follow-up of kidney disease and is also used by healthy individuals for drug use and evaluating kidney function in donors. The gold standard method of the GFR test is to measure by continuously injecting the inulin which is extrinsic marker, but it takes a long time and the test method is complicated. so, the method of measuring the serum concentration of creatinine is used. Estimated glomerular filtration rate (eGFR) is used instead. However, creatinine is known to be affected by age, gender, muscle mass, etc. eGFR formulas that are currently used include the Cockroft-Gault formula, the modification of diet in renal disease (MDRD) formula, and the chronic kidney disease epidemilogy collaboration (CKD-EPI) formula for adults. For children, the Schwartz formula is used. Measurement of GFR using ⁵¹Cr-EDTA (diethylenetriamine tetraacetic acid), ^99mTc-DTPA (diethylenetriamine pentaacetic acid) can replace inulin and is currently in use. Therefore, We compared the GFR measured using ^99mTc-DTPA with the eGFR using CKD-EPI formula. Materials and Methods For 200 kidney transplant donors who visited Asan medical center.(96 males, 104 females, 47.3 years ± 12.7 years old) GFR was measured using plasma(Two-plasma-sample-method, TPSM) obtained by intravenous administration of ^99mTc-DTPA(0.5mCi, 18.5 MBq). eGFR was derived using CKD-EPI formula based on serum creatinine concentration. Results GFR average measured using ^99mTc-DTPA for 200 kidney transplant donors is 97.27±19.46(ml/min/1.73m²), and the eGFR average value using the CKD-EPI formula is 96.84±17.74(ml/min/1.73m²), The concentration of serum creatinine is 0.84±0.39(mg/dL). Regression formula of ^99mTc-DTPA GFR for serum creatinine-based eGFR was Y = 0.5073X + 48.186, and the correlation coefficient was 0.698 (P<0.01). Difference (%) was 1.52±18.28. Conclusion The correlation coefficient between the ^99mTc-DTPA and the eGFR derived on serum creatinine concentration was confirmed to be moderate. This is estimated that eGFR is affected by external factors such as age, gender, and muscle mass and use of formulas made for kidney disease patients. By using ^99mTc-DTPA, we can provide reliable GFR results, which is used for diagnosis, treatment and observation of kidney disease, and kidney evaluation of kidney transplant patients.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.393-401
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• 2003

Objective: Pullulan derivatives (PD) can be used to make self-assembled hydrogel nanoparticles which are responsive to ionic strength. The aim of this study is to evaluate the potential of PD as a retaining carrier of radioisotope inside tumors. Materials and Methods: Four types of PD were evaluated which included pullulan acetate (PA), succinylated PA (SPA), PA-DTPA and SPA-DTPA conjugates. They were radiolabeled with Tc-99m. Labelling efficiencies were determined at 30 min, 1, 2, 4 and 12 hours after radiolabeling. CT-25 colon cancer cells were subcutaneously injected into Balb/c mice. After 2 weeks of subcutaneous injection, Tc-99m-labelled PD (Tc-99m-PD) were injected into the tumors. Whole body images of mice were obtained at 30 min, 1, 2, and 12 hr after intratumoral injection. All twenty mice were grouped into four groups by largest diameter; control A (largest diameter = 5 mm, n = 5), control B (largest diameter = 10 mm, n = 5), pullulan A (largest diameter = 5 mm, n = 5), pllulan B (largest diameter = 10 mm, n = 5). Dynamic images were obtained for 1 hour after intratumoral injection. Static images were obtained at 1 hr, 2 hr, 3 hr and 4 hr after intratumoral injection with Tc-99m pertechnetate and Tc-99m-PA. Target-to-background ratios and retention rates were calculated. Results: Labeling efficiencies of PA, SPA, PA-DTPA and SPA-DTPA were $94.5{\pm}5.9%,\;97.8{\pm}3.5%\;94.2{\pm}3.8%,\;and\;92.5{\pm}6.2%$, respectively (p>0.05). Percent retention rates (%RR) of PA and PA-DTPA were significantly higher than those of control, however, those of SP-DTPA and SPA became similar to control at 4 and 12 hr, respectively. %RR of pullulan A and pullulan B at 1, 4 and 8 hr is significantly higher than that of control (p < 0.05). However, %RR between pullulan A and pullulan B were similar. Conclusion: The lonic strength dependent PD-nanoparticles are retained in the tumor. No difference of %RR according to tumor size was noted. Therapeutic application of PD labelled with beta- or alpha- emitting radionuclides can be expected.

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.367-371
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• 1996

The $MAG_3$ is a tubular excreting radiopharmaceutical for renal image. We synthesized benzoyl $MAG_3\;(Bz-MAG_3)$ and made a kit for labeling with $^{99m}Tc$. We checked the labeling efficieny of $^{99m}Tc$ labeled $MAG_3$ and biodistribution. Labeling efficieny was checked by TLC-SG (acetonitrile/$H_2O$=2/1). After injecting of 1 mCi of $^{99m}Tc-MAG_3$ to ICR-mice, $T_{max}(min),\;T_{1/2}(min)$ were obtained in the renogram. Sequential images (30sec, 2min, 5min, 10min, 15min, 20min) of $^{99m}Tc-MAG_3$ were compared with those of commercial $^{99m}Tc$-DTPA (Du Pont Merck Pharmaceutical Co.) kit. 1) The $R_f$ value of synthesized $^{99m}Tc-MAG_3$ was 0.78 and labeling efficiency was $97.5{\pm}1.9%$ (n=10). 2) The dynamic images of the $^{99m}Tc-MAG_3$ were better than those of the $^{99m}Tc$-DTPA. 3) The $T_{max}(min.)$ and $T_{1/2}(min.)$ of $^{99m}Tc-MAG_3$ (n=10) were $1.5{\pm}0.5$ (left), $1.4{\pm}0.4$ (right), and $4.3{\pm}1.4$ (left), $4.8{\pm}2.0$ (right), respectively. The $T_{max}(min.)$ and $T_{1/2}(min.)$ of $^{99m}Tc$-DTPA (n=7) were $2.7{\pm}1.6$ (left), $2.7{\pm}1.6$ (right), and $3.8{\pm}1.7$ (left), $4.5{\pm}2.7$ (right), respectively. The quaility of image and labeling efficiency of the synthesized $Bz-MAG_3$ kit were excellent, that it was supposed to be used in routine clinical work.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.227-236
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• 1991

Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ were R=0.9190 (p < 0.001), R: 0.9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p < 0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake $^{99m}Tc-DTPA$ had the best correlation with relative glomerular filteration rate of $^{99m}Tc-DTPA$ and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.