sodium-pertechnetate-tc-99m and sodium-perchlorate

Topics: Humans; Iodine Radioisotopes; Perchlorates; Radionuclide Imaging; Sodium Compounds; Sodium Pertechnetate Tc 99m; Thiocyanates; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Triiodothyronine

(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.. 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.. (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.. 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.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Biological Transport; Embolization, Therapeutic; Gastric Mucosa; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Perchlorates; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Sodium Compounds; Sodium Pertechnetate Tc 99m; Stomach; Technetium Tc 99m Aggregated Albumin

Topics: Clinical Trials as Topic; Humans; Parathyroid Glands; Perchlorates; Radionuclide Imaging; Radiopharmaceuticals; Sodium Compounds; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Sestamibi; Thyroid Gland

Topics: Humans; Parathyroid Glands; Perchlorates; Radionuclide Imaging; Sodium Compounds; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Sestamibi; Thyroid Gland

Radioactive wires and other linear sources are currently being used in clinical trials as endovascular brachytherapy to prevent restenosis after percutaneous transluminal coronary angioplasty. A new concept is the use of a liquid-filled balloon containing a beta-emitting radioisotope. A major advantage is optimal delivery of the radioactivity to the vessel wall. Rhenium-188 (188Re) is a high-energy beta-emitter that is routinely available from a 188W/188Re generator in liquid form. Since 188Re-perrhenate could be released in the unlikely event of balloon rupture, we investigated whether, in analogy to pertechnetate, subsequent use of perchlorate can reduce the uptake of perrhenate in the thyroid. We performed static (n = 9) and dynamic (n = 11) thyroid scintigraphy with 99Tcm-pertechnetate to estimate the overall reduction in activity within 30 min and the washout from the thyroid after oral administration of 600 mg perchlorate (T1/2). In two patients, 188Re was injected to estimate the whole-body distribution and the discharge of thyroid activity after perchlorate use. Based on MIRD Dose Estimate Report No. 8 (valid for 99Tcm-pertechnetate), the radiation burden was calculated for intravenous administration of 188Re and competitive blocking with perchlorate. In 20 patients, 99Tcm uptake by the thyroid was reduced by 85% within 30 min by perchlorate. The mean (+/- S.D.) washout rate (T1/2) was 8 +/- 2 min in 11 patients. Perrhenate showed a whole-body distribution similar to that of pertechnetate and the thyroid activity could be displaced (T1/2 = 6.3 and 9.3 min, respectively) by oral administration of perchlorate, with reductions in uptake of 83% and 75% within 30 min, respectively. Whole-body scanning demonstrated no regional accumulation of 188Re-perrhenate with excretion by urine. Dose estimates gave an effective dose equivalent of 0.42 mSv MBq-1, which decreased to 0.16 mSv MBq-1 after perchlorate blocking. 188Re has favourable properties for endovascular brachytherapy via a balloon catheter and, in the unlikely event of balloon rupture, whole-body radiation can be reduced to 38% by subsequent oral administration of perchlorate.

Topics: Administration, Oral; Adult; Aged; Angioplasty, Balloon, Coronary; Brachytherapy; Catheterization; Coronary Disease; Female; Humans; Male; Middle Aged; Perchlorates; Radioisotopes; Radionuclide Imaging; Recurrence; Rhenium; Sodium Compounds; Sodium Pertechnetate Tc 99m; Thyroid Gland

The uptake of radioactive iodide or chloride by plasma membrane vesicles of bovine thyroid was studied by a rapid filtration technique. A Na(+)-I- cotransport was demonstrated. When this Na(+)-I- cotransport is inactive (i.e., at 4 degrees C and in the absence of Na+), an uptake of iodide above chemical equilibrium could be induced, driven by the membrane potential. The latter was set up by allowing potassium to diffuse into the membrane vesicles in the presence of valinomycin and of an inward K+ gradient. This potential difference (positive inside) induced the uptake of iodide (or other anion present). The data support the existence of two anionic channels. The first one, observed at low near-physiological iodide concentration (micromolar range), which exhibits a high permeability and specificity for iodide (hence called the iodide channel), has a Km of 70 microM. The other one appears similar to the epithelial anion channel as described by Landry et al. (J. Gen. Physiol. 90: 779-798, 1987); it is still about fourfold more permeable to iodide than to chloride and presents a Km of 33 mM. Under physiological conditions the latter channel would mediate chloride transport, and the iodide channel, which is proposed to be restricted to the apical plasma membrane domain of the thyrocyte, transports iodide from the cytosol to the colloid space.

Topics: Animals; Anions; Cattle; Cell Membrane; Chloride Channels; Chlorides; Detergents; Iodides; Ion Channels; Membrane Potentials; Membrane Proteins; Perchlorates; Sodium; Sodium Compounds; Sodium Pertechnetate Tc 99m; Thyroid Gland

The use of perchlorate to block gastric uptake of free 99Tcm-pertechnetate after in vivo labelling of red cells was investigated. In 19 out of 20 cases there was no evidence that previous administration of perchlorate adversely affected red cell labelling using commercial stannous agents. Adequate scintigraphic images of the vascular system could be obtained for up to 24 h after the cells were labelled. The technique was found to be of value in the investigation of sites of gastrointestinal bleeding.

Topics: Colon; Colonic Diseases; Erythrocytes; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Male; Perchlorates; Radionuclide Imaging; Sodium Compounds; Sodium Pertechnetate Tc 99m; Stomach