Emmanuelle Vidal-Petiot1,2,3, Marie Courbebaisse4,5,6, Marine Livrozet7,8, Gwénaëlle Corrégé9, Timofei Rusu9, Françoise Montravers7,9, Stéphanie Baron4,5,10, Léa Dupont11, Clara Balouzet11, Corinne Smadja11, Sébastien Leygnac4,12,13, Guillaume Pariscoat12,14,15, Jimmy Rose14, François Rouzet4,12,15, Pascal Houillier4,5,10, Jean-Philippe Haymann7,8, Martin Flamant4,16,17. 1. Université de Paris, Paris, France. emmanuelle.vidal-petiot@aphp.fr. 2. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 46, rue Henri Huchard, 75018, Paris, France. emmanuelle.vidal-petiot@aphp.fr. 3. Inserm U1149, Center for Research on Inflammation, Paris, France. emmanuelle.vidal-petiot@aphp.fr. 4. Université de Paris, Paris, France. 5. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France. 6. Institut Necker-Enfants Malades, INSERM U1151-CNRS UMR8253, Paris, France. 7. Sorbonne Université, Paris, France. 8. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France. 9. Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France. 10. Centre de Recherche Des Cordeliers, INSERM, Université de Paris, 75006, Paris, France. 11. Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France. 12. Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France. 13. Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France. 14. Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France. 15. Inserm U1148, Laboratory for Vascular Translational Research, 75018, Paris, France. 16. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 46, rue Henri Huchard, 75018, Paris, France. 17. Inserm U1149, Center for Research on Inflammation, Paris, France.
Abstract
PURPOSE: The production of 51Cr-labelled ethylenediaminetetraacetic acid (51Cr-EDTA), a validated and widely used radio-isotopic tracer for glomerular filtration rate (GFR) measurement in Europe, was recently halted by the manufacturer. Technetium-99m-diethylenetriaminepentaacetic acid (99mTc-DTPA) clearance has so far mostly been restricted to assessment of separate renal function by scintigraphy, but scarcely used and validated for GFR measurement. We compared the performances of 51Cr-EDTA and 99mTc-DTPA for GFR and extracellular fluid measurement. METHODS: In a multi-centre prospective study, 51Cr-EDTA and 99mTc-DTPA were simultaneously injected into 88 patients, and their urinary and plasma clearances, as well as their volumes of distribution, were measured during seven 30-min periods after a 90-min equilibrium time. RESULTS: Mean age was 52.2 ± 14.5 years, 59% were men. Urinary clearances of 51Cr-EDTA and 99mTc-DTPA were 64.1 ± 27.6 and 66.1 ± 28.0 mL/min, respectively, with a mean bias of 2.00 ± 2.25 mL/min, an accuracy within 10% of 95% [95% CI 91-99], and a coefficient of determination (R2) of 0.994. Plasma clearances of 51Cr-EDTA and 99mTc-DTPA were 66.1 ± 25.8 and 68.1 ± 26.6 mL/min, respectively, with a mean bias of 1.96 ± 3.32 mL/min, an accuracy within 10% of 91% [95% CI 85-97] and a R2 of 0.985. Distribution volumes were 17.3 ± 4.6 L for 51Cr-EDTA and 16.6 ± 4.6 L for 99mTc-DTPA (R2 0.930). CONCLUSION: The accuracy and precision of 99mTc-DTPA clearance, compared to 51Cr-EDTA clearance, was excellent for both urinary and plasma clearance methods, despite an approximate 2 mL/min overestimation, showing that the tracer is a reliable alternative to 51Cr-EDTA for GFR measurement.
PURPOSE: The production of 51Cr-labelled ethylenediaminetetraacetic acid (51Cr-EDTA), a validated and widely used radio-isotopic tracer for glomerular filtration rate (GFR) measurement in Europe, was recently halted by the manufacturer. Technetium-99m-diethylenetriaminepentaacetic acid (99mTc-DTPA) clearance has so far mostly been restricted to assessment of separate renal function by scintigraphy, but scarcely used and validated for GFR measurement. We compared the performances of 51Cr-EDTA and 99mTc-DTPA for GFR and extracellular fluid measurement. METHODS: In a multi-centre prospective study, 51Cr-EDTA and 99mTc-DTPA were simultaneously injected into 88 patients, and their urinary and plasma clearances, as well as their volumes of distribution, were measured during seven 30-min periods after a 90-min equilibrium time. RESULTS: Mean age was 52.2 ± 14.5 years, 59% were men. Urinary clearances of 51Cr-EDTA and 99mTc-DTPA were 64.1 ± 27.6 and 66.1 ± 28.0 mL/min, respectively, with a mean bias of 2.00 ± 2.25 mL/min, an accuracy within 10% of 95% [95% CI 91-99], and a coefficient of determination (R2) of 0.994. Plasma clearances of 51Cr-EDTA and 99mTc-DTPA were 66.1 ± 25.8 and 68.1 ± 26.6 mL/min, respectively, with a mean bias of 1.96 ± 3.32 mL/min, an accuracy within 10% of 91% [95% CI 85-97] and a R2 of 0.985. Distribution volumes were 17.3 ± 4.6 L for 51Cr-EDTA and 16.6 ± 4.6 L for 99mTc-DTPA (R2 0.930). CONCLUSION: The accuracy and precision of 99mTc-DTPA clearance, compared to 51Cr-EDTA clearance, was excellent for both urinary and plasma clearance methods, despite an approximate 2 mL/min overestimation, showing that the tracer is a reliable alternative to 51Cr-EDTA for GFR measurement.
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