ABSTRACT
A simplified technique of labelling leucocytes with technetium-99m is described and applied to patients with active rheumatoid arthritis. The clinically active and less active knees in seven patients were imaged and the uptake of labelled leucocytes was measured. The measurements were repeated after local steroid injection into nine painful knees. A 50-80% reduction in leucocyte uptake localized to the region of the synovium was demonstrated in the eight knees which showed clinical responses and a rise of 8% in the non-responder. There was a variable response in the knees that were not injected. 99Tcm leucocyte imaging in rheumatoid arthritis is able to assess objectively joint inflammation and its response to treatment.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Leukocytes , Technetium , Aged , Arthritis, Rheumatoid/drug therapy , Female , Humans , Injections, Intra-Articular , Isotope Labeling/methods , Knee Joint/diagnostic imaging , Knee Joint/drug effects , Male , Middle Aged , Organometallic Compounds , Oximes , Radionuclide Imaging , Technetium Tc 99m Exametazime , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/therapeutic useABSTRACT
The preparation, application and clinical usage of 99mTc-mercaptoacetyltriglycine, MAG3, a tubular secreted compound, is described in the first 225 patients in a phase III study. Image quality, relative renal function, and renal transit times were compared with a 4 fold greater administered activity of 99mTc-DTPA in 11 patients. Correlation coefficients of 0.94 for relative function, 0.83 for parenchymal transit time index and 0.82 for whole kidney transit time index were found. Frusemide responses were similar. 99mTc-MAG3 is an efficacious radiopharmaceutical for routine renal radionuclide studies, giving excellent image quality in patients with hypertension, poor renal function, obstructive nephropathy or a renal transplant.
