Pancreas transplants: Evaluation using perfusion scintigraphy

Journal Article · Sat Jul 01 04:00:00 EDT 1989 · AJR, Am. J. Roentgenol.; (United States)

DOI:https://doi.org/10.2214/ajr.153.1.57· OSTI ID:5931744

Kuni, C C; du Cret, R P; Boudreau, R J

To determine the value of scintigraphic perfusion studies in evaluating pancreas transplant patients, we reviewed 56 of these studies in 22 patients who had 27 transplants. Seventeen patients underwent two or more studies. The perfusion studies were performed with 20 mCi (740 MBq) of 99mTc-DTPA injected as a bolus followed by eight to 16 serial 2-sec images and a 500,000-count immediate static image. Images were evaluated for (1) the time and intensity of pancreatic peak radioactivity relative to the time and intensity of the iliac arterial peak; (2) relative pancreatic to iliac arterial intensity on the static image; and (3) size, homogeneity, and definition of the pancreas. Clinical diagnoses at the time of scintigraphy of normal function (n = 36), rejection (n = 13), pancreatitis (n = 6), or arterial thrombosis (n = 1) were based on insulin requirement, urine amylase, serum glucose, serum amylase, response to therapy, cultures, CT, MR, sonography, scintigraphy with 67Ga or 111In-WBCs, percutaneous drainage results, angiography, surgery, and pathologic examination of resected transplants. Three 99mTc-DTPA perfusion studies showed no pancreatic perfusion, four showed decreasing perfusion on serial studies, and five showed progressive loss of definition of the pancreas on serial studies. Of the three patients with no detectable perfusion, one had a normally functioning transplant, one had arterial thrombosis with transplant infarction, and one had severe rejection with minimal function. Decreasing perfusion was associated with rejection in three patients and pancreatitis in one. Decreasing definition was seen in four patients with rejection and one with pancreatitis. We conclude that perfusion scintigraphy is useful, primarily when performed serially, although nonspecific for evaluating pancreas transplants.

• Research Organization: Univ. of Minnesota Hospital and Clinics, Minneapolis (USA)
• OSTI ID: 5931744
• Journal Information: AJR, Am. J. Roentgenol.; (United States), Journal Name: AJR, Am. J. Roentgenol.; (United States) Vol. 153:1; ISSN AAJRD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ALANINES
AMINO ACIDS
ANIMALS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DRUGS
DTPA
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE GLANDS
EVALUATION
GALLIUM 67
GALLIUM ISOTOPES
GLANDS
GRAFT-HOST REACTION
HOURS LIVING RADIOISOTOPES
INDIUM 111
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MAN
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
PANCREAS
PATIENTS
PERFUSED ORGANS
PRIMATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
SCINTISCANNING
TECHNETIUM 99
TECHNETIUM ISOTOPES
TRANSPLANTS
VERTEBRATES
YEARS LIVING RADIOISOTOPES