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Title: Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate

Abstract

Technetium-99m 2,3-dimercaptosuccinic acid (Tc-99m DMSA) has been used successfully for imaging acute myocardial infarction in a canine model. The application in humans, however, has not been previously reported. In order to determine the feasibility of using this agent in clinical studies and to compare the agent to technetium-99m pyrophosphate (Tc-99m PPi), ten patients with proven myocardial infarction were studied. While imaging of transmural infarctions in humans was achieved using Tc-99m DMSA, scores for the Tc-99m DMSA images (1.8 +/- 0.96) were not as high as for Tc-99m PPi (2.5 +/- 0.45) (P less than 0.05). Discordance among four independent interpreters was greater for images obtained with Tc-99m DMSA. The superiority of Tc-99m PPi was evident whether images were obtained early (within 24 hours) or late (within five days). Although DMSA images were not obscured by rib uptake, they were less sensitive (63%) than Tc-99m PPi (97%). A potential advantage of Tc-99m DMSA in imaging acute myocardial infarction is that radiotracer concentration in the infarct occurs primarily in the early postinfarction period. The longer postinfarction that Tc-99m DMSA imaging was attempted, the lower the concentration of radiotracer. Thus, Tc-99m DMSA would not be expected to have the same persistence pattern asmore » Tc-99m PPi into the remote postinfarction period. The persistent positivity of Tc-99m PPi has made it difficult to diagnose reinfarction.« less

Authors:
; ; ; ;
Publication Date:
Research Org.:
Veterans Administration Medical Center, Long Beach, CA
OSTI Identifier:
6021837
Resource Type:
Journal Article
Journal Name:
Clin. Nucl. Med.; (United States)
Additional Journal Information:
Journal Volume: 12:7
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MYOCARDIAL INFARCTION; DIAGNOSIS; RADIOPHARMACEUTICALS; COMPARATIVE EVALUATIONS; BIOLOGICAL MODELS; DOGS; ISOMERIC NUCLEI; MYOCARDIUM; ORGANOMETALLIC COMPOUNDS; PATIENTS; PYROPHOSPHATES; TECHNETIUM 99; ANIMALS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; DISEASES; DRUGS; HEART; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LABELLED COMPOUNDS; MAMMALS; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC COMPOUNDS; ORGANS; OXYGEN COMPOUNDS; PHOSPHORUS COMPOUNDS; RADIOISOTOPES; TECHNETIUM ISOTOPES; VERTEBRATES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Lyons, K P, Milne, N, Karlsberg, R P, Olson, H G, and Kuperus, J. Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate. United States: N. p., 1987. Web. doi:10.1097/00003072-198707000-00005.
Lyons, K P, Milne, N, Karlsberg, R P, Olson, H G, & Kuperus, J. Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate. United States. https://doi.org/10.1097/00003072-198707000-00005
Lyons, K P, Milne, N, Karlsberg, R P, Olson, H G, and Kuperus, J. 1987. "Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate". United States. https://doi.org/10.1097/00003072-198707000-00005.
@article{osti_6021837,
title = {Myocardial infarct imaging in patients with technetium-99m 2,3-dimercaptosuccinic acid. Superiority of technetium-99m pyrophosphate},
author = {Lyons, K P and Milne, N and Karlsberg, R P and Olson, H G and Kuperus, J},
abstractNote = {Technetium-99m 2,3-dimercaptosuccinic acid (Tc-99m DMSA) has been used successfully for imaging acute myocardial infarction in a canine model. The application in humans, however, has not been previously reported. In order to determine the feasibility of using this agent in clinical studies and to compare the agent to technetium-99m pyrophosphate (Tc-99m PPi), ten patients with proven myocardial infarction were studied. While imaging of transmural infarctions in humans was achieved using Tc-99m DMSA, scores for the Tc-99m DMSA images (1.8 +/- 0.96) were not as high as for Tc-99m PPi (2.5 +/- 0.45) (P less than 0.05). Discordance among four independent interpreters was greater for images obtained with Tc-99m DMSA. The superiority of Tc-99m PPi was evident whether images were obtained early (within 24 hours) or late (within five days). Although DMSA images were not obscured by rib uptake, they were less sensitive (63%) than Tc-99m PPi (97%). A potential advantage of Tc-99m DMSA in imaging acute myocardial infarction is that radiotracer concentration in the infarct occurs primarily in the early postinfarction period. The longer postinfarction that Tc-99m DMSA imaging was attempted, the lower the concentration of radiotracer. Thus, Tc-99m DMSA would not be expected to have the same persistence pattern as Tc-99m PPi into the remote postinfarction period. The persistent positivity of Tc-99m PPi has made it difficult to diagnose reinfarction.},
doi = {10.1097/00003072-198707000-00005},
url = {https://www.osti.gov/biblio/6021837}, journal = {Clin. Nucl. Med.; (United States)},
number = ,
volume = 12:7,
place = {United States},
year = {Wed Jul 01 00:00:00 EDT 1987},
month = {Wed Jul 01 00:00:00 EDT 1987}
}