51 Cr-EDTA 和 99m Tc-DTPA 用于肾小球滤过率测量的比较,Journal of Nephrology

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51 Cr-EDTA 和 99m Tc-DTPA 用于肾小球滤过率测量的比较
Journal of Nephrology ( IF 2.7 ) Pub Date : 2021-03-04 , DOI: 10.1007/s40620-020-00932-9
Emmanuelle Vidal-Petiot _{1,

2,

3} , Marie Courbebaisse _{1,

4,

5} , Marine Livrozet _{6,

7} , Gwénaëlle Corrégé ₈ , Timofei Rusu ₈ , Françoise Montravers _{6,

8} , Stéphanie Baron _{1,

4,

9} , Léa Dupont ₁₀ , Clara Balouzet ₁₀ , Corinne Smadja ₁₀ , Sébastien Leygnac _{1,

11,

12} , Guillaume Pariscoat _{11,

13,

14} , Jimmy Rose ₁₃ , François Rouzet _{1,

11,

14} , Pascal Houillier _{1,

4,

9} , Jean-Philippe Haymann _{6,

7} , Martin Flamant _{1,

2,

3}

Affiliation

Université de Paris, Paris, France.
Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 46, rue Henri Huchard, 75018, Paris, France.
Inserm U1149, Center for Research on Inflammation, Paris, France.
Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France.
Institut Necker-Enfants Malades, INSERM U1151-CNRS UMR8253, Paris, France.
Sorbonne Université, Paris, France.
Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France.
Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France.
Centre de Recherche Des Cordeliers, INSERM, Université de Paris, 75006, Paris, France.
Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France.
Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France.
Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France.
Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France.
Inserm U1148, Laboratory for Vascular Translational Research, 75018, Paris, France.

目的

生产的⁵¹ Cr标记的乙二胺四乙酸（⁵¹的Cr-EDTA）中，验证和广泛使用的放射性同位素示踪剂肾小球滤过率（GFR）的测量，在欧洲，最近由生产停止。迄今为止，锝-99m-二亚乙基三胺五乙酸 ( ^99m Tc-DTPA) 的清除率主要限于通过闪烁扫描法评估单独的肾功能，但很少用于 GFR 测量和验证。我们比较了⁵¹ Cr-EDTA 和^99m Tc-DTPA 在 GFR 和细胞外液测量方面的性能。

方法

在一项多中心前瞻性研究中，将⁵¹ Cr-EDTA 和^99m Tc-DTPA 同时注射到 88 名患者体内，并在 90 分钟后的七个 30 分钟内测量了他们的尿液和血浆清除率以及分布容积。 -min 平衡时间。

结果

平均年龄为 52.2 ± 14.5 岁，59% 为男性。⁵¹ Cr-EDTA 和^99m Tc-DTPA 的尿液清除率分别为 64.1 ± 27.6 和 66.1 ± 28.0 mL/min，平均偏差为 2.00 ± 2.25 mL/min，准确度在 95% [95% CI] 的 10% 以内91–99]，决定系数 ( R ² ) 为 0.994。⁵¹ Cr-EDTA 和^99m Tc-DTPA 的血浆清除率分别为 66.1 ± 25.8 和 68.1 ± 26.6 mL/min，平均偏差为 1.96 ± 3.32 mL/min，准确度在 91% [95% CI] 的 10% 以内85–97] 和0.985的R ²。⁵¹ Cr-EDTA 的分布体积为 17.3 ± 4.6 L ，^99m Tc-DTPA 的分布体积为16.6 ± 4.6 L ( R ² 0.930）。

结论

与⁵¹ Cr-EDTA 清除率相比，^99m Tc-DTPA 清除率的准确度和精密度对于尿液和血浆清除率方法都非常出色，尽管高估了大约 2 mL/min，表明示踪剂是⁵¹ Cr-的可靠替代品用于 GFR 测量的 EDTA。

图形摘要

"点击查看英文标题和摘要"

Comparison of 51 Cr-EDTA and 99m Tc-DTPA for glomerular filtration rate 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.

Graphic abstract

更新日期：2021-03-04

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