小儿患者的肾脏Tc-DMSA药代动力学

Renal Tc-DMSA pharmacokinetics in pediatric patients.

作者信息

Plyku Donika, Ghaly Michael, Li Ye, Brown Justin L, O'Reilly Shannon, Khamwan Kitiwat, Goodkind Alison B, Sexton-Stallone Briana, Cao Xinhua, Zurakowski David, Fahey Frederic H, Treves S Ted, Bolch Wesley E, Frey Eric C, Sgouros George

机构信息

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.

J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.

出版信息

EJNMMI Phys. 2021 Jul 20;8(1):53. doi: 10.1186/s40658-021-00401-7.

DOI:10.1186/s40658-021-00401-7

PMID:34283316

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8292521/

Abstract

UNLABELLED

Tc-DMSA is one of the most commonly used pediatric nuclear medicine imaging agents. Nevertheless, there are no pharmacokinetic (PK) models for Tc-DMSA in children, and currently available pediatric dose estimates for Tc-DMSA use pediatric S values with PK data derived from adults. Furthermore, the adult PK data were collected in the mid-70's using quantification techniques and instrumentation available at the time. Using pediatric imaging data for DMSA, we have obtained kinetic parameters for DMSA that differ from those applicable to adults.

METHODS

We obtained patient data from a retrospective re-evaluation of clinically collected pediatric SPECT images of Tc-DMSA in 54 pediatric patients from Boston's Children Hospital (BCH), ranging in age from 1 to 16 years old. These were supplemented by prospective data from twenty-three pediatric patients (age range: 4 months to 6 years old).

RESULTS

In pediatric patients, the plateau phase in fractional kidney uptake occurs at a fractional uptake value closer to 0.3 than the value of 0.5 reported by the International Commission on Radiological Protection (ICRP) for adult patients. This leads to a 27% lower time-integrated activity coefficient in pediatric patients than in adults. Over the age range examined, no age dependency in uptake fraction at the clinical imaging time was observed. Female pediatric patients had a 17% higher fractional kidney uptake at the clinical imaging time than males (P < 0.001).

CONCLUSIONS

Pediatric Tc-DMSA kinetics differ from those reported for adults and should be considered in pediatric patient dosimetry. Alternatively, the differences obtained in this study could reflect improved quantification methods and the need to re-examine DMSA kinetics in adults.

摘要

未标注

锝-二巯基丁二酸（Tc-DMSA）是儿科核医学中最常用的显像剂之一。然而，目前尚无儿童Tc-DMSA的药代动力学（PK）模型，当前可用的儿童Tc-DMSA剂量估计是使用源自成人的PK数据的儿童S值。此外，成人PK数据是在70年代中期使用当时可用的定量技术和仪器收集的。利用儿童DMSA的显像数据，我们获得了与成人适用的动力学参数不同的DMSA动力学参数。

方法

我们从对波士顿儿童医院（BCH）54例年龄在1至16岁的儿科患者的临床收集的Tc-DMSA儿科单光子发射计算机断层扫描（SPECT）图像进行回顾性重新评估中获得患者数据。这些数据由来自23例儿科患者（年龄范围：4个月至6岁）的前瞻性数据补充。

结果

在儿科患者中，肾脏摄取分数的平台期出现在摄取分数值更接近0.3时，而不是国际放射防护委员会（ICRP）报告的成人患者的0.5值。这导致儿科患者的时间积分活度系数比成人低27%。在所研究的年龄范围内，在临床显像时未观察到摄取分数与年龄相关。在临床显像时，女性儿科患者的肾脏摄取分数比男性高17%（P<0.001）。