Evaluation of 99mTc-albumin dilution curve with simultaneous injection of 99mTc- and 131I-albumins.

A critical comparison of radiocardiograms with 99mTc- and 131I-albumins was made to determine whether or not 99mTc-albumin can be used as a tracer for measuring blood volume (BV) and cardiac output (CO). Simultaneous injection of both isotopes was given to twenty-two patients to obtain radiocardiograms for each by means of a single scintillation counter with two pulse height analyzers. Such method allows for the determination of the energy levels for both 99mTc and 131I. The radiocardiographic pattern was somewhat different between 99mTc- and 131I-radiocardiograms: The ratio of left to right peak height was 16% on the average lower in the 99mTc-radiocardiogram in the 131I-one. The reason for the lower ratio is explained by greater absorption of 99mTc-radioactivity within the soft tissue interposing between the scintillation probe and heart. The values for 99mtc-derived blood volume were 7.4% on the average larger than those for 131I-derived blood volume (p less than 0.01), although the correlation was excellent (r = 0.98, p less than 0.01). There was no systemic difference between cardiac output determined by 99mTc- and 131I-albumins since the overstimation of blood volume can compensate for the understimation of CO/BV by 99mTc-study. In view of its rapid extravasation, 99mTc-albumin is not so appropriate tracer for accurate measurements of BV and CO/BV, although it may be used for measurement of cardiac output.