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99mTc-sodium phytate is a valid alternative to the gold-standard 99mTc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized cross-over trial.

ABSTRACT: BACKGROUND:It is unclear if the 99mTc-sodium phytate (99mTc-SP) is as reliable as the gold-standard 99mTc-sulfur colloid (99mTc-SC) for gastric emptying scintigraphy (GES). This study is aimed to compare the emptying rates of both radiotracers in a prospective, randomized cross-over trial and to determine the normative data of a healthy multi-ethnic Asian population. METHODS:Out of the 44?healthy individuals screened, 31 (14 females; mean age: 28.4?±?7.0?years) were enrolled and underwent GES using the standardized egg-white meal. All participants were randomly assigned to either 99mTc-SP or 99mTc-SC on the first GES session before crossed over to the other formulation after 2 weeks. RESULTS:Both kits achieved the radiochemical purities of >?95%. The median rate (95th upper normative limit) of gastric emptying, reported as total gastric meal retention between 99mTc-SP and 99mTc-SC, was found to be comparable at all measured time points: 0.5?h [85.0% (96.6%) vs. 82.0% (94.0%)], 1?h [70.0% (86.4%) vs. 65.0% (86.6%)], 2?h [31.0% (55.8%) vs. 25.0% (64.4%)], 3?h [7.0% (26.3%) vs. 5.0% (29.9%)], and 4?h [3.0% (10.3%) vs. 2.0% (9.9%)]; P?>?0.05. In addition, both radiotracers correlated well (Kendall's Tau (?) coefficient?=?0.498, P?

SUBMITTER: Mat Nawi N

PROVIDER: S-EPMC7457507 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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<sup>99m</sup>Tc-sodium phytate is a valid alternative to the gold-standard <sup>99m</sup>Tc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized cross-over trial.

Mat Nawi Norazlina N Tagiling Nashrulhaq N Mohd Rohani Mohd Fazrin MF Wan Zainon Wan Mohd Nazlee WMN Zanial Muhammad Saifuddin MS Wong Mung Seong MS Lee Yeong Yeh YY

BMC gastroenterology 20200831 1

<h4>Background</h4>It is unclear if the <sup>99m</sup>Tc-sodium phytate (<sup>99m</sup>Tc-SP) is as reliable as the gold-standard <sup>99m</sup>Tc-sulfur colloid (<sup>99m</sup>Tc-SC) for gastric emptying scintigraphy (GES). This study is aimed to compare the emptying rates of both radiotracers in a prospective, randomized cross-over trial and to determine the normative data of a healthy multi-ethnic Asian population.<h4>Methods</h4>Out of the 44 healthy individuals screened, 31 (14 females; mea ...[more]

PMID: 32867699

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Project description:PurposeSentinel lymph node (SLN) biopsy has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). [99mTc]Tc-tilmanocept may be of benefit in OSCC with complex lymphatic drainage patterns and close spatial relation to SLNs.MethodsA prospective within-patient evaluation study was designed to compare [99mTc]Tc-tilmanocept with [99mTc]Tc-nanocolloid for SLN detection. A total of 20 patients with early-stage OSCC were included, who underwent lymphoscintigraphy with both tracers. Both lymphoscintigraphic images of each patient were evaluated for SLN detection and radiotracer distribution at 2-4 h post-injection.ResultsThe injection site's remaining radioactivity was significantly lower for [99mTc]Tc-tilmanocept (29.9%), compared with [99mTc]Tc-nanocolloid (60.9%; p < 0.001). Radioactive uptake in SLNs was significantly lower for [99mTc]Tc-tilmanocept (1.95%) compared with [99mTc]Tc-nanocolloid (3.16%; p = 0.010). No significant difference was seen in SLN to injection site ratio in radioactivity between [99mTc]Tc-tilmanocept (0.066) and [99mTc]Tc-nanocolloid (0.054; p = 0.232). A median of 3.0 and 2.5 SLNs were identified with [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid, respectively (p = 0.297). Radioactive uptake in higher echelon nodes was not significantly different between [99mTc]Tc-tilmanocept (0.57%) and [99mTc]Tc-nanocolloid (0.86%) (p = 0.052). A median of 2.0 and 2.5 higher echelon nodes was identified with [99mTc]Tc-tilmanocept and [99mTc]Tc-nanocolloid, respectively (p = 0.083).Conclusion[99mTc]Tc-tilmanocept had a higher injection site clearance, but at the same time a lower uptake in the SLN, resulting in an SLN to injection site ratio, which was not significantly different from [99mTc]Tc-nanocolloid. The relatively low-radioactive uptake in SLNs of [99mTc]Tc-tilmanocept may limit intraoperative detection of SLNs, but can be overcome by a higher injection dose.

Project description:PurposeAccurate dosimetry is essential in radioembolization. To this purpose, an automatic protocol for healthy liver dosimetry based on dual isotope (DI) SPECT imaging, combining holmium-166 (166Ho)-microspheres, and technetium-99 m (99mTc)-colloid was developed: 166Ho-microspheres used as scout and therapeutic particles, and 99mTc-colloid to identify the healthy liver. DI SPECT allows for an automatic and accurate estimation of absorbed doses, introducing true personalized dosimetry. However, photon crosstalk between isotopes can compromise image quality. This study investigates the effect of 99mTc downscatter on 166Ho dosimetry, by comparing 166Ho-SPECT reconstructions of patient scans acquired before (166Ho-only) and after additional administration of 99mTc-colloid (166Ho-DI).MethodsThe 166Ho-only and 166Ho-DI scans were performed in short succession by injecting 99mTc-colloid on the scanner table. To compensate for 99mTc downscatter, its influence was accounted for in the DI image reconstruction using energy window-based scatter correction methods. The qualitative assessment was performed by independent blinded comparison by two nuclear medicine physicians assessing 65 pairs of SPECT/CT. Inter-observer agreement was tested by Cohen's kappa coefficient. For the quantitative analysis, two volumes of interest within the liver, VOITUMOR, and VOIHEALTHY were manually delineated on the 166Ho-only reconstruction and transferred to the co-registered 166Ho-DI reconstruction. Absorbed dose within the resulting VOIs, and in the lungs (VOILUNGS), was calculated based on the administered therapeutic activity.ResultsThe qualitative assessment showed no distinct clinical preference for either 166Ho-only or 166Ho-DI SPECT (kappa = 0.093). Quantitative analysis indicated that the mean absorbed dose difference between 166Ho-DI and 166Ho-only was - 2.00 ± 2.84 Gy (median 27 Gy; p value < 0.00001), - 5.27 ± 8.99 Gy (median 116 Gy; p value = 0.00035), and 0.80 ± 1.08 Gy (median 3 Gy; p value < 0.00001) for VOIHEALTHY, VOITUMOR, and VOILUNGS, respectively. The corresponding Pearson's correlation coefficient between 166Ho-only and 166Ho-DI for absorbed dose was 0.97, 0.99, and 0.82, respectively.ConclusionThe DI protocol enables automatic dosimetry with undiminished image quality and accuracy.Clinical trialsThe clinical study mentioned is registered with Clinicaltrials.gov (NCT02067988) on 20 February 2014.

Dataset Information

99mTc-sodium phytate is a valid alternative to the gold-standard 99mTc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized cross-over trial.

Publications

<sup>99m</sup>Tc-sodium phytate is a valid alternative to the gold-standard <sup>99m</sup>Tc-sulfur colloid in the measurement of gastric emptying among healthy multi-ethnic Asian population: results of a randomized cross-over trial.

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