Delving into the Latest Updates on Technetium(99mTc) Dimercaptosuccinic Acid with Synapse

Overview

Basic Info

Drug Type

Small molecule drug, Diagnostic radiopharmaceuticals

Synonyms

Technetium Tc-99M Succimer Kit, Kidneyscinti

+ [5]

Target-

Mechanism

PET imaging(Positron-emission tomography enhancers), SPECT(Single-photon emission-computed tomography enhancers)

Therapeutic Areas

Urogenital Diseases

Active Indication

Kidney Diseases

Inactive Indication-

Originator Organization

Nihon Medi-Physics Co., Ltd.

Active Organization

Nihon Medi-Physics Co., Ltd.PDRadiopharma, Inc.

Inactive Organization

GE Healthcare, Inc.

Drug Highest PhaseApproved

First Approval Date

JP (01 Aug 1978),

Kidney Diseases

Regulation-

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Structure/Sequence

Molecular FormulaC4H6O4S2Tc

InChIKeyUEGHKGHBANZTIM-NLQOEHMXSA-N

CAS Registry65438-08-6

The radiation exposure resulting from medical imaging is a topic of some concern. Nuclear medicine provides potentially life-saving information regarding physiological processes, and is of particular value in children where the rapid and unequivocal diagnosis of pathological concerns is essential for the health of these patients. The overall objective of this investigation is to optimize pediatric patient absorbed dose by keeping it as low as possible while maintaining excellent diagnostic quality of nuclear medicine images. This is particularly important since children are at increased risk due to the enhanced radiosensitivity of their tissues and the longer time-period over which radiation effects may manifest. Current dosimetric estimations in children are based on either animal biokinetic or pharmacokinetic data from adults due to paucity of data that exists for children. This situation will be improved through the following specific aims:
Collect image-based pharmacokinetic (PK) data from patient volunteers in different age groups scheduled for routine nuclear medicine studies for 4 radiopharmaceuticals commonly used in pediatric nuclear medicine
Pool and analyze the data for different age groups for each radiopharmaceuticals and
Generate biokinetic models to be used in subsequent dosimetric models for the optimization of pediatric nuclear medicine procedures.
Since inadequate pharmacokinetic data currently exist in these patients, the investigators will use the data acquired in this study to establish PK models applicable to different age categories. Data on the pharmacokinetics of agents used in pediatric nuclear medicine are almost completely lacking. Internationally adopted dose coefficients (mSv/MBq) for pediatric nuclear medicine make age-dependent adjustments only for patient size and anatomical differences, while time-dependent kinetics from adult PK models are assumed due to the lack of kinetic data for children. The data obtained from this study will make it possible for the first time to determine how the PK in pediatric patients differs from adults. This will be done for Tc-99m dimethylsuccinic acid (DMSA), a radiopharmaceutical commonly used for pediatric nuclear medicine imaging. The overall hope is that results will allow the molecular imaging community to implement pediatric dose-reduction approaches that substantially improve upon current guidelines pointing to future technological advances that could yield even greater dose-reduction while simultaneously improving diagnostic image quality.

Start Date31 Oct 2017

Sponsor / Collaborator

The Children's Hospital Corp.

[+3]

JPRN-UMIN000008860

/ CompletedNot ApplicableIIT

Evaluation of 99mTc-DMSA static renal scintigraphy in acute period of first upper urinary tract infection. - 99mTc-DMSA scintigraphy in acute period upper UTI.

Start Date01 May 2011

Sponsor / Collaborator-

100 Clinical Results associated with Technetium(99mTc) Dimercaptosuccinic Acid

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100 Translational Medicine associated with Technetium(99mTc) Dimercaptosuccinic Acid

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100 Patents (Medical) associated with Technetium(99mTc) Dimercaptosuccinic Acid

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283

Literatures (Medical) associated with Technetium(99mTc) Dimercaptosuccinic Acid

01 Sep 2024·Journal of Nuclear Medicine Technology

Review of the Clinical and Technical Aspects of^99mTc-Dimercaptosuccinic Acid Renal Imaging: The Comeback “Kit”

Review

Author: Collins, Katelyn N ; Vali, Reza ; Treves, S Ted ; Fahey, Frederic H ; Ferrer Valencia, Valentina ; Lim, Ruth ; Kwatra, Neha

^99mTc-labeled dimercaptosuccinic acid (^99mTc-DMSA) imaging is a well-established and highly sensitive method for the diagnosis of several renal cortical disorders affecting children and adults. Beginning in 2014, ^99mTc-DMSA availability was severely impaired when it was added to the Drug Shortages List of the U.S. Food and Drug Administration and was commercially unavailable thereafter. The agent shortage negatively impacted practitioners' ability to evaluate renal cortical defects in children and adults and changed renal imaging practice. A survey among pediatric nuclear medicine clinicians confirmed the clinical need for ^99mTc-DMSA. Finally, in early 2023 the Food and Drug Administration again approved ^99mTc-DMSA in the United States. During the ^99mTc-DMSA shortage, established practitioners may not have had the opportunity of using ^99mTc-DMSA as they were accustomed in their experience. Also, newer imaging specialists and referring physicians and technologists may not have benefited from having ^99mTc-DMSA in their training. Therefore, it is time to bring back ^99mTc-DMSA into the armamentarium of imaging methods available to evaluate regional cortical renal function.

01 Sep 2024·World Journal of Nuclear Medicine

Renal Cortical Imaging with Tc-99m DMSA in Children: An Institutional Review

Article

Author: Kartamihardja, Achmad Hussein Sundawa ; Nugrahadi, Trias ; Budiawan, Hendra ; Hardina, Septi

Abstract Background Urinary tract infection (UTI) is one of the commonly encountered conditions in children. Dimercaptosuccinic acid (DMSA) scintigraphy is widely advocated for functional and morphological evaluation of the renal cortex including parenchymal defect. Moreover, only a small percentage of renal defects are detected by ultrasound. We aimed to examine DMSA scintigraphy of children and identify factors associated with cortical defect. Methods Patients aged ≤ 18 years old who underwent DMSA scintigraphy (November 18, 2019–February 2, 2023, 30 children) were included. All children received intravenous injections of 99mTc-DMSA followed by static planar and single-photon-emission computed tomography imaging at 3 hours. Cortical findings and differential functions of the worst affected kidney were graded accordingly. Grade I has no more than two cortical defects, grade II has more than two cortical defects with normal parenchyma between the defects, while grade III is when generalized damage is noted, and grade IV is when a shrunken kidney is seen with no DMSA uptake. Normal functioning kidney is when the relative function at 45 to 55%, mildly reduced function at 40 to 44%, and substantially impaired function at 10 to 39%, while nonfunctioning is when the differential split renal function < 10%. All data were then statistically analyzed. Results Majority was female (53%). The mean age was 5.85 years. UTI episodes were 73%. Twenty-two children had congenital urinary tract anomalies. All patients with vesicoureteric refluxes (VURs) had positive defects. Scintigraphy showed abnormalities in 17 children affecting unilateral (64%) or both kidneys (36%). There were 17 children (57%) respectively in the abnormal DMSA scan findings category with normal until significant impairment of the functioning kidney category. VURs were significantly associated with abnormal scintigraphy (p < 0.05). A significant association was found between abnormal DMSA scan findings and differential renal function (p < 0.05). Conclusion Significant association was noted between VURs and abnormal DMSA scintigraphy, abnormal DMSA scan findings, and impaired differential renal function. Special consideration should be given to these cases.

01 Sep 2024·Nuclear Medicine Communications

The physiological basis of renal nuclear medicine

Review

Author: Peters, Adrien Michael

Renal physiology underpins renal nuclear medicine, both academic and clinical. Clearance, an important concept in renal physiology, comprises tissue uptake rate of tracer (tissue clearance), disappearance rate from plasma (plasma clearance), appearance rate in urine (urinary clearance) and disappearance rate from tissue. In clinical research, steady-state plasma clearances of para-amino-hippurate and inulin have been widely used to measure renal blood flow (RBF) and glomerular filtration rate (GFR), respectively. Routinely, GFR is measured at non-steady state as plasma clearance of a filtration agent, such as technetium-99m diethylenetriaminepentaacetic acid. Scaled to three-dimensional whole body metrics rather than body surface area, GFR in women is higher than in men but declines faster with age. Age-related decline is predominantly from nephron loss. Tubular function determines parenchymal transit time, which is important in renography, and the route of uptake of technetium-99m dimercaptosuccinic acid, which is via filtration. Resistance to flow is defined according to the pressure-flow relationship but in renography, only transit time can be measured, which, being equal to urine flow divided by collecting system volume, introduces further uncertainty because the volume is also unmeasurable. Tubuloglomerular feedback governs RBF and GFR, is regulated by the macula densa, mediated by adenosine and renin, and can be manipulated with proximal tubular sodium–glucose cotransporter-2 inhibitors. Other determinants of renal haemodynamics include prostaglandins, nitric oxide and dopamine, while protein meal and amino acid infusion are used to measure renal functional reserve. In conclusion, for measuring renal responses to exogenous agents, steady-state para-amino-hippurate and inulin clearances should be replaced with rubidium-82 and gallium-68 EDTA for measuring RBF and GFR.

100 Deals associated with Technetium(99mTc) Dimercaptosuccinic Acid

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R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Kidney Diseases	JP	PDRadiopharma, Inc.	01 Aug 1978
Kidney Diseases	JP	Nihon Medi-Physics Co., Ltd.	01 Aug 1978

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


EP-61 (EANM2022)	Not Applicable	high creatinine	-	99mTc-DMSA (Normal saline batch A (NO 132129))	qhqphxynlr(wlfoqgfvye) = lilckxpzyg yeplefvzoy (hptznrwzxd )	Positive	22 Sep 2022
				99mTc-DMSA (Normal saline batch B (NO 132589 and NO 133325))	qhqphxynlr(wlfoqgfvye) = ubcdgorods yeplefvzoy (hptznrwzxd )
EANM2022	Not Applicable	-	55	99m Tc DMSA (Full Dosage (19.1 MBq))	exixvtdfsw(mmybwlcrla) = dlgkjcqjro rxxrwkquke (kuvqmcndpx )	-	22 Sep 2022
				99m Tc DMSA (Reduced Dosage (1.85 MBq/kg))	exixvtdfsw(mmybwlcrla) = sywlibxggx rxxrwkquke (kuvqmcndpx )
EANM2019	Not Applicable	Renal Insufficiency	7	99m Tc-DMSA (CZT 360° VERITON camera)	pvlllusfam(fqvukcrxzh) = otjaoyykyl ngulgxdbxt (cqogpjgdlg, 25.48)	-	18 Sep 2019
				99m Tc-DMSA (Conventional dual head ANGER camera)	pvlllusfam(fqvukcrxzh) = hubxoqjhkm ngulgxdbxt (cqogpjgdlg, 23.66)
SNMMI2019	Not Applicable	Hydronephrosis	-	99m Tc-DMSA (99mTc-DMSA SPECT/CT)	kmwyvednhq(cbmvlvpalu) = cuecogdeqk mucxhstbfw (jdkaolwupl, 4.4)	-	21 May 2019
SNMMI2019	Not Applicable	-	-	99mTc-DMSA	eteguwfuxz(ycvvebadfj) = kdyrgxtkzb mjufgkqxbe (zouehwmbhb, 20 - 36)	-	21 May 2019
EANM2017	Not Applicable	Nephrolithiasis	-	99mTc-DMSA (Patients with non-functional kidneys)	samcubdijz(xitycttoeh) = fgligexwqu gcjvyhmvoy (vjjyzdmgle )	-	11 Sep 2017
				99mTc-DMSA (Patients with relative uptake value <10%)	umzuzjkycq(svifouoewh) = azwkrhyres hlmcwpbqbh (emfbbfdxja )
SNMMI2016	Not Applicable	-	-	99mTc-DMSA	zwarmxdpie(eujwzumufm) = nuukpqgevt msefxbfokm (gzcsjuuawr, 6)	-	24 May 2016