ArticleEJNMMI radiopharmacy and chemistry2025
Impact of prolonged use of NSAID (Diclofenac) on 99mTc-MAG3 and 99mTc-DTPA renography.
Article in EJNMMI radiopharmacy and chemistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNon-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, are globally recognized as the primary choice for alleviating kidney pain and ureteric colic. This study examines the effects of long-term diclofenac administration on renography using two radiopharmaceuticals: 99mTc-mercaptoacetyltriglycine (99mTc-MAG3), which is excreted almost exclusively by the renal tubules, and 99mTc-diethylenetriamine pentaacetic acid (99mTc-DTPA), which is predominantly excreted by glomerular filtration.
resultsDiclofenac administration caused a rightward shift in renograms, indicating delayed renal uptake and clearance for both tracers. For 99mTc-MAG3, the average time to peak activity (Tmax) increased from 2.88 ± 0.3 min (control) to 4.2 ± 0.3 min (treated), while time from peak to 50% activity (T½) rose from 4.16 ± 0.1 min to 5.48 ± 0.5 min. For 99mTc-DTPA, Tmax increased from 4.3 ± 0.4 min to 12.9 ± 2.0 min, and T½ extended from 13.35 ± 1.5 min to 29.75 ± 2.0 min (n = 12; *p < 0.05 for all comparisons). Delayed tracer arrival in the bladder was particularly pronounced with 99mTc-DTPA.
conclusionsChronic diclofenac exposure significantly delays Tmax and T½ for both tracers, with a greater impact observed using 99mTc-DTPA. These findings highlight 99mTc-MAG3 as the preferred radiopharmaceutical for renography in settings involving long-term NSAID administration, ensuring accurate and reliable interpretation and minimizing variability associated with radiopharmaceutical selection.
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