Scintigraphic Evaluation of Pancreatic Transplants Using Technetium-99m-Sestamibi

The purpose of this study was to evaluate the feasibility of using 99m Tc-sestamibi in the assessment of pancreatic transplant. Methods: Ten transplant recipients with a history of insulin-dependent diabetes mellitus were studied. Fourteen 99m Tc-sestamibi studies were performed. Each patient was injected intravenously with 10 mCi of 99m Tc-sestamibi. Two-second frames were obtained for 1 min, followed by serial dynamic and static images every 5 min for 30 min. Technetium-99m sestamibi studies, read by two nuclear medicine physicians, were correlated with clinicopathologic findings and compared to the ten 201 Tl studies obtained in seven of these patients. Results: On 99m Tc-sestamibi images, normally functioning grafts showed adequate perfusion on the angiogram and good uptake followed by cleaance on static images. Time-activity curves showed an initial upslope followed by a downslope after the initial uptake peak. The quality of 99m Tc-sestamibi images was superior to those of 201 Tl in five, similar in four and marginally inferior in one paired study. Technetium-99m-sestamibi was used for both flow and static images, whereas a 99m Tc radiotracer angiogram was needed to accompany the 201 Tl study. Conclusion: Our preliminary experience indicates that 99m Tc-sestamibi helps evaluate pancreatic transplants and provides high count statistics, which result in better image quality and diagnostic dill. Extensive quantitative studies are being performed to further evaluate this agent's role in the clinical management of pancreatic transplant patients