Biliary tract scanning with 99Tc(m) pyridoxylideneglutamate: A new gallbladder scanning agent

N. M. Matolo, R. C. Stadalnik, K. A. Krohn

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Technetium 99m pyridoxylideneglutamate (99Tc(m) PG) is a radiopharmacological agent that is taken up by hepatocytes and excreted into the bile canaliculi which enter the gallbladder through the cystic duct. Therefore, this agent can be used for scanning the biliary ductal system and gallbladder. Biliary scanning with 99Tc(m) PG was performed on 15 dogs, ten normal human volunteers, and 40 patients with hepatobiliary tract disease. The animals were divided into three groups: normal dogs, those with cystic duct ligation, and those that had ligation of both the cystic duct and proximal portion of the common hepatic duct. In normal (control) dogs and people, the agent reached the liver in 5 minutes and the common bile duct (CBD), gallbladder, and duodenum in 10 to 15 minutes. Satisfactory images of the biliary tract were obtained with small doses (one to 2 μCi) of 99Tc(m) PG. The gallbladder was not visualized when the cystic duct or proximal common hepatic duct was occluded. There was no concentration of 99Tc(m) PG in the gallbladder when radiological studies showed a nonfunctioning gallbladder in the presence of acute cholecystitis, cystic duct obstruction, or in chronic cholecystitis. In partial CBD obstruction, a distended CBD was visualized and there was delay in transit of radioactivity into the duodenum. In complete CBD obstruction, no radioactivity was seen in the biliary and gastrointestinal tracts up to 24 hours after injection, but there was immediate and intense secretion of the radioactive agent into the genitourinary system. In severe hepatocellular disease, delayed liver clearance and 99Tc(m) delayed visualization of the gallbladder were observed. There were no toxic or other untoward effects noted in any patient. Therefore the study can be used for evaluating patients with biliary tract disease. The advantages of biliary scanning include safety, simplicity, and availability, in addition to the fact that it can be performed in jaundiced patients as well as in those allergic to contrast agents used for cholangiography.

Original languageEnglish (US)
Pages (from-to)317-321
Number of pages5
JournalSurgery
Volume80
Issue number3
StatePublished - Jan 1 1976

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ASJC Scopus subject areas

  • Surgery

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