The aim of this paper was to determine the reproducibility (precision)
of technetium-99m mercaptoacetyltriglycine (MAG3) clearance and to co
mpare it with that of chromium-51 ethylenediamine tetra-acetic acid (E
DTA). Twelve young volunteers (aged between 21 and 34 years), without
any history of medical problems, were enrolled in this study. The test
was performed twice, at an interval of 8 days and under similar physi
ological conditions, After the intravenous injection of both tracers,
15 blood samples were taken between 3 and 240 min. A biexponential fit
was adapted to the plasma disappearance curves (5- to 120-min samples
for Tc-99m-MAG3 and 10- to 240-min samples for Cr-51-ED-TA); the clea
rances were calculated according to Sapirstein and corrected for body
surface area. The mean clearance values were 110 (range 85-130) and 22
6 (range 109-319) ml/min/1.73 m(2), respectively, for Cr-51- EDTA and
Tc-99m-MAG3. For Cr-51-EDTA clearance, the mean difference between the
first and the second measurement was -2.1% of the mean of the two suc
cessive values (SD: 8.4%). In ten cases, the difference was less than
12%; in two cases, the differences were 15% and 18%, respectively. For
Tc-99m-MAG3 clearance, the mean difference between the first and the
second measurement was -20% of the mean of the two successive values (
SD: 25%). In six cases, the difference was less than 12%; in four case
s, between 15% and 40%; and in two cases, more than 60%. Methodologica
l factors (impurites contained in the commercial kit, variable protein
binding) as well as physiological factors (pH of urine, sodium load,
stress) may explain the lack of precision of the (99m)TcMAG3 clearance
, It is concluded that changes in Tc-99m-MAG3 plasma clearance should
be interpreted with care in daily routine.