AN EVALUATION OF I-123 IODOAZOMYCINARABINOSIDE AS A MARKER OF LOCALIZED TISSUE HYPOXIA IN PATIENTS WITH DIABETES-MELLITUS

Peripheral vascular disease is a serious and common complication in pa tients with diabetes mellitus (DM). Evaluation is, conventionally. by transcutaneous oxygen tension measurements (TcpO(2)), although this te chnique has some limitations in the evaluation of tissue viability. We have evaluated a new, radiolabelled, in vivo marker of tissue hypoxia , iodoazomycinarabinoside (IAZA), by comparing TcpO(2) measurements wi th patterns of iodine-123 IAZA uptake in ten patients (19 lower limbs) with DM and peripheral vascular disease using conventional gamma came ra imaging techniques. Normal uptake patterns were seen in limbs in wh ich normal TcpO(2) measurements were obtained. Diffusely increased upt ake of [123]IAZA was seen in limbs with reduced TcpO(2). Focally incre ased uptake was seen in ulcers or in areas of atrophic skin change. A semiquantitative measure showed an inverse correlation between [123]IA ZA and TcpO(2) values. These data suggest that tissue hypoxia can be i maged in this population of patients and that severity of disease can be assessed. A longitudinal prospective trial is now being developed.