99mTc-DMSA is one of the most commonly used pediatric nuclear medicine imaging agents. Nevertheless, there are no pharmacokinetic (PK) models for 99mTc-DMSA in children, and currently available pediatric dose estimates for 99mTc-DMSA use pediatric S values with PK data derived from adults. Furthermore, the adult PK data were collected in the mid-70’s using quantification techniques and instrumentation available at the time. Using pediatric imaging data for DMSA, we have obtained kinetic parameters for DMSA that differ from those applicable to adults. We obtained patient data from a retrospective re-evaluation of clinically collected pediatric SPECT images of 99mTc-DMSA in 54 pediatric patients from Boston’s Children Hospital (BCH), ranging in age from 1 to 16 years old. These were supplemented by prospective data from twenty-three pediatric patients (age range: 4 months to 6 years old). In pediatric patients, the plateau phase in fractional kidney uptake occurs at a fractional uptake value closer to 0.3 than the value of 0.5 reported by the International Commission on Radiological Protection (ICRP) for adult patients. This leads to a 27% lower time-integrated activity coefficient in pediatric patients than in adults. Over the age range examined, no age dependency in uptake fraction at the clinical imaging time was observed. Female pediatric patients had a 17% higher fractional kidney uptake at the clinical imaging time than males (P < 0.001). Pediatric 99mTc-DMSA kinetics differ from those reported for adults and should be considered in pediatric patient dosimetry. Alternatively, the differences obtained in this study could reflect improved quantification methods and the need to re-examine DMSA kinetics in adults.

中文翻译：

---

儿科患者肾脏 99mTc-DMSA 药代动力学

99mTc-DMSA 是最常用的儿科核医学显像剂之一。然而，没有儿童 99mTc-DMSA 的药代动力学 (PK) 模型，目前可用的 99mTc-DMSA 儿科剂量估计使用儿科 S 值和来自成人的 PK 数据。此外，成人 PK 数据是在 70 年代中期使用当时可用的量化技术和仪器收集的。使用 DMSA 的儿科成像数据，我们获得了 DMSA 的动力学参数，这些参数与适用于成人的参数不同。我们从波士顿儿童医院 (BCH) 的 54 名儿科患者中对临床收集的 99mTc-DMSA 儿科 SPECT 图像进行回顾性重新评估，获得了患者数据，年龄范围为 1 至 16 岁。来自 23 名儿科患者（年龄范围：4 个月至 6 岁）的前瞻性数据对这些数据进行了补充。在儿科患者中，肾脏摄取分数的平台期发生在接近 0.3 的分数摄取值，而不是国际放射防护委员会 (ICRP) 报告的成人患者的 0.5 值。这导致儿科患者的时间积分活动系数比成人低 27%。在检查的年龄范围内，没有观察到临床成像时间的摄取分数的年龄依赖性。在临床成像时，女性儿科患者的肾脏摄取分数比男性高 17%（P < 0.001）。儿科 99mTc-DMSA 动力学不同于成人报道的动力学，应在儿科患者剂量测定中加以考虑。或者，