The clinical utility of radionuclide emission tomography of the kidney in comparison with conventional gamma-camera imaging has been assessed from scans of 60 patients suspected of having space-occupying lesions of the kidney. Nineteen patients had renal tumour, 17 had cysts and seven had renal pseudotumours; the remainder had no lesion. Objective trials using four observers showed only a slight, statistically insignificant advantage from the addition of tomographic sections to conventional images. However, in several individual cases tomography had aided diagnosis, particularly in obese patients, when an alternative non-invasive investigation (ultrasonography) was inconclusive. In seven patients a positive diagnosis of renal pseudotumour was made possible by tomography; definite identification of ectopic functioning cortical tissue at the location of a mass suspected after urography was considered to be a distinct diagnostic advantage gained from emission tomography of the kidney.

Emission computed tomography is a new, useful imaging technique; when a rotating gamma camera capable of such imaging is used multiple adjacent transverse sections may be obtained simultaneously, from which coronal and sagittal sections may be computed. The technique was used in a man undergoing urological investigation in whom excretion urography indicated a space-occupying lesion in the left kidney. Ultrasonography and radionuclide imaging showed nothing abnormal, but emission computed tomography using a rotating gamma camera showed that functioning cortical tissue extended across the middle of the left kidney. Radiographs were therefore reviewed and ultrasonography repeated, and it was concluded that the abnormality was a hypertrophied column of Bertin.Emission tomographic imaging of the kidney is a useful adjunct to other non-invasive studies.

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