This study shows that planar LPS may be applied for prediction of postoperative pulmonary function in patients qualified for pneumonectomy and lobectomy. If actual FEV1postop value is to be ≥ 800 mL, predicted value should exceed 1000 mL.

BACKGROUND: One of the basic clinical indications for dynamic renal scintigraphy (DRS) is a diagnosis of obstructive uropathy and/or nephropathy. Currently, a basic quantitative criterion for diagnosing nephropathy is the percentage of individual kidney's contribution in the global uptake of a radiopharmaceutical from the blood (so-called Split Function -SF).From a clinical point of view, a parameter evaluating a radiopharmaceutical uptake and reflecting the efficiency of a specific kidney, determined independently of the total uptake of both kidneys, would be much more useful. Based on a Rutland theory, a kidney uptake constant K proportional to a radiotracer uptake by individual kidney was introduced and applied to DRS with 99m Tc-ethylene-1-dicysteine ( 99m Tc-EC). In addition, a kidney efficiency index (KEi) was also worked out as a new parameter obtained by dividing the uptake constant K by the surface of the ROI of a given kidney, which can be interpreted as the average "efficiency" of clearance of a kidney. MATERIAL AND METHODS:K and KEi values were verified in 72 studies selected retrospectively from patients referred routinely for DRS, with available current level of blood creatinine, used for calculation of estimated GFR (eGFR) according to a CKD-EPI formula. After splitting of eGFR values into individual kidneys according to SF, single kidney eGFR values (SKeGFR) were obtained and then used as a verification method for SF, K and KEi values. RESULTS:Correlation between SF and SKeGFR values, r sp = 0.64, was significantly weaker (p < 0.0022) than the correlation of SKeGFR values with K uptake constants and KEi indices: 0.90 and 0.84, respectively. CONCLUSIONS: Uptake constant K and KEi, as quantitative parameters, give the opportunity to analyze a function of each kidney separately and in an absolute way. KEi also allows for a reliable assessment of kidneys of atypical sizes (larger or smaller than average). It also gives the opportunity to create normative values for this parameter and may be useful in a number of clinical situations where the diagnostic effectiveness of such a relative parameter as SF, is severely limited, e.g. in assessing a large kidney with hydronephrosis or while differing a cirrhotic from hypoplastic (i.e. a small but properly functioning) kidney.

Background: Myocardial blood flow (MBF) and flow reserve (MFR) examination, especially useful in the diagnosis of multivessel coronary artery disease (CAD), can be assessed with a cadmium-zinc-telluride (CZT) SPECT gamma camera, as an alternative to the expensive and less available PET. However, study processing is not free from subjective factors. Therefore, this paper aims to evaluate intra- and interobserver repeatability of MBF and MFR values obtained by the same operator and two independent operators. Methods: This study included 57 adult patients. MBF and MFR were assessed using a Discovery NM530c camera in a two-day, rest/dipyridamople protocol, using 99mTc-MIBI. Data were processed using Corridor4DM software, twice by one operator and once by another operator. Results: The repeatability of the assessed values was quite good in the whole myocardium, LAD and LCX vascular territories, but was poor in the RCA territory. Conclusions: The poor repeatability of MBF and MFR in RCA vascular territory can be explained by poor automatic orientation of the heart axis during post-processing and a so-called “cardiac creep” phenomenon. Better automatic heart orientation and introduction of automatic motion correction is likely to drastically improve this repeatability. In the present state of the software, PET is better for patients requiring assessment of MFR in the RCA territory.

BACKGROUND:The clinical significance of MTT and PTT, determined by deconvolution of renographic curves, is arguable. Their usefulness in diagnosis of obstructive uro-and nephropathy, renovascular hypertension and monitoring of transplanted

This study evaluates the usefulness of parameters allowing assessment of renal function in absolute values in dynamic renal scintigraphy (DRS) with 99mTc-ethylenedicysteine (99mTc-EC) uptake constant (K), mean transit time (MTT), and parenchymal transit time (PTT) in the diagnosis of obstructive uro/nephropathy. The study included 226 people: 20 healthy volunteers, for whom normative values of assessed parameters were determined, and 206 patients. Reproducibility of results obtained by two independent operators, specificity, correlation with estimated GFR (eGFR), and Cohen’s kappa were used to evaluate reliability of assessed parameters. Normative values were as follows: K ≥ 1.6, MTT ≤ 250 s, and PTT ≤ 225 s. Reproducibility of determination of K (rs = 0.99) and MTT (rs = 0.98) was significantly higher than that of PTT (rs = 0.95) (p = 0.001). Specificity was 100% for K, 81% for MTT, and 91% for PTT. Correlation of eGFR with K (rs = 0.89) was significantly higher than with PTT (rs = 0.53) and with split function (SF) (rs = 0.66) (p < 0.0001). Cohen’s kappa was κ = 0.89 for K, κ = 0.88 for MTT, and κ = 0.77 for PTT. In a group of patients where standard DRS parameters are unreliable (bilateral obstructive uro/nephropathy or single functioning kidney), the use of K (the most effective among assessed parameters) changed the classification of 23/79 kidneys (29%). K enables reproducible assessment of absolute, individual kidney function without modifying routine DRS protocol. Diagnostic value of MTT and PTT is limited.