Clinical Usefulness of ^99mTc-DMSA Renal SPECT Using High Sensitivity-All Purpose Collimator for Pediatric Patients

Abstract

Tc-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to 99m Tc-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, 256×256, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, 128×128, step and shoot, 180°, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of 99m Tc-DMSA renal SPECT using high sensitivity all purpose collimator.

Static Renal Scintigraphy in Diagnosis of Pediatric Renal Pyelonephritis

“…The mismatching between static and SPECT images may return to renal impairment, high background activity or very small scars. Another study by Kim et al, [15] who found that SPECT images offered statistically significant value over static renal scintigraphy for detection of cortical defects, SPECT images found more lesions in kidneys by 21% than static images.…”