Comparison of <sup>99m</sup>Tc-DMSA Dual-Head SPECT Versus High-Resolution Parallel-Hole Planar Imaging for the Detection of Renal Cortical Defects

Brenner, M.; Bonta, Dacian; Eslamy, Hedieh; Ziessman, Harvey A.

doi:10.2214/ajr.08.1788

Cited by 26 publications

(11 citation statements)

References 13 publications

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“…Of the various methods available for doing DMSA renal scans, we used planar images instead of SPECT because the latter would have posed substantial problems in standardization, quality control, and the review process (10). Furthermore, some studies have reported that the SPECT images offer no statistically significant diagnostic advantage over planar imaging for detection of cortical defects (30,34).…”

Section: Discussionmentioning

confidence: 99%

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Mattoo¹,

Chesney²,

Greenfield³

et al. 2016

Clinical Journal of the American Society of Nephrology

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106

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Background and objectives The main objectives of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial were to evaluate the role of antimicrobial prophylaxis in the prevention of recurrent urinary tract infection (UTI) and renal scarring in children with vesicoureteral reflux (VUR). We present a comprehensive evaluation of renal scarring outcomes in RIVUR trial participants.Design, setting, participants, & measurements This multicenter, randomized, placebo-controlled trial enrolled 607 children aged 2-71 months with grade 1-4 VUR diagnosed after a first or second febrile or symptomatic UTI. Study participants received trimethoprim-sulfamethoxazole or placebo and were followed for 2 years. Renal scarring was evaluated by baseline and follow-up 99m technetium dimercaptosuccinic acid (DMSA) renal scans that were reviewed independently by two blinded reference radiologists.Results At the end of the study, 58 (10%) of 599 children and 63 (5%) of 1197 renal units had renal scarring. New renal scarring did not differ between the prophylaxis and placebo groups (6% versus 7%, respectively). Children with renal scarring were significantly older (median age, 26 versus 11 months; P=0.01), had a second UTI before enrollment (odds ratio [OR], 2.85; 95% confidence interval [95% CI], 1.38 to 5.92), were more likely to be Hispanic (OR, 2.22; 95% CI, 1.13 to 4.34), and had higher grades of VUR (OR, 2.79; 95% CI, 1.56 to 5.0). The proportion of new scars in renal units with grade 4 VUR was significantly higher than in units with no VUR (OR, 24.2; 95% CI, 6.4 to 91.2).Conclusions Significantly more renal scarring was seen in relatively older children and in those with a second episode of febrile or symptomatic UTI before randomization. Preexisting and new renal scars occurred significantly more in renal units with grade 4 VUR than in those with low-grade or no VUR. Antimicrobial prophylaxis did not decrease the risk of renal scarring.

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Section: Discussionmentioning

confidence: 99%

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Mattoo¹,

Chesney²,

Greenfield³

et al. 2016

Clinical Journal of the American Society of Nephrology

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106

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“…Recently, in a 99m Tc-DMSA renal cortical SPECT imaging study by dual head gamma camera, reconstruction was performed similarly on both cameras using a Hann prefilter (cutoff frequency, 0.9 cm −1 ; order, 0) and a Butterworth postfilter (cutoff frequency, 0.5 cm −1 ; order, 10) with two iterations and 10 subsets for the detection of renal parenchyma focal defects [29]. …”

Section: Type Of Filters Depending On Type Of Studymentioning

confidence: 99%

Filtering in SPECT Image Reconstruction

Lyra

Ploussi

2011

International Journal of Biomedical Imaging

117

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Single photon emission computed tomography (SPECT) imaging is widely implemented in nuclear medicine as its clinical role in the diagnosis and management of several diseases is, many times, very helpful (e.g., myocardium perfusion imaging). The quality of SPECT images are degraded by several factors such as noise because of the limited number of counts, attenuation, or scatter of photons. Image filtering is necessary to compensate these effects and, therefore, to improve image quality. The goal of filtering in tomographic images is to suppress statistical noise and simultaneously to preserve spatial resolution and contrast. The aim of this work is to describe the most widely used filters in SPECT applications and how these affect the image quality. The choice of the filter type, the cut-off frequency and the order is a major problem in clinical routine. In many clinical cases, information for specific parameters is not provided, and findings cannot be extrapolated to other similar SPECT imaging applications. A literature review for the determination of the mostly used filters in cardiac, brain, bone, liver, kidneys, and thyroid applications is also presented. As resulting from the overview, no filter is perfect, and the selection of the proper filters, most of the times, is done empirically. The standardization of image-processing results may limit the filter types for each SPECT examination to certain few filters and some of their parameters. Standardization, also, helps in reducing image processing time, as the filters and their parameters must be standardised before being put to clinical use. Commercial reconstruction software selections lead to comparable results interdepartmentally. The manufacturers normally supply default filters/parameters, but these may not be relevant in various clinical situations. After proper standardisation, it is possible to use many suitable filters or one optimal filter.

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“…[ 7 ] Different acquisition methodologies have been used, including planar parallel-hole collimator imaging, planar high-resolution parallel-hole collimator imaging, pinhole collimator imaging, SPECT and PSPECT. [ 4 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] Different acquisition methodologies have been used, including planar parallel-hole collimator imaging, pinhole collimator imaging, single photon emission computerized tomography (SPECT) and pinhole SPECT (PSPECT). [ 4 5 ] Controversy exists regarding the superiority of Tc-99m DMSA SPECT over planner imaging. The purpose of the current study was to compare planar parallel-hole cortical scintigraphy and dual-head SPECT for detection of cortical defects.…”

Section: Introductionmentioning

confidence: 99%

Technetium-99m dimercaptosuccinic acid scan in evaluation of renal cortical scarring: Is it mandatory to do single photon emission computerized tomography?

Farghaly

Sayed

2015

Indian J Nucl Med

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Objectives:Renal cortical scintigraphy with technetium-99m (Tc-99m) dimercaptosuccinic acid (DMSA) is the method of choice to detect acute pyelonephritis and cortical scarring. Different acquisition methods have been used: Planar parallel-hole or pinhole collimation and single photon emission tomography (SPECT). This study compared planar parallel-hole cortical scintigraphy and dual-head SPECT for detection of cortical defects.Patients and Methods:We retrospectively reviewed 190 consecutive patients with 380 kidneys and 200 DMSA scans referred to rule out renal cortical scarring. The diagnoses were 52 vesicoureteric reflux, 61 recurrent urinary tract infection, 39 hydronephrosis, 20 renal impairment, and 18 hypertension. All patients were imaged 3 h after injection of Tc-99m DMSA with SPECT and planar imaging (posterior, anterior, left, and right posterior oblique views). For each patient, planar and SPECT images were evaluated at different sittings, in random order. Each kidney was divided into three cortical segments (upper, middle and lower) and was scored as normal or reduced uptake. The linear correlation coefficient for the number of abnormal segments detected between planner and SPECT techniques was calculated.Results:From 200 DMSA scans, 100 scans were positive for scar in SPECT images, from which only 95 scans were positive for scar in planner imaging. Out of the five mismatched scans, three scans were for patients with renal impairment and high background activity and two scans were for very small scars. No significant difference was seen in the average number of abnormal segments detected by planar versus SPECT imaging (P = 0.31). The average correlation coefficient between was high (r = 0.91 – 0.92).Conclusions:Tc-99m DMSA renal cortical scanning using SPECT offers no statistically significant diagnostic advantage over multiple views planar imaging for detection of cortical defect.

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Comparison of ^99mTc-DMSA Dual-Head SPECT Versus High-Resolution Parallel-Hole Planar Imaging for the Detection of Renal Cortical Defects

Abstract: (99m)Tc-DMSA renal cortical imaging using dual-head SPECT offers no statistically significant diagnostic advantage over planar imaging for detection of cortical defects.

Cited by 26 publications

References 13 publications

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Filtering in SPECT Image Reconstruction

Technetium-99m dimercaptosuccinic acid scan in evaluation of renal cortical scarring: Is it mandatory to do single photon emission computerized tomography?

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Comparison of 99mTc-DMSA Dual-Head SPECT Versus High-Resolution Parallel-Hole Planar Imaging for the Detection of Renal Cortical Defects

Abstract: (99m)Tc-DMSA renal cortical imaging using dual-head SPECT offers no statistically significant diagnostic advantage over planar imaging for detection of cortical defects.

Cited by 26 publications

References 13 publications

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

Filtering in SPECT Image Reconstruction

Technetium-99m dimercaptosuccinic acid scan in evaluation of renal cortical scarring: Is it mandatory to do single photon emission computerized tomography?

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Comparison of ^99mTc-DMSA Dual-Head SPECT Versus High-Resolution Parallel-Hole Planar Imaging for the Detection of Renal Cortical Defects