Determination of split renal function from gamma camera renography

Moonen, M.; Jacobsson, Lars; Granérus, G.; Friberg, Peter; Volkmann, Reinhard

doi:10.1097/00006231-199409000-00007

Cited by 28 publications

(17 citation statements)

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“…Both studies have used healthy adult volunteers. A similar study has compared three different methods and time intervals of DRF calculation: the integral method had the lowest variation with SD of repeated DRF calculation of 1.0%; only three patients were analyzed in this patient group [14]. In an older study comparing 131 I-OIH (ortho-iodohippurate) renography with 99m Tc-DMSA (dimercaptosuccinic acid) cortical scintigraphy in 100 patients, the SD of differences of paired measurements was 3.94 and 4.27% for a single posterior view and geometric mean 99m Tc-DMSA uptake, respectively [15].…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of 99mTc-mercaptoacetyltriglycine renography: population comparison

Ležaič

Hodolič²,

Fettich³

et al. 2008

Nuclear Medicine Communications

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Reproducibility of DRF estimation was excellent in adults in both intraobserver and interobserver analysis. In pediatric patients, intraobserver DRF reproducibility was very good, whereas variation in interobserver analysis was rather high with a potential influence on patient management, but occurred mainly in a subgroup of patients with impaired drainage and ipsilaterally reduced DRF. Drainage assessment was highly reproducible in both patient groups; factors confounding drainage interpretation in discordant patient cases remained unidentified.

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Section: Discussionmentioning

confidence: 99%

Reproducibility of 99mTc-mercaptoacetyltriglycine renography: population comparison

Ležaič

Hodolič²,

Fettich³

et al. 2008

Nuclear Medicine Communications

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“…Images were collected at 3‐s intervals for 1.5 min and then at 60‐s intervals for 60 min. Total GFR was derived from plasma clearance of 99m Tc‐DTPA computed from two venous blood samples, collected at 1 h and 3 h after contrast injection (12, 13). Single‐kidney GFR values were determined from the relative uptake of 99m Tc‐DTPA by the left and the right kidney at 2–3 min, derived from scintigraphy.…”

Section: Methodsmentioning

confidence: 99%

Functional assessment of the kidney from magnetic resonance and computed tomography renography: Impulse retention approach to a multicompartment model

Zhang

Rusinek

Bokacheva

et al. 2008

Magnetic Resonance in Med

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A three-compartment model is proposed for analyzing magnetic resonance renography (MRR) and computed tomography renography (CTR) data to derive clinically useful parameters such as glomerular filtration rate (GFR) and renal plasma flow (RPF). The model fits the convolution of the measured input and the predefined impulse retention functions to the measured tissue curves. A MRR study of 10 patients showed that relative root mean square errors by the model were significantly lower than errors for a previously reported three-compartmental model (11.6% ؎ 4.9 vs 15.5% ؎ 4.1; P < 0.001). GFR estimates correlated well with reference values by 99m Tc-DTPA scintigraphy (correlation coefficient r ‫؍‬ 0.82), and for RPF, r ‫؍‬ 0.80. Parameter-sensitivity analysis and Monte Carlo simulation indicated that model parameters could be reliably identified. Key words: computed tomography; glomerular filtration rate; impulse retention function; magnetic resonance renography; renal plasma flow MR renography (MRR) and computed tomography renography (CTR) are increasingly used for noninvasive measurement of single-kidney function (1-7). These dynamic imaging techniques record the transit of a tracer, such as Gd-DTPA or iodinated contrast agents, from the aorta through the renal system. Tracer activity versus time curves can then be derived for intrarenal regions such as renal cortex, medulla, and collecting system. Design of an appropriate physiologic model is an essential part of accurate quantification of renal function (1,2).Several models have been proposed to estimate glomerular filtration rate (GFR) from MRR (3-6) and CTR (7). Baumann and Rudin (3) computed the GFR from the medullary uptake of the tracer using the cortical concentration as the input function. Another method (4) used a PatlakRutland plot to estimate GFR from the clearance of the tracer from the vascular compartment. This approach used whole-kidney concentration, obviating the need for regional segmentation of the kidneys. Both of these methods ignored the outflow of the tracer, and the results can be biased by improper selection of the "upslope" interval. Annet et al. (5) extended these techniques to account for tracer leaving the nephron space, thus enabling fitting of the model to measured data over a longer time period. All of these models assume instantaneous mixing of tracer within every compartment.More recently, models have been proposed with the aim of extending physiologic measures beyond GFR. Krier et al. (7) represented the cortex and medulla curves as extended gamma-variate functions with parameters shown to yield renal plasma flow (RPF) and tubular transit times in addition to GFR. GFR and RPF measures were validated against the reference values in pig model using CT renography. Hermoye et al. (8) determined RPF and GFR in rabbits from the cortical impulse response function by numerical deconvolution of renal cortical enhancement curves. The impulse response function exhibited three sequential peaks presumed to reflect the contrast in glomeruli, pro...

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“…The relative renal function (RRF) was calculated from cither the integral counts [16] or from uptake slopes [17], All renograms were re-examined by one o f the authors (G.G.). Background subtraction was applied in all renographic studies.…”

Section: Renographymentioning

confidence: 99%

Studies on Renal Function in Patients with Cystinuria

Lindell¹,

Denneberg²,

Granérus³

1997

Nephron

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Total and separate renal functions were evaluated in 40 patients with cystinuria. The average duration of the renal stone disease was 26 years (range 1-53). The patients had been subjected to a stone-preventing regimen composed of increased fluid intake, urinary alkalinization and treatment with a sulphydryl compound, tiopronin or D-penicillamine, for an average of 11.7 years (range 1-24). Urinary cystine concentration was determined regularly to monitor the treatment. All patients were examined with gamma camera renography and an assessment of glomerular filtration rate (GFR), and early and late renographic results could be compared in 30 patients. The early renographic evaluation showed that 43% of binephric patients (13/30) had an abnormal relative renal function (RRF) before the start of the stone-preventing treatment. At the late evaluation, 50% of binephric patients (17/34) had an abnormal RRF, while 30% of all patients (12/40) had a GFR below the age-related normal range. Thirty percent of 74 evaluated kidneys (22/74) had a separate GFR below an estimated age-related normal range. At the late evaluation only 30% of the patients had functionally unaffected kidneys with both normal GFR and bilateral normal renography. There was, however, no case with terminal renal failure. The separate GFR of kidneys with a history of staghorn stones was significantly lower than for kidneys without that special type of stones, but otherwise there was no relationship between renal functional impairment and other estimates of the activity of the renal stone disease. In conclusion, impairment of renal function is common in patients with stone-forming cystinuria. Stone-preventive treatment appears to be effective in preserving renal function. The high frequency of renal functional impairment justifies close surveillance of this group of patients. By renographic examination, unilateral changes in renal function can be detected at an early stage and patients at risk for further deterioration of renal function can be identified.

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Determination of split renal function from gamma camera renography

Cited by 28 publications

References 0 publications

Reproducibility of 99mTc-mercaptoacetyltriglycine renography: population comparison

Reproducibility of 99mTc-mercaptoacetyltriglycine renography: population comparison

Functional assessment of the kidney from magnetic resonance and computed tomography renography: Impulse retention approach to a multicompartment model

Studies on Renal Function in Patients with Cystinuria

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