Estimation of Split Renal Function With ^99mTc-DMSA SPECT: Comparison Between 3D Volumetric Assessment and 2D Coronal Projection Imaging

Abstract

OBJECTIVE Split renal function (SRF) can be estimated with 99mTc-labeled dimercaptosuccinic acid (DMSA) SPECT cortical renal scintigraphy on either 2D projected images or 3D images. The purpose of this study was to determine whether there is a significant difference between SRF values calculated with the 2D method and those calculated with the 3D method. MATERIALS AND METHODS This retrospective study was performed with 99mTc-DMSA SPECT images of 316 patients (age range, 1–26 years). All images were reconstructed by filtered back projection. An automated computational method was developed to estimate SRF using both 2D projection images and direct 3D images. A paired t test was used to evaluate the difference between SRFs determined with the two methods and the association between the magnitude of the differences and kidney size, patient age, and SRF. RESULTS There was strong correlation between SRFs estimated with the 2D and 3D methods (r = 0.94, p < 0.001). There was small significant difference (0.14% ± 0.86%, p = 0.003) in SRFs obtained with the two methods. The difference was clinically negligible and independent of renal length (p = 0.698), volume (p = 0.297), and patient age (p = 0.768) but was associated with SRF (p = 0.018). CONCLUSION For determination of split renal function, 99mTc-DMSA SPECT renal scintigraphy 2D coronal projection images perform as well as and are simpler to analyze than 3D images.

Nuclear Medicine in Pediatric Nephro-Urology: An Overview

“…If pinhole views are required, the guidelines advocate 100,000 -150,000 counts for better detection of small cortical defects. In the majority of cases high-quality static planar images are sufficient for an accurate diagnostic assessment, but a SPECT acquisition, with the possible addition of a low dose CT (where such a scanner is available), can be useful in complex cases, such as crossed-fused renal ectopia and complex renal stones (22,23). Recent studies have suggested Tc-99m-DMSA scintigraphy for predicting dilating vesicoureteral reflux (VUR) in young children with febrile urinary tract infection but so far only limited (and sometimes conflicting) data is available in the literature (24)(25)(26)(27)(28)(29).…”

Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA

“…Absolute renal uptake (ARU %) is a quantifiable parameter to assess the absolute kidney function for each kidney independently. Multiple previous studies have discussed various methods for calculation of ARU (%) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). We used posterior view for image acquisition which is probably a practical method for ARU (%) quantification and could be easily incorporated in the routine processing of daily clinical renal studies as acquired by H.I abdelkader et al [11].…”

“…Discrepancies exist in ARU (%) values due to various quantitative methods used and standardization of normal ARU (%) values is probably required at different centers [1]. SRF, differential renal function, or relative kidney function are commonly expressed as a percent of total renal function [2]. Information about SRF is very important in patients with unilateral renal disorders and is used to understand and predict sufficient postoperative renal function, otherwise, other options such as renal replacement therapy must be considered [3].…”

Comparison of tomographic kidney volumes measured by semiautomatic segmentation method with scintigraphic split renal function in predicting posttransplant kidney functions

“…In the evaluation of SRF, scintigraphic methods are used such as technetium‐99m‐mercaptoacetyltriglycine ( 99m Tc‐MAG3), 99m Tc‐DTPA, technetium‐99m‐dimercaptosuccinic acid ( 99m Tc)‐DMSA and chromium‐51 ethylenediamine tetraacetic acid ( 51 Cr‐EDTA) and so forth. (Cao et al, 2016; Chroustová et al, 2016; Gardan et al, 2018; Miyazaki et al, 2010; Ritchie et al, 2008).…”