Nuclear Medicine in Pediatric Urology

Jang, Su Jin

doi:10.3339/chikd.2015.19.1.14

Cited by 11 publications

(10 citation statements)

References 38 publications

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“…For an infant, 6 weeks of age is generally accepted as a reasonable time to undergo first renal scintigraphy. As mentioned earlier, Tc-99m-MAG3 provides superior diagnostic images and is the agent of choice for renal scintigraphy in children (127).…”

Section: Diagnostic Imaging -Definition Of Obstructionmentioning

confidence: 82%

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Nuclear Medicine in Pediatric Nephro-Urology: An Overview

Mendichovszky

Solar

Smeulders

et al. 2017

Seminars in Nuclear Medicine

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In the context of ante-natally diagnosed hydronephrosis, the vast majority of children with a dilated renal pelvis do not need any surgical treatment, as the dilatation resolves spontaneously with time. Slow drainage demonstrated at Tc-99m-mercaptoacetyltriglycine (MAG3) renography does not necessarily mean obstruction. Obstruction is defined as resistance to urinary outflow with urinary stasis at the level of the pelvic-ureteric junction (PUJ) which, if left untreated, will damage the kidney. Unfortunately this definition is retrospective and not clinically helpful. Therefore, the identification of the kidney at risk of losing function in an asymptomatic patient is a major research goal. In the context of renovascular hypertension a DMSA scan can be useful before and after revascularisation procedures (angioplasty or surgery) to assess for gain in kidney function. Renal calculi are increasingly frequent in children. Whilst the vast majority of patients with renal stones do not need functional imaging, DMSA scans with SPECT and a low dose limited CT can be very helpful in the case of complex renal calculi. Congenital renal anomalies such as duplex kidneys, horseshoe kidneys, crossed-fused kidneys and multi-cystic dysplastic kidneys greatly benefit from functional imaging to identify regional parenchymal function, thus directing further management. Positron emission tomography (PET) is being actively tested in genito-urinary malignancies. Encouraging initial reports suggest that F-18-fluorodeoxyglucose (FDG) PET is more sensitive than CT in the assessment of lymph nodal metastases in patients with genito-urinary sarcomas; an increased sensitivity in comparison to isotope bone scans for skeletal metastatic disease has also been reported. Further evaluation is necessary, especially with the promising advent of PET/MRI scanners. Nuclear Medicine in paediatric nephro-urology has stood the test of time and is opening up to new exciting developments.

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Section: Diagnostic Imaging -Definition Of Obstructionmentioning

confidence: 82%

“…Radionuclide studies may reveal information of prognostic significance, with a normal study predicting a rapid and complete recovery. Dynamic renography is not indicated unless there are issues of impaired drainage (127).…”

Section: Renal Vein Thrombosismentioning

confidence: 99%

Nuclear Medicine in Pediatric Nephro-Urology: An Overview

Mendichovszky

Solar

Smeulders

et al. 2017

Seminars in Nuclear Medicine

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“…The dose is approximately 1 mSv/examination regardless of the age of the child, adapted according to body surface compared to a pediatric chest CT which is 2-5mSV. [20][21][22]. Cellular exposure to ionizing radiation leads to oxidizing events, chronic inflammation and has long term effects on genomic instability [23].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Tc-99m Dmsa Scintigraphy on Dna Damage and Oxidative Stress in Children

varol¹,

Öktem

Koçyiğit

et al. 2021

Preprint

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Background: Tc-99m DMSA scintigraphy is a commonly used imaging modality in the pediatric population. The radiopharmaceuticals which have the effects of ionizing are used in this method. This study aimed to investigate the impact of the Tc-99m DMSA scan on renal oxidative stress and mononuclear leukocyte DNA damage. Methods: Twenty-seven patients who performed Tc-99m DMSA scintigraphy were included in this study. Three ml heparinized blood samples were taken just before, during, and after a week from the scintigraphy. Mononuclear leukocyte(MNL) DNA damage, total antioxidant status (TAS), and total oxidant status(TOS) were measured in blood samples. The oxidative stress index (OSI) was calculated. The spot urine samples were taken from each patient before and within three days after performing the scintigraphy. TAS/Creatinine(TAS/Cr), TOS/Creatinin(TOS/Cr), and N-acetyl-glucosaminidase/creatinine(NAG/Cr) levels were measured in urine samples. OSI was calculated. Results: There was no statistically significant difference in the values of TAS, TOS and OSI studied in serum samples between controls and study group(p=0.105, p=0.913, and p=0.721, respectively). There was no statistically significant difference in the levels of TAS/Cr, TOS/Cr, NAG/Cr, and OSI which were studied in urine samples before and after scintigraphy scan(p=0.381, p=0.543, p=0.129 and p=0.08 respectively). The levels of DNA damage were increased only after the performance of the scintigraphy scan and decreased a week later(p<0.05). Conclusions: The effect of Tc-99m DMSA scintigraphy is insufficient to create oxidative damage, but it can cause DNA damage via the direct impact of ionizing radiation which can be repaired again in a short time. Keywords: Tc-99m DMSA, DNA damage; reactive oxygen species; renal tubular injury; children

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“…All patients were evaluated preoperatively with ultrasonography (USG) KUB region and 99m Tc-DTPA diuretic renography to confirm significant PUJO as per the well-tempered protocol. [ 5 ] Ultrasound KUB showing progressive hydronephrosis and renal scan showing deteriorating renal function or significant obstruction were considered as surgical indications for pyeloplasty. All patients underwent standard AH pyeloplasty with internal ureteral stent placement.…”

Section: Methodsmentioning

confidence: 99%

“…Diethylenetriamine pentaacetic acid (DTPA) renal scan is a procedure which involves minimal but some radiation exposure. [ 5 6 ] Hence, how long to follow these patients with renal scan and minimum number of scans required for follow-up? We try to answer these questions through this prospective observational study.…”

Section: Introductionmentioning

confidence: 99%

To evaluate the minimum number of renal scans required to follow pediatric patient postpyeloplasty

Verma¹,

Saxena²,

Singh

et al. 2020

World J Nucl Med

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The aim of the study is to evaluate the minimum number of renal scans required to follow pediatric patients postpyeloplasty. We prospectively reviewed the renal scans of 145 children with unilateral pelvi-ureteric junction obstruction who underwent dismembered pyeloplasty. Patients were then divided into four groups based on preoperative split renal function. All patients were followed with renal scan and ultrasound for minimum of 4 years. Renal scan and ultrasound were done after stent removal at 3, 6, and 12 months and then yearly after surgery. Drainage pattern (T1/2) was seen in all groups, except in patients where there was no comment on drainage pattern. Statistical analysis was performed using the Friedman ANOVA and Wilcoxon signed-ranks test as a post hoc test with Bonferroni correction and Kruskal–Wallis test with Mann–Whitney U-test as a post hoc test with Bonferroni correction. On comparison of the pattern of drainage with time in Groups 1–4, it was found that there was no significant difference with time in Group 1. Then, further, using Wilcoxon signed-rank test as post hoc test for Friedman ANOVA, Group 2 showed statistically significant difference in drainage pattern in scans between 6 months and 1 year, Group 3 showed statistically significant difference in drainage pattern in scans between 3 months and 1 year, and Group 4 showed statistically significant difference in drainage pattern in scans done between 3 and 6 months ( P < 0.05). Minimum of three renal scans were required for paediatric patients post pyeloplasty at 3 months, 6 months and 1 year in the follow up period.

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Nuclear Medicine in Pediatric Urology

Cited by 11 publications

References 38 publications

Nuclear Medicine in Pediatric Nephro-Urology: An Overview

Nuclear Medicine in Pediatric Nephro-Urology: An Overview

The Impact of Tc-99m Dmsa Scintigraphy on Dna Damage and Oxidative Stress in Children

To evaluate the minimum number of renal scans required to follow pediatric patient postpyeloplasty

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