SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0

Taylor, Andrew; Brandon, David; Palma, Diego De; Blaufox, M. Donald; Durand, Emmanuel; Erbaş, Belkıs; Grant, Sandra; Hilson, A. J.W.; Morsing, Anni

doi:10.1053/j.semnuclmed.2018.02.010

Cited by 71 publications

(79 citation statements)

References 76 publications

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“…These can result in false positive or equivocal results, particularly in the diagnosis of obstruction [ 9 ]. Indeed, several studies, consensus reports and guidelines in the field have tried to address the issue of standardized acquisition and interpretation of the examination [ 2 , 3 , 4 , 10 , 11 ]. In the quest to reach (insomuch as is possible) an objective scan reading, specific quantitative parameters, such as the herein calculated parameters of DRF, T max and T 1/2 , have been introduced in the interpretation of diuretic renography [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patients were in a supine position with the kidneys and urinary bladder in the field of view (FoV). The diuretic (intravenous furosemide, 20 mg in 2 mL) was administered intravenously 10 min post-injection of the radiopharmaceutical (F + 10 protocol), the study was continued for another 10 min and, finally, post-micturition images were acquired after patients’ voiding and assuming a sitting, upright position [ 4 ]. The image acquisition consisted of three phases: a first phase of 90 frames with 2.0 s per frame, a second phase consisting of 170 frames with 6.0 s per frame and the last phase which was a static image of 1 min.…”

Section: Methodsmentioning

confidence: 99%

“…The examination provides information on urine transit as well as renal function in a single procedure, which, in turn, may affect therapeutic decisions. Owing to its more efficient extraction, 99m Tc-mercaptoacetyltriglycine ( 99m Tc-MAG3) is the preferred radiopharmaceutical for diuretic renography in patients with suspected urinary tract obstruction or impaired renal function [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although other imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET), have been applied, 99m Tc-MAG3 diuretic renography remains the mainstay for renal function assessment. Its clinical indications are several, including the measurement of the differential renal function (DRF) of a possibly obstructed kidney, the differentiation between obstructive and non-obstructive uropathy in patients with signs or symptoms of obstruction and the determination of the presence of renal obstruction in asymptomatic patients with radiologic signs of hydronephrosis detected on prior imaging [ 4 ]. These clinical applications assume a sufficient degree of repeatability—in this case, agreement between different analyses of a single acquisition of renography data—since the modality is often performed serially in the same patient in terms of renal function monitoring or treatment response evaluation.…”

Section: Introductionmentioning

confidence: 99%

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99mTc-MAG3 Diuretic Renography: Intra- and Inter-Observer Repeatability in the Assessment of Renal Function

et al. 2020

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The aim of the present study is to evaluate the intra- and inter-observer agreement in assessing the renal function by means of 99mTc-MAG3 diuretic renography. One hundred and twenty adults were enrolled in the study. One experienced and one junior radiographer processed the renograms twice by assigning manual and semi-automated regions of interest. The differential renal function (DRF, %), time to maximum counts for the right and left kidney (TmaxR-TmaxL, min) and time to half-peak counts (T1/2, min) were calculated. The Bland–Altman analysis (bias±95% limits of agreement), Lin’s concordance correlation coefficient and weighted Fleiss’ kappa coefficient were used to assess agreement. Based on the Bland–Altman analysis, the intra-observer repeatability results for the experienced radiographer using the manual and the semi-automated techniques were 0.2 ± 2.6% and 0.3 ± 6.4% (DRF), respectively, −0.01 ± 0.24 and 0.00 ± 0.34 (TmaxR), respectively, and 0.00 ± 0.26 and 0.00 ± 0.33 (TmaxL), respectively. For the junior radiographer, the respective results were 0.5 ± 5.0% and 0.8 ± 9.4% (DRF), 0.00 ± 0.44 and 0.01 ± 0.28 (TmaxR), and 0.01 ± 0.28 and −0.02 ± 0.44 (TmaxL). The inter-observer repeatability for the manual method was 0.6 ± 5.0% (DRF), −0.10 ± 0.42 (TmaxR) and −0.05 ± 0.38 (TmaxL), and for the semi-automated method −0.2 ± 9.1% (DRF), 0.00 ± 0.31 (TmaxR) and −0.05 ± 0.40 (TmaxL). The weighted Fleiss’ kappa coefficient for the T1/2 assessments ranged between 0.85–0.97 for both intra- and inter-observer repeatability with both methods. These findings suggest a very good repeatability in DRF assessment with the manual method—especially for the experienced observer—but a less good repeatability with the semi-automated approach. The calculation of Tmax was also operator-dependent. We conclude that reader experience is important in the calculation of renal parameters. We therefore encourage reader training in renal scintigraphy. Moreover, the manual tool seems to perform better than the semi-automated tool. Thus, we encourage cautious use of automated tools and adjunct validation by manual methods where possible.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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99mTc-MAG3 Diuretic Renography: Intra- and Inter-Observer Repeatability in the Assessment of Renal Function

et al. 2020

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“…In nuclear medicine, radioactive isotopes are useful for providing functional information related to specific tissues, and for treating diseases [ 1 , 2 ]. Two components are used for preparing radiopharmaceuticals; one of them is a radionuclide for radioactivity and second is a chemical compound for tracing the pathology [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of 99mTc Injected Activity with Prescribed Activity in Four Types of Nuclear Medicine Exams

Khan

Farwa

Iqbal

et al. 2020

CRP

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Background: 99mTc is a radioactive isotope that is obtained by eluting a 99Mo/99mTc generator. (PINSTECH, Islamabad) and used for radionuclide scanning. Objectives: The objective of this work is to study the uncertainties in 99mTc activity that exist due to time delay between injection preparation and administration to patients, during the process of gamma camera scanning. Methods: Lead canisters were used for storing elution vials and dose calibrator for measuring 99mTc activity in mCi. The activity of preparing 99mTc injection and its administration to patients were compared with the prescribed values of activity recommended in the Society of Nuclear Medicine procedure guidelines. Results: This study showed that uncertainty in the activity existed in one thyroid patient, 38 bone patients, 5 renal patients and 45 cardiac patients. Conclusion: This uncertainty in activity exists due to time delay between injection preparation and administration to patients, as well as due to residual radionuclide that is not injected into patients and remains in the syringe.

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Radiopharmaceuticals

Calabria¹,

Leporace²,

Tavolaro³

et al. 2023

Radiology‐Nuclear Medicine Diagnostic Imaging

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SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0

Cited by 71 publications

References 76 publications

99mTc-MAG3 Diuretic Renography: Intra- and Inter-Observer Repeatability in the Assessment of Renal Function

99mTc-MAG3 Diuretic Renography: Intra- and Inter-Observer Repeatability in the Assessment of Renal Function

Comparison of 99mTc Injected Activity with Prescribed Activity in Four Types of Nuclear Medicine Exams

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