Scintigraphy of Kidneys Located at Different Depths: The Geometric Mean Method for Determination of Differential Renal Function

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.

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Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

Vojnosanitetski pregled ◽

10.2298/vsp0804299a ◽

2008 ◽

Vol 65 (4) ◽

pp. 299-302

Author(s):

Boris Ajdinovic ◽

Ljiljana Jaukovic ◽

Amira Peco-Antic ◽

Sanja Dugonjic

Keyword(s):

Renal Function ◽

Vesicoureteral Reflux ◽

Ureteropelvic Junction Obstruction ◽

No Reduction ◽

Renal Scintigraphy ◽

Newborn Period ◽

Antenatal Hydronephrosis ◽

Differential Renal Function ◽

Renal Pelvis Dilatation

Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls) presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU) less than 40% was found in three, and poor kidney function (RKU less than 10%) in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes) with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

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Visual Determination of Differential Renal Function

Clinical Nuclear Medicine ◽

10.1097/00003072-198605000-00004 ◽

1986 ◽

Vol 5 (11) ◽

pp. 313-318

Author(s):

MICHAEL S. KIPPER ◽

KATHRYN F. WITZTUM ◽

ANDREW TAYLOR

Keyword(s):

Renal Function ◽

Differential Renal Function

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Should Geometric Mean Calculation of Differential Renal Function be Used When Evaluating Children with Moderate to Severe Hydronephrosis?

The Journal of Urology ◽

10.1016/j.juro.2015.11.003 ◽

2016 ◽

Vol 195 (2) ◽

pp. 247-248 ◽

Cited By ~ 1

Author(s):

Paul A. Merguerian

Keyword(s):

Renal Function ◽

Geometric Mean ◽

Differential Renal Function

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Determination of Differential Renal Function by Sequential Renal Scintigraphy

The Journal of Urology ◽

10.1016/s0022-5347(17)60013-2 ◽

1974 ◽

Vol 111 (5) ◽

pp. 556-559 ◽

Cited By ~ 21

Author(s):

Michael Hayes ◽

Stanley Brosman ◽

George V. Taplin

Keyword(s):

Renal Function ◽

Renal Scintigraphy ◽

Differential Renal Function

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Classical vs. unit area method in the evaluation of differential renal function in unilateral hydronephrosis

Diagnosis ◽

10.1515/dx-2014-0044 ◽

2015 ◽

Vol 2 (1) ◽

pp. 61-65

Author(s):

Ferat Kepenek ◽

Zehra Pınar Koç ◽

İrfan Orhan ◽

Tansel Ansal Balcı ◽

Funda Aydın ◽

...

Keyword(s):

Renal Function ◽

Unit Area ◽

Classical Method ◽

Renal Scintigraphy ◽

Area Method ◽

Dmsa Scintigraphy ◽

Differential Renal Function ◽

Before And After ◽

Unilateral Hydronephrosis

Abstract: There are some problematic results in determination of differential renal function (DRF) by means of Tc-99m DMSA renal scintigraphy in hydronephrotic kidneys. In this study the classical method (CM) and unit area methods (UAM) in the estimation of DRF in unilateral hydronephrosis before and after intervention were compared.: Twenty patients (12 M, 8 F; mean: 42.6±18.5 years old) who were candidates for surgery or intervention because of unilateral hydronephrosis were the subjects of this study. All the patients were evaluated by Tc-99m DMSA scintigraphy before and 3–6 months after the intervention. In order to estimate DRF both CM and UAM (obtained by division of the counts including the kidney ROI to pixel of the same ROI) were performed. Bland-Altman analyses were performed in order to compare the DRF values obtained from both methods.: The agreement between CM and UAM was poor in the preoperative estimation, however, the agreement was good after the operation or intervention.: In this study it seems that DRF estimation with CM in unilateral hydronephrosis might be problematic in the determination of surgery thus UAM might be introduced as the method of choice in the determination of DRF in unilateral hyronephrosis.

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