Maria Spiliotopoulou, Nikolaos Papathanasiou, Łukasz Łabieniec, Evangelos Papachristou, Eleftherios Fokaefs, Trifon Spyridonidis, Andreas Fotopoulos, Dimitrios J Apostolopoulos
{"title":"成人 99mTc-DTPA 动态 SPECT/CT 肾图:可行性和诊断效果。","authors":"Maria Spiliotopoulou, Nikolaos Papathanasiou, Łukasz Łabieniec, Evangelos Papachristou, Eleftherios Fokaefs, Trifon Spyridonidis, Andreas Fotopoulos, Dimitrios J Apostolopoulos","doi":"10.1097/MNM.0000000000001865","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to investigate the feasibility and potential advantages of 99m Tc-DTPA dynamic single photon emission computed tomography/computed tomography (SPECT/CT) renogram in adults.</p><p><strong>Methods: </strong>Fifty-five patients aged 19-80 years (mean 56.3) were enrolled. The imaging protocol included: day 1: 99m Tc-DTPA planar renogram, followed by planar 99m Tc-DMSA scan. Day 3: attenuation-corrected dynamic 99m Tc-DTPA SPECT renogram [DSPECT(AC)] and Cr-51 ethylenediamine tetraacetic acid (EDTA) glomerular filtration rate (GFR) calculation. DSPECT(AC) included an initial CT scan followed by 12 consecutive SPECT sessions acquired via continuous-mode acquisition for a total of 24 min. Fast SPECT sequences (1-2 s/projection, 60 projections, every 6°) were obtained for the first 8 min, followed by slower acquisitions (3-4 s/projection) during the rest of the study. Renal activity was measured in the total kidney volume by regions of interest drawn on consecutive transaxial slices of the third SPECT, which were then copied on the whole 12-SPECT series. Corresponding time-activity curves were created. DSPECT(AC) parameters were compared with those of planar renogram. The reference method for split renal function was 99m Tc-DMSA (geometrical mean of anterior and posterior projection counts) and for GFR the Cr-51 EDTA 2-blood sample clearance method.</p><p><strong>Results: </strong>DSPECT(AC) images were of good quality. There was good correlation between renogram parameters (time to peak activity and NORA20) comparing the two techniques ( r = 0.959 and 0.933, respectively). In 21 cases with >30% absolute difference between the two kidneys, spilt renal function calculation by DSPECT(AC) correlated perfectly ( r = 0.968) with the reference method, whereas planar renogram was less accurate ( r = 0.843). Anatomic information provided by nonenhanced CT offered an integrated structural-functional view valuable for final diagnosis. DSPECT(AC) early kidney uptake as a fraction of injected dose correlated better with reference GFR ( r = 0.789) than the Gates' method ( r = 0.642).</p><p><strong>Conclusion: </strong>99m Tc-DTPA dynamic SPECT/CT renogram is feasible with conventional SPECT/CT systems. It allows accurate split renal function measurement, offers additional anatomical information and can be used for closer approximation of GFR compared with Gates' method.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"99m Tc-DTPA dynamic SPECT/CT renogram in adults: feasibility and diagnostic benefit.\",\"authors\":\"Maria Spiliotopoulou, Nikolaos Papathanasiou, Łukasz Łabieniec, Evangelos Papachristou, Eleftherios Fokaefs, Trifon Spyridonidis, Andreas Fotopoulos, Dimitrios J Apostolopoulos\",\"doi\":\"10.1097/MNM.0000000000001865\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The objective of this study is to investigate the feasibility and potential advantages of 99m Tc-DTPA dynamic single photon emission computed tomography/computed tomography (SPECT/CT) renogram in adults.</p><p><strong>Methods: </strong>Fifty-five patients aged 19-80 years (mean 56.3) were enrolled. The imaging protocol included: day 1: 99m Tc-DTPA planar renogram, followed by planar 99m Tc-DMSA scan. Day 3: attenuation-corrected dynamic 99m Tc-DTPA SPECT renogram [DSPECT(AC)] and Cr-51 ethylenediamine tetraacetic acid (EDTA) glomerular filtration rate (GFR) calculation. DSPECT(AC) included an initial CT scan followed by 12 consecutive SPECT sessions acquired via continuous-mode acquisition for a total of 24 min. Fast SPECT sequences (1-2 s/projection, 60 projections, every 6°) were obtained for the first 8 min, followed by slower acquisitions (3-4 s/projection) during the rest of the study. Renal activity was measured in the total kidney volume by regions of interest drawn on consecutive transaxial slices of the third SPECT, which were then copied on the whole 12-SPECT series. Corresponding time-activity curves were created. DSPECT(AC) parameters were compared with those of planar renogram. The reference method for split renal function was 99m Tc-DMSA (geometrical mean of anterior and posterior projection counts) and for GFR the Cr-51 EDTA 2-blood sample clearance method.</p><p><strong>Results: </strong>DSPECT(AC) images were of good quality. There was good correlation between renogram parameters (time to peak activity and NORA20) comparing the two techniques ( r = 0.959 and 0.933, respectively). In 21 cases with >30% absolute difference between the two kidneys, spilt renal function calculation by DSPECT(AC) correlated perfectly ( r = 0.968) with the reference method, whereas planar renogram was less accurate ( r = 0.843). Anatomic information provided by nonenhanced CT offered an integrated structural-functional view valuable for final diagnosis. DSPECT(AC) early kidney uptake as a fraction of injected dose correlated better with reference GFR ( r = 0.789) than the Gates' method ( r = 0.642).</p><p><strong>Conclusion: </strong>99m Tc-DTPA dynamic SPECT/CT renogram is feasible with conventional SPECT/CT systems. It allows accurate split renal function measurement, offers additional anatomical information and can be used for closer approximation of GFR compared with Gates' method.</p>\",\"PeriodicalId\":19708,\"journal\":{\"name\":\"Nuclear Medicine Communications\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nuclear Medicine Communications\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MNM.0000000000001865\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nuclear Medicine Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MNM.0000000000001865","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
99m Tc-DTPA dynamic SPECT/CT renogram in adults: feasibility and diagnostic benefit.
Objective: The objective of this study is to investigate the feasibility and potential advantages of 99m Tc-DTPA dynamic single photon emission computed tomography/computed tomography (SPECT/CT) renogram in adults.
Methods: Fifty-five patients aged 19-80 years (mean 56.3) were enrolled. The imaging protocol included: day 1: 99m Tc-DTPA planar renogram, followed by planar 99m Tc-DMSA scan. Day 3: attenuation-corrected dynamic 99m Tc-DTPA SPECT renogram [DSPECT(AC)] and Cr-51 ethylenediamine tetraacetic acid (EDTA) glomerular filtration rate (GFR) calculation. DSPECT(AC) included an initial CT scan followed by 12 consecutive SPECT sessions acquired via continuous-mode acquisition for a total of 24 min. Fast SPECT sequences (1-2 s/projection, 60 projections, every 6°) were obtained for the first 8 min, followed by slower acquisitions (3-4 s/projection) during the rest of the study. Renal activity was measured in the total kidney volume by regions of interest drawn on consecutive transaxial slices of the third SPECT, which were then copied on the whole 12-SPECT series. Corresponding time-activity curves were created. DSPECT(AC) parameters were compared with those of planar renogram. The reference method for split renal function was 99m Tc-DMSA (geometrical mean of anterior and posterior projection counts) and for GFR the Cr-51 EDTA 2-blood sample clearance method.
Results: DSPECT(AC) images were of good quality. There was good correlation between renogram parameters (time to peak activity and NORA20) comparing the two techniques ( r = 0.959 and 0.933, respectively). In 21 cases with >30% absolute difference between the two kidneys, spilt renal function calculation by DSPECT(AC) correlated perfectly ( r = 0.968) with the reference method, whereas planar renogram was less accurate ( r = 0.843). Anatomic information provided by nonenhanced CT offered an integrated structural-functional view valuable for final diagnosis. DSPECT(AC) early kidney uptake as a fraction of injected dose correlated better with reference GFR ( r = 0.789) than the Gates' method ( r = 0.642).
Conclusion: 99m Tc-DTPA dynamic SPECT/CT renogram is feasible with conventional SPECT/CT systems. It allows accurate split renal function measurement, offers additional anatomical information and can be used for closer approximation of GFR compared with Gates' method.
期刊介绍:
Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.