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Reappraisal of single-sample and gamma camera methods for determination of the glomerular filtration rate with99mTc-DTPA

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Abstract

The aim of this study was to assess the clinical validity of single-sample methods and gamma camera uptake methods with99mTc-DTPA for the estimation of the glomerular filtration rate (GFR). The study was performed in 50 patients with various degrees of renal function (29 males and 21 females; age 27–90 yrs; serum creatinine level 0.34–6.49 mg/dl). As a reference the “true” GFR (GFRt) was determined from plasma clearance by means of the two compartment model curve fitting 10 plasma samples. The GFRt of more than 30 ml/min in 46 patients was compared to the GFR which was estimated with 7 single-sample methods, two gamma camera uptake methods and 24-hour endogenous creatinine clearance (24hCcr). Close correlation was observed in all single-sample methods. The highest linear correlation was observed in the Christensen and Groth’s method rewritten by Watson for a 180-min plasma sample (r=0.991, see=5.84 ml/min). The smallest random error was observed in the Groth and Aasted’s method for a 180-min plasma (r=0.989, see=4.31 ml/min/1.73 m2). Our method was lowest in % absolute difference analysis (mean-4.10%). The gamma camera uptake methods correlated significantly with the GFRt (r=0.746–0.774), but were less reliable than any of the single-sample methods (see=15.41 ml/min-19.14 ml/min). The lowest correlation was observed in the 24h Ccr (r=0.698, see=50.76 ml/min/1.73 m2). The single-sample method was more accurate than the gamma camera method, and the gamma camera method was more accurate than 24hCcr. The single-sample method should be recommended for the accurate determination of the GFR with99mTc-DTPA in a patient with mild to moderate renal dysfunction.

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Authors and Affiliations

  1. Department of Radiology, JR Sapporo General Hospital, Higashi-1, Kita-3, Chuo-ku, 060-0033, Sapporo, Japan

    Kazuo Itoh

  2. Department Internal Medicine, JR Sapporo General Hospital, Higashi-1, Kita-3, Chuo-ku, 060-0033, Sapporo, Japan

    Satoshi Tsushima

  3. Department of Nuclear Medicine, Hokkaido University School of Medicine, Hokkaido, Japan

    Eriko Tsukamoto & Nagara Tamaki

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  1. Kazuo Itoh
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  2. Satoshi Tsushima
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  3. Eriko Tsukamoto
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  4. Nagara Tamaki
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Correspondence to Kazuo Itoh.

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Itoh, K., Tsushima, S., Tsukamoto, E. et al. Reappraisal of single-sample and gamma camera methods for determination of the glomerular filtration rate with99mTc-DTPA. Ann Nucl Med 14, 143–150 (2000). https://doi.org/10.1007/BF02987852

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  • DOI: https://doi.org/10.1007/BF02987852

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