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Feasibility of gamma camera-based GFR measurement using renal depth evaluated by lateral scan of 99mTc-DTPA renography

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Abstract

Objective

Gamma camera-based measurement of glomerular filtration rate (GFR) with 99mTc-diethylenetriaminepentaacetic acid (DTPA) is an established non-invasive measurement of split renal function; however, it is not as accurate as the plasma sample method. Therefore, study into improving the accuracy of such method is clinically relevant. The aim of this study was to elucidate the feasibility of gamma camera-based GFR measurement using renal depth evaluated by lateral scan of 99mTc-DTPA renography and comparing the results with those of GFR using renal depth measured by CT, and three representative formulas.

Methods

The study population comprised 38 patients (median, 69 years; male 28, female 10; median estimated GFR, 67.4 ml/min) with renourinary disorders. Scintigraphy was performed after intravenous injection of 370 MBq 99mTc-DTPA by dynamic data acquisition for 20 min, followed by a bilateral static scan of the abdomen for 3 min. All patients underwent computed tomography (CT) within 2 months from renography. GFR was calculated by renography using renal depth determined in five ways; lateral scan of 99mTc-DTPA, CT, and three formulas previously created with using weight, height and age. GFRs were compared with estimated GFR (eGFR). The depth of both kidneys measured as described above was compared and evaluated the laterality of the renal depth.

Results

The median values of GFR calculated with renal depth determined by 99mTc-DTPA renography, CT, and the three formulas were 87.3, 83.9, 67.8, 68.3, and 71.5 ml/min, respectively. All of them correlated significantly with eGFR (r = 0.734, r = 0.687, r = 0.728, r = 0.726, and r = 0.686, respectively), however, no significant difference was observed among five correlation coefficients. Bland–Altman plot revealed that eGFR had error and fixed bias when compared with GFRs calculated using renal depth determined by renography, CT, and Taylor’s formula.

The depth of both kidneys measured by 99mTc-DTPA renography was equivalent to that measured by CT, however, those measured by the three formulas were significantly smaller than that measured by 99mTc-DTPA renography. The depth of the right kidney was larger than that of the left kidney using all three formulas in all patients. However, CT detected only 66% of patients to have a deeper right kidney than left kidney.

Conclusion

Lateral scanning is a feasible procedure to measure renal depth for accurate and reasonable split GFR measurements using 99mTc-DTPA renography.

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Authors and Affiliations

  1. Advanced Clinical Research Center, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan

    Shigeyasu Sugawara, Hiroshi Ito, Yoshiyuki Suzuki & Noboru Oriuchi

  2. Department of Radiology, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan

    Shigeyasu Sugawara, Shiro Ishii & Hiroshi Ito

  3. Department of Urology, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan

    Yoshiyuki Kojima

  4. Department of Radiation Oncology, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan

    Yoshiyuki Suzuki

  5. Department of Nuclear Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan

    Shigeyasu Sugawara & Noboru Oriuchi

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  1. Shigeyasu Sugawara
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  2. Shiro Ishii
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Correspondence to Shigeyasu Sugawara.

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All the procedures in the present studies involving human participants were performed in accordance with the ethical standards and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by our Institutional Review Board at Fukushima Medical University.

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Informed consent was obtained from all participants included in the study.

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Sugawara, S., Ishii, S., Kojima, Y. et al. Feasibility of gamma camera-based GFR measurement using renal depth evaluated by lateral scan of 99mTc-DTPA renography. Ann Nucl Med 34, 349–357 (2020). https://doi.org/10.1007/s12149-020-01455-w

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  • DOI: https://doi.org/10.1007/s12149-020-01455-w

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