2192 DEVELOPMENT AND EVALUATION OF NEAR INFRARED FLUORESCENT IMAGING AS A SENSITIVE, NON-RADIATING ALTERNATIVE TO SCINTILLOGRAPHY FOR DIAGNOSIS OF PYELONEPHRITIS

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 20122192 DEVELOPMENT AND EVALUATION OF NEAR INFRARED FLUORESCENT IMAGING AS A SENSITIVE, NON-RADIATING ALTERNATIVE TO SCINTILLOGRAPHY FOR DIAGNOSIS OF PYELONEPHRITIS Brian M. Rosman, Joao A. Barbosa, S. Ted Trevis, Alan B. Retik, and Hiep T. Nguyen Brian M. RosmanBrian M. Rosman Boston, MA More articles by this author , Joao A. BarbosaJoao A. Barbosa Boston, MA More articles by this author , S. Ted TrevisS. Ted Trevis Boston, MA More articles by this author , Alan B. RetikAlan B. Retik Boston, MA More articles by this author , and Hiep T. NguyenHiep T. Nguyen Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2366AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Imaging with Di-Mercaptosuccinic acid (DMSA) is the current radiographic standard for diagnosing pyelonephritis in children. This test necessitates the injection of a radioactive tracer agent and produces a low-resolution image that requires a high level of training and experience to properly interpret. Near infrared imaging is a modality that does not involve ionizing radiation and has the potential for being highly sensitive for diagnosing various urological conditions. Previous work has demonstrated that Prosense 750 FAST (Perkin Elmer), a near infrared fluorescent imaging agent that is specifically activated by inflammatory enzymes (Cathepsins), can be used to identify pyelonephritis in a swine model. The objective of this study is to determine and compare the sensitivity and specificity of Prosense imaging with that of DMSA and direct histologic evaluation. METHODS Human pathogenic E. coli was cultured in broth and mixed with swine blood. The resultant clot was injected under ultrasound guidance into the parenchyma of a swine kidney to simulate pyelonephritis. Two to five days later, the animal was anesthetized, and imaging with DMSA followed by Prosense 750 FAST was performed. The DMSA scan was interpreted by a pediatric nuclear medicine specialist. Histological evaluation was performed on the represented sections from the infected kidney. RESULTS Imaging with Prosense demonstrated higher sensitivity and specificity for areas of infection/inflammation than DMSA. Fluorescent areas observed in renal cortex on Prosense imaging correlated with histological findings of inflammatory cells, suggestive of an active infection. In contrast, these same areas of inflammation/infection were not detected on the DMSA scan. Only when the infection progressed and became extensive did it become evident on DMSA imaging. CONCLUSIONS Near infrared fluorescent imaging with Prosense 750 FAST is a sensitive and non-radiating alternative to DMSA for the detection of pyelonephritis. Its use may allow for early detection of renal infection and provides a mean of distinguishing between active and prior infection or dysplasia. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e884 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian M. Rosman Boston, MA More articles by this author Joao A. Barbosa Boston, MA More articles by this author S. Ted Trevis Boston, MA More articles by this author Alan B. Retik Boston, MA More articles by this author Hiep T. Nguyen Boston, MA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...