Dynamic Scintigraphy Research Articles

Evaluation of Renal Function in Patients with Acute Heart Failure Through Dynamic Scintigraphy Examination. A pilot study

Evaluation of Renal Function in Patients with Acute Heart Failure Through Dynamic Scintigraphy Examination. A pilot study

Incompatibility of Lacrimal Syringing Test with Dacryoscintigraphy in Patients Undergoing Successful Dacryocystorhinostomy Surgery

Abstract Purpose The aim of our study was to evaluate the compatibility of lacrimal syringe test with dacryoscintigraphy (DSG) in the postoperative evaluation of external dacryocystorhinostomy (Ext-DCR) surgery. Material and Methods Thirty eyes of 30 patients suffering from unilateral epiphora with discharge and showing complete obstruction on lacrimal irrigation test were included in the study. Patients with dysfunctional lacrimal pump function, revision surgery, partial obstruction, and ocular surface diseases were not included in the study.Verification of the nasolacrimal duct obstruction (NLDO) was achieved with dye disappearance test, Jones test 1 (JT 1), and JT 2. According to the type of obstruction seen on DSG, patients were classified into two groups: presac and postsac obstruction. Patients with complete obstruction detected in the lacrimal syringing and dynamic scintigraphy underwent Ext-DCR, and the results were evaluated. Results Thirty patients, mean age 58.93 ± 12.11 years, all with unilateral NLDO were included in the study. All had grade 5 Munk score epiphora and discharge. The mean duration of obstruction was 24.57 ± 10.65 months. In the lacrimal irrigation test, all patients had complete obstruction in one eye, while the other eye was normal. According to preoperative DSG results, there were 20 (66.7%) patients with presac delay and 10 (33.3%) patients with postsac delay. All patients underwent Ext-DCR with silicone tube intubation and were followed for 1 year. Although there was symptomatic improvement in all patients and the lacrimal syringing test was patent, no change was seen in scintigraphy. Conclusion Although DSG is a sensitive nuclear medicine method, it is not useful for predicting the functional success of the Ext-DSR.

Assessment of ureteric jets as a supportive diagnostic modality for unilateral pelvi-ureteric junction obstruction and its utility in follow-up: A pilot study

Pelvi-Ureteric Junction Obstruction (PUJO) is a common cause of hydronephrosis (HDN) in children. While ultrasonography (USG) is useful for initial assessment and grading of hydronephrosis, it cannot differentiate obstructive from non-obstructive cases. Renal Dynamic Scintigraphy (RDS) confirms the diagnosis but involves ionizing radiation exposure. Ureteric jets using colour Doppler USG have been proposed for diagnosing obstructive HDN. Our study aimed to evaluate Ureteric Jet Frequency (UJF) and Relative Jet Frequency (RJF) in unilateral PUJO before and after furosemide (Lasix) administration, assessing their diagnostic and post-operative utility. Children (<14 years) with unilateral HDN underwent USG and RDS for PUJO diagnosis. Pyeloplasty was performed based on standard criteria. UJF and RJF were assessed before and after furosemide administration (0.5mg/kg) by colour Doppler USG. The non-obstructed side was taken as the control. Follow-up included repeat RDS and ureteric jet assessment. Fifty-two cases were included. UJF (pre- and post-Lasix) was significantly lower in the obstructed side compared to the non-obstructed side at baseline and post-pyeloplasty (p<0.0001). However, the baseline UJF difference between cases and controls was not significant (p>0.05). UJF and RJF (pre- and post-Lasix) increased postoperatively. The UJF difference decreased postoperatively (p<0.05). (attached Table) CONCLUSION: UJF and RJF are useful for diagnosing and monitoring unilateral PUJO. The effect of furosemide on UJF needs to be assessed using additional studies with larger sample sizes to understand if it can affect UJF in a way similar to that noted in diuretic scintigraphy.

Correlation Diagnostic Contribution of SPECT/CT Imaging to 99mTc-DTPA Dynamic Scintigraphy in Patients with Different Renal Pathologies

Introduction: Dynamic renal scintigraphy with 99mTechnetium diethylenetriaminepentaacetic acid (99mTc-DTPA) is a widely performed imaging method to evaluate kidney function of patients with various renal pathologies. However the one-stop-shop combination with subsequent SPECT/CT imaging is a rarely discussed topic. Objective: The aim of the study was to evaluate the diagnostic benefits of SPECT/CT imaging to 99mTc-DTPA dynamic renal scintigraphy. Materials and Methods: A group of 32 patients (21 females and 11 males) who underwent dy- namic nephroscintigraphy with subsequent SPECT/CT was retrospectively studied. A dose of 185MBq (5mCi) 99mTc-DTPA was intravenously applied. A low-dose non-contrast CT protocol was used for attenuation correction and anatomical correlation. Results: Impaired relative renal function in various degrees of left kidney was detected in 18 patients (56%) and of right kidney in 14 patients (44%). SPECT/CT imaging identified the particular cause for the renal dysfunction in the analyzed subjects. The hybrid imaging demonstrated urolithiasis in 11 patients, postoperative ureteral strictures in 5 patients, diagnosed urological cancer in 4 patients and external compression of ureter in 2 patients as a possible obstructive cause. Congenital renal anomalies were the identified causes of impaired renal function in 10 patients – hypoplastic kidney in 4 patients, duplex kidney in 2 patients, multiple cortical cysts in 2 patients, aberrant vessel obstructing the pyeloureteral segment in 1 patient and horseshoe kidney in 1 patient. Conclusion: Dynamic renal scintigraphy combined with SPECT/CT is a very useful clinical tool, by providing not only functional but also anatomical information of the urinary tract, especially in the evaluation of obstructive uropathies and congenital renal abnormalities, that has the potential to change clinical management.

Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA.

The purpose of this study is to compare the value of absolute renal uptake (ARU %) in patients by using Tc-99m MAG-3 and Tc-99m DMSA scan. Absolute renal uptake is calculated using Tc-99m MAG-3 and Tc-99m DMSA in renal scintigraphy, Itoh and Tauex kidney depth methods used, respectively. n = 40 adult patients of both genders were included. All patients underwent Tc-99m MAG-3 and Tc-99m DMSA, respectively. The values of ARU (%) were calculated separately in selected patients n = 40, (left = 17, right = 23 normal functioning kidneys) by MAG-3 and DMSA. Absolute renal uptake (%) of Tc-99m MAG-3 in left kidneys was found to be 15.2 ± 3.4, with spilt renal function 79.2 ± 14.7 and ARU (%) in right kidneys 16.2 ± 3.4 with spilt renal function 77.5 ± 19. Absolute renal uptake of Tc-99m DMSA in left kidneys was 17.5 ± 3.2 and in right kidneys 17.9 ± 4.5 with spilt renal function 81.8 ± 10.7 and 79.3 ± 13.8 for left and right kidney, respectively. Statistical analysis showed strong Pearson correlation. Absolute renal uptake % was found to be more reliable in cases of bilateral compromised kidneys. ARU (%) calculated by Tc-99m MAG-3 solely can be used as predictor of renal function. The use of Tc-99m MAG-3 has more advantages than Tc-99m DMSA alone in renal scintigraphy as dynamic scintigraphy gives less radiation burden to patient, more information regarding renal function, and shorter stay time at hospital in comparison to static renal imaging. SRF % is less reliable than ARU (%).

Radionuclide Diagnosis of Esophageal Dysmotility and Gastroesophageal Reflux in Patients with Systemic Sclerosis

Objective: to evaluate the possibilities of dynamic scintigraphy for the diagnosis of esophageal dysmotility (ED) and gastroesophageal reflux (GER) in patients with systemic sclerosis (SS).Material and methods. The study group included 77 patients with established SS of different disease duration (from several months to 30 years) who underwent Technephyt 99mTc dynamic esophageal scintigraphy using two-stage protocol. During the first stage, the esophageal transport function was evaluated; during the second stage, the presence and severity of GER were assessed. Scans were analyzed using visual assessment, quantitative estimation of time/activity curves, and a proposed three-point scale for evaluating ED and GER severity. The control group consisted of 19 practically healthy individuals who underwent a routine examination to exclude digestive system and gastrointestinal tract diseases, the algorithm of which included dynamic scintigraphy.Results. ED was found in 74 of 77 patients (96%). According to three-point scale, severe ED (3 points) was registrated in 41 (55%) patients, moderate ED (2 points) in 15 (21%), and mild ED in 18 (24%). GER was diagnosed in 35 of 77 cases (45%): mild GER in 13 (37%), moderate GER (2 points) in 22 (63%), and none of the patients was found to have severe GER (3 points). A significant relationship between the presence of GER and the severity of ED was not obtained, but a direct correlation was established between ED and GER severity.Conclusion. Most SS patients demonstrated ED of varying severity associated with mild and moderate GER in nearly 45% of the cases. The study results confirm the practical significance of dynamic scintigraphy for assessing the esophageal transport function and GER in SS patients.

Comparative Study between some Parameters in Ultrasonography and Renal Scintigraphy in the Evaluation of Hydronephrosis among Iraqi Paediatric patients

Hydronephrosis describes a urinary tract abnormality where hydrostatic dilatation of the renal pelvis and calyces exists and considered as a hallmark for obstruction to urine flow downstream. Detecting the pathologic hydronephrosis cases along with the cause using the least invasive techniques is a matter of interest since ages especially in pediatric community. In the Iraqi healthcare practice, many cases are referred for advanced urology imaging tests without clear rational. This study aims to evaluate the rational of referring hydronephrosis pediatric cases to renal scintigraphy studies by comparing the results with the ultrasonography using particular parameters. A cross-sectional observational study involved prospective measurement of a number of variables via two main radiology techniques; sonography and scintigraphy was carried on in Baghdad, Iraq. Classical US and dynamic renal MAG-3 were performed on the same day for each of 35 children aged between 1-5 years presumed or suspected to have obstructive type of hydronephrosis by earlier US work-up. Results revealed a clear statistical significance between normal differential renal function and the good quality of renal drainage of Mag-3 test with the undilated PCS category (p-value 0.028) when measured by our team using the sonography technique. Other results of the calyceal dimension (CD) and the parenchymal thickness (PT) have failed to obtain a statistical significant difference when compared with the categories of the three variables of MAG-3. This study supports the inference of assessing renal function based on sensitive parameters of evolutionary sonography. Each radiologist/nephrologist/urologist should evaluate the measurement of reliable parameters of sonography especially the anteroposterior diameter of the pelvicalyceal system (APD of PCS) at the hilum area and the parenchymal thickness (PT) in millimeters and set the pediatric patient for logical follow-up before recommending the dynamic scintigraphy tests.

Estimation of differential renal function on routine abdominal imaging employing compressed-sensed contrast-enhanced MR: a feasibility study referenced against dynamic renal scintigraphy in patients with deteriorating renal retention parameters

PurposeTo assess whether high temporal/spatial resolution GRASP MRI acquired during routine clinical imaging can identify several degrees of renal function impairment referenced against renal dynamic scintigraphy.MethodsThis retrospective study consists of method development and method verification parts. During method development, patients subject to renal imaging using gadoterate meglumine and GRASP post-contrast MRI technique (TR/TE 3.3/1.6 ms; FoV320 × 320 mm; FA12°; Voxel1.1 × 1.1x2.5 mm) were matched into four equally-sized renal function groups (no-mild-moderate-severe impairment) according to their laboratory-determined estimated glomerular filtration rates (eGFR); 60|120 patients|kidneys were included. Regions-of-interest (ROIs) were placed on cortices, medullary pyramids and collecting systems of bilateral kidneys. Cortical perfusion, tubular concentration and collecting system excretion were determined as TimeCortex=Pyramid(sec), SlopeTubuli (sec−1), and TimeCollecting System (sec), respectively, and were measured by a combination of extraction of time intensity curves and respective quantitative parameters. For method verification, patients subject to GRASP MRI and renal dynamic scintigraphy (99mTc-MAG3, 100 MBq/patient) were matched into three renal function groups (no-mild/moderate-severe impairment). Split renal function parameters post 1.5–2.5 min as well as MAG3 TER were correlated with time intensity parameters retrieved using GRASP technique; 15|30 patients|kidneys were included.ResultsMethod development showed differing values for TimeCortex=Pyramid(71|75|93|122 s), SlopeTubuli(2.6|2.1|1.3|0.5 s−1) and TimeCollecting System(90|111|129|139 s) for the four renal function groups with partial significant tendencies (several p-values < 0.001). In method verification, 29/30 kidneys (96.7%) were assigned to the correct renal function group.ConclusionHigh temporal and spatial resolution GRASP MR imaging allows to identify several degrees of renal function impairment using routine clinical imaging with a high degree of accuracy.

The urinary lithiasis – a challenge of contemporary medicine, under the sign of scientific achievements

The efficacy of various diagnostic imaging methods in determining the morphofunctional features of the affected kidney, the characteristics of kidney stones and its complications, as well as the sensitivity and specificity of conventional imaging methods (ultrasonography, simple KUB radiography, intravenous urography), functional (isotopic renography and dynamic renal scintigraphy) and complex (computed tomography and densitometric tomography associated with infrared spectroscopy) were assessed. Comparison of imaging data with the results of macroscopic evaluation of affected kidneys by stones during surgery allowed to specify the diagnostic contribution of each method with determining its influence on the selection of any applied treatment method. The article assesses an analysis of the main aspects related to diagnosis, the selection criteria for medical-surgical treatment, but especially the surgical techniques, selected from case to case, individualized with the introduction and implementation of numerous diagnostic procedures, treatments, prophylaxis, and metaphylaxis, during the years 2010–2021. The current study of kidney stone disease is complex scientific research, with a multilateral character, which is determined by the multitude of the examined aspects.

Hydronephrosis In Children and Kidney Dynamic Scintigraphy

Hydronephrosis In Children and Kidney Dynamic Scintigraphy

P-37 Use of dynamic scintigraphy for objective quantitative estimation of the risk of salivary gland xerostomia after radiotherapy

P-37 Use of dynamic scintigraphy for objective quantitative estimation of the risk of salivary gland xerostomia after radiotherapy

Dynamic perfusion digital radiography for predicting pulmonary function after lung cancer resection

BackgroundAccurate prediction of postoperative pulmonary function is important for ensuring the safety of patients undergoing radical resection for lung cancer. Dynamic perfusion digital radiography is an excellent and easy imaging method for detecting blood flow in the lung compared with the less-convenient conventional lung perfusion scintigraphy. As such, the present study aimed to confirm whether dynamic perfusion digital radiography can be evaluated in comparison with pulmonary perfusion scintigraphy in predicting early postoperative pulmonary function and complications.MethodsDynamic perfusion digital radiography and spirometry were performed before and 1 and 3 months after radical resection for lung cancer. Correlation coefficients between blood flow ratios calculated using dynamic perfusion digital radiography and pulmonary perfusion scintigraphy were then confirmed in the same cases. In all patients who underwent dynamic perfusion digital radiography, the correlation predicted values calculated from the blood flow ratio, and measured values were examined. Furthermore, ppo%FEV1 or ppo%DLco values, which indicated the risk for perioperative complications, were examined.ResultsA total of 52 participants who satisfied the inclusion criteria were analyzed. Blood flow ratios measured using pulmonary perfusion scintigraphy and dynamic perfusion digital radiography showed excellent correlation and acceptable predictive accuracy. Correlation coefficients between predicted FEV1 values obtained from dynamic perfusion digital radiography or pulmonary perfusion scintigraphy and actual measured values were similar. All patients who underwent dynamic perfusion digital radiography showed excellent correlation between predicted values and those measured using spirometry. A significant difference in ppo%DLco was observed for respiratory complications but not cardiovascular complications.ConclusionsOur study demonstrated that dynamic perfusion digital radiography can be a suitable alternative to pulmonary perfusion scintigraphy given its ability for predicting postoperative values and the risk for postoperative respiratory complications. Furthermore, it seemed to be an excellent modality because of its advantages, such as simplicity, low cost, and ease in obtaining in-depth respiratory functional information.Trial registrationRegistered at UMIN on October 25, 2017. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000033957Registration number: UMIN000029716

Assessment of Renal Function Based on Dynamic Scintigraphy Parameters in the Diagnosis of Obstructive Uro/Nephropathy.

This study evaluates the usefulness of parameters allowing assessment of renal function in absolute values in dynamic renal scintigraphy (DRS) with 99mTc-ethylenedicysteine (99mTc-EC) uptake constant (K), mean transit time (MTT), and parenchymal transit time (PTT) in the diagnosis of obstructive uro/nephropathy. The study included 226 people: 20 healthy volunteers, for whom normative values of assessed parameters were determined, and 206 patients. Reproducibility of results obtained by two independent operators, specificity, correlation with estimated GFR (eGFR), and Cohen’s kappa were used to evaluate reliability of assessed parameters. Normative values were as follows: K ≥ 1.6, MTT ≤ 250 s, and PTT ≤ 225 s. Reproducibility of determination of K (rs = 0.99) and MTT (rs = 0.98) was significantly higher than that of PTT (rs = 0.95) (p = 0.001). Specificity was 100% for K, 81% for MTT, and 91% for PTT. Correlation of eGFR with K (rs = 0.89) was significantly higher than with PTT (rs = 0.53) and with split function (SF) (rs = 0.66) (p < 0.0001). Cohen’s kappa was κ = 0.89 for K, κ = 0.88 for MTT, and κ = 0.77 for PTT. In a group of patients where standard DRS parameters are unreliable (bilateral obstructive uro/nephropathy or single functioning kidney), the use of K (the most effective among assessed parameters) changed the classification of 23/79 kidneys (29%). K enables reproducible assessment of absolute, individual kidney function without modifying routine DRS protocol. Diagnostic value of MTT and PTT is limited.

Unilateral Üreteropelvik Bileşke Obstrüksiyonu Nedeniyle Opere Edilen Pediatrik Hastaların Dinamik Renal Sintigrafi Sonuçları: İpsilateral Diferansiye Renal Fonksiyonun Yüksek Ölçümüne Yeni Yaklaşım

Objective: The aim of this study was to scintigraphically investigate the preoperative and postoperative renal functions of patients operated due to ureteropelvic junction obstruction, discuss the factors affecting the indication of surgery and emphasize the important points to consider during scintigraphic examination. Method: We retrospectively analyzed pediatric cases who underwent pyeloplasty due to ureteropelvic junction obstruction. Patients operated for primary ureteropelvic junction obstruction whose preoperative and postoperative dynamic scintigraphy results could be obtained were included in the study. The patients were divided into two groups as those with &lt;50% and ≥50% ipsilateral differentiated renal function. The difference between the groups was considered statistically significant when p&lt;0.05. Results: The median ages of 36 cases in &lt;50% DRF group and 24 cases in ≥50% DRF group were 7.7 months and 8.5 months, respectively. The mean ipsilateral differentiated renal function values of the main groups were significantly different from each other both in the preoperative and postoperative periods. The changes within the two main groups were also analyzed, yielding significant differences. Ipsilateral differentiated renal function changes on a general, group and subgroup basis, and preoperative ultrasound findings of the ipsilateral kidney in subgroups were revealed. Conclusion: Increased hydronephrosis degree and renal pelvis anterior-posterior diameter are closely related to overestimated ipsilateral kidney function. For deciding on surgery in patients with ureteral obstruction, scintigraphic examinations make sense with the help of US and the clinical condition of the patient.

Influence of Early Bladder Imaging in Experimental Rabbits on the Quantitative Determination of Glomerular Filtration Rate by the Gates Method.

Objective To investigate the influence of early bladder imaging (EBI) in experimental rabbits on the quantitative calculation of glomerular filtration rate (GFR) by the Gates method. Methods We retrospectively analyzed the data of dynamic renal scintigraphy (DRS) in experimental rabbits. We calculated renal uptake during minutes 1-2 and 2-3 by correcting bladder radioactivity and computed the split GFR by renal uptake. Then, the EBI and GFR between 1-2 min and 2-3 min were compared, respectively. Results The EBI proportion (57.3%) at 2-3 min of DRS was higher than that (8.5%) at 1-2 min (P < 0.05). The correlations between the 1-2 min and 2-3 min uptake rates of unobstructed kidneys after correction (r = 0.952‐0.979) were higher than those before correction (r = 0.859‐0.936). However, the correlation between the two in obstructed kidneys was not improved (rbefore = 0.967 versus rafter = 0.968). For unobstructed kidneys, the difference in GFR based on 2-3 min uptake between before and after correction was significant (P < 0.05), but not in obstructed kidneys (P > 0.05). For GFR based on 1-2 min uptake, the difference between before and after correction was not significant in obstructed or unobstructed kidneys (P > 0.05). Before correction, the GFR of unobstructed kidneys of 10.5% of the rabbits in the protein load test was lower than that in the baseline status, but not so after correction. Conclusion The 2-3 min EBI on DRS has a significant influence on the GFR calculated by the Gates method in experimental rabbits. Controlling water intake or calculating the GFR by 1-2 min renal uptake helps to avoid the influence of EBI on GFR.

Influence of Internal Thoracic Artery Harvesting on Sternal Osteoblastic Activity and Perfusion.

The purpose of this study was to assess the sternal osteoblastic activity and perfusion in the early period after a coronary artery bypass graft (CABG) using single-photon emission computed tomography (SPECT) and three-phasic dynamic scintigraphy (3PDS) with 99mTc methylene diphosphonate (MDP). Methods: The study group consisted of 57 male patients that were 57.3 ± 6.6 years of age. Thirty-six of them were randomized into two groups: in group I (n = 18), the internal thoracic artery (ITA) was skeletonized, and in group II (n = 18), the ITA was pedicled. All the patients in groups I and II underwent an off-pump CABG using 1.7 ± 0.3 grafts, including one anastomosis of the ITA to the left anterior descending coronary artery. The control group III (n = 21) consisted of patients that underwent mitral valve repair surgery, in whom the sternotomy without the ITA harvesting was performed. The 3PDS and SPECT of the thorax with 99mTc MDP were performed 2 weeks after surgery. Results: The sternal phosphates uptake in group I was approximately twice as high as in group II and approximately 1.5 times higher than in group III (p < 0.05). The MDP uptake asymmetry after the ITA skeletonization was the same as in the group with both intact ITAs. In contrast, after the pedicled ITA harvesting, the osteoblastic activity of the ipsilateral side of the sternum was lower than in the contralateral one. There was no statistically significant difference in scintillation count in the xiphoid process between groups I and II (p > 0.05); however, we observed a significant difference in the manubrium and body (p < 0.05). Conclusion: The main factor that improved the sternal perfusion after a CABG was the preservation of branches supplying the sternum using the skeletonization technique of ITA harvesting.

Severely Impaired Renal Function in Unilateral Atherosclerotic Renal Artery Stenosis Indicated by Renal Slow Perfusion.

PurposeRenal artery stenosis leads to ischemic renal insufficiency, but methods for assessing renal perfusion are limited. This study aimed to evaluate the association between renal slow perfusion and impaired renal function in atherosclerotic renal artery stenosis (ARAS).Patients and MethodsA total of 79 consecutive patients with uncontrolled hypertension who underwent renal angiography and renal dynamic scintigraphy for suspected ARAS were enrolled in the retrospective descriptive study. Based on the status of renal artery stenosis and renal perfusion, participants were divided into three groups: the control group (n=26), the unilateral ARAS with renal normal perfusion group (RNP, n=30), and the unilateral ARAS with renal slow perfusion group (RSP, n=23). RSP was defined as renal blush grade (RBG) ≤1, while RBG>1 belonged to RNP. Split renal function (SRF) was achieved from 99mTc-DTPA renal scintigraphy. The value of the difference in split renal function (DSRF) is contralateral SRF minus impaired SRF of paired kidneys in ARAS. We compared the SRF and DSRF between different groups to identify the association between renal slow perfusion and renal impairment in ARAS.ResultsWe analyzed SRF for paired kidneys and found the following: (1) The SRF of the paired kidney was similar in the RNP group (24.3 ± 10.2 mL/min vs 27.5 ± 8.4 mL/min; P = 0.19); however, the impaired SRF was obviously decreased compared with the contralateral SRF in the RSP group (13.5 ± 8.6 mL/min vs 36.7 ± 16.9 mL/min; P < 0.001); and (2) The difference in SRF in the RSP group was significantly higher than that in the control and RNP groups (19.8 ± 11.9 mL/min vs 4.8 ± 8.1 mL/min; 19.8 ± 11.9 mL/min vs 4.6±3.7 mL/min; P < 0.05).ConclusionAs an angiographic phenomenon, renal slow perfusion might be an indicator of severely impaired renal function.

Early Renal Function Alterations in Renal Branches vs. Renal Fenestrations – A Dynamic Scintigraphy Based Prospective Study

The objective of this prospective single centre study was to assess whether branches and fenestrations have different outcomes on renal function in the early phase. From March 2018 to June 2019, 67 patients who underwent elective fenestrated and branched endovascular aneurysm repair (F/BEVAR) procedures were enrolled in this study. The patients were divided into two groups according to the renal bridging component configuration (fenestration vs. branch). All of them underwent dynamic renal scintigraphy with 99mTc diethylenetriaminepentaacetic acid (DTPA), two weeks pre-operatively, and three months and one year post-operatively. The primary end points were peri-procedural technical success, 30 day major adverse events, differences in glomerular filtration rate (GFR) between the branch and fenestration configurations, and variations between the pre-operative and the post-operative dynamic renal scintigraphy. Overall, 135 kidneys were analysed: 63 in the 32 patients treated with fenestrations, and 72 in the 35 patients treated with branches; the mean GFR on baseline scintigraphy was 58.4±30.9mL/min in the fenestration group, and 65.1±29.2mL/min in the branch group. Only kidneys associated with a patent fenestration/branch were included in the split GFR final analysis. The mean total GFR at three month scintigraphy decreased by 6.0±2.9mL/min in the fenestration group and by 23.4±6.4mL/min in the branch group. The split GFR decreased by 3.5±0.6mL/min in the fenestration group, and by 15.4±5.4mL/min in the branch group. The GFR decrease remained stable at one year. In this study, the use of branches for renal arteries during F/BEVAR resulted in a greater decrease in the GFR than in those patients who were treated with fenestrations alone. The scintigraphic alterations were evident at an early phase.

The Role of Tc-99m DTPA Renal Dynamic Scintigraphy in Retroperitoneal Liposarcoma

Purpose Technetium-99m diethylene triamine pentaacetic acid (Tc-99m DTPA) renal dynamic scintigraphy is a widely used imaging technique that evaluates renal function of patients with extrarenal abnormalities, but its clinical value in potentially offering us information on proliferation of liposarcoma has not yet been reported. Methods We retrospectively reviewed 7 patients with histopathologically confirmed retroperitoneal liposarcoma who underwent Tc-99m DTPA renal dynamic scintigraphy. The clinical data, histopathological findings, Glomerular Filtration Rate (GFR), and Tc-99m DTPA uptake were recorded. Results Dedifferentiated liposarcoma and well-differentiated liposarcoma showed dissimilar degrees of Tc-99m DTPA uptake, an observation that correlated with Ki-67 expression (p < 0.01). 4 of the 7 patients were diagnosed with dedifferentiated liposarcoma, showing a moderate uptake of Tc-99m DTPA and greater than 20% Ki-67 expression on histological slides. Meanwhile, the remaining 3 patients, diagnosed with well-differentiated liposarcoma, showed no uptake of Tc-99m DTPA and Ki-67 expression of less than 5%. Conclusions This study suggests that Tc-99m DTPA renal dynamic scintigraphy provides diagnostic value in patients with retroperitoneal liposarcoma, not only in evaluating renal function but also in visualizing lesion-related radionuclide uptake, which may potentially offer further clinical insights into tumor proliferation and provide prognostic value for clinical outcomes in patients with retroperitoneal liposarcoma.

Pharmacokinetic modeling in dynamic scintigraphy of the hepatobiliary system

Pharmacokinetic modeling in dynamic scintigraphy of the hepatobiliary system