99mTc-MAG3 diuretic renography in children: a comparison between F0 and F+20

Donoso, G.; Kuyvenhoven, Jacob D.; Ham, Hamphrey; Piepsz, Amnon

doi:10.1097/00006231-200311000-00010

Cited by 28 publications

(15 citation statements)

References 9 publications

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“…Time of injection of the diuretic in relation to the radiopharmaceutical is crucial in the interpretation of the renogram curve and calculation of excretion T 1/2 . Different methods have been described: the diuretic may be given after the renogram phase of the TAC (20 min, F þ 20) or when entire collecting system is believed to be full 36,37 ; the radiopharmaceutical and diuretic may be injected simultaneously (F þ 0) 38,39 or the diuretic may be administered 15 min before injection of the radiopharmaceutical (FÀ15). 40 The latter method shortens the overall examination time, which is advantageous especially in pediatric applications.…”

Section: Discussionmentioning

confidence: 99%

Diuretic Renal Scintigraphy in Normal Dogs

Hecht

Daniel

Mitchell

2006

Vet Radiology Ultrasound

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Diuretic renal scintigraphy is commonly used in human medicine to differentiate obstructive from nonobstructive pyelectasia. In order to determine normal parameters, 99mTc-DTPA renal scintigraphy was performed twice in 20 healthy adult Mongrel dogs. Each dog was injected with either 3.0 mg/kg furosemide or an equivalent volume of saline 4.5 min following injection of the radiopharmaceutical. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) time of peak (TOP) of the time-activity curve (TAC); (3) shape of the TAC; (4) individual kidney excretion half-time (T1/2); (5) proportion of maximum activity measured at end of study (8 min); (6) time of onset; and (7) duration of the effect of the diuretic. Most TAC in the diuretic renography group showed a steep drop in the curve following administration of the diuretic compared with a gradual slope in the saline control group. There was a statistically significant difference in T1/2 between the control renograms (median 10.25 min, range 4.41-18.07 min) and the diuretic renograms (median 4.16 min, range 3.62-5.90 min). There was a statistically significant difference in percentage maximum activity between the control renograms (median 65.25%, range 48.27-93.68%) and the diuretic renograms (median 48.54%, range 35.64-58.76%). Median time of onset of the diuretic effect was 1.10 min (0.20-2.40 min), and median duration was 0.83 min (0.30-2.35 min).

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Section: Discussionmentioning

confidence: 99%

Diuretic Renal Scintigraphy in Normal Dogs

Hecht

Daniel

Mitchell

2006

Vet Radiology Ultrasound

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“…Obviously not when trying to apply the traditional criteria of the F+20 washout curve (T 1/2 ) to the renogram in F0. However, recently described variables, where calculations were based on the residual activity, might allow this kind of comparison [35]. The OE and PEE are analogous physiological, robust and well‐validated variables [30,32,36,37] which, based on the cardiac curve and the renal activity at a given moment of the acquisition, allows an evaluation of the amount which left the kidney and expressed as a percentage of what came in.…”

Section: What If Frusemide Is Injected Early (F0 or F−15)?mentioning

confidence: 99%

Interpretation of the renogram: problems and pitfalls in hydronephrosis in children

et al. 2004

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The role of diuretic renography has become central in cases of upper tract dilatation, and in the first paper in this section the difficulties in interpreting results in asymptomatic congenital hydronephrosis are examined. These difficulties and controversies exist despite the presence of guidelines and consensus protocols, probably because renography procedures differ among centres. The authors found that there is a need for renography to be standardized for the optimum value to be obtained from the procedure. There are three papers from Los Angeles which attempt to standardize the measurement of bladder compliance, from both the theoretical and clinical perspective, and which assess the detrusor pressure rise of a normal bladder when filled to capacity. OBJECTIVE To discuss the main steps of renographic technique and underline some pitfalls related to the acquisition, processing and interpretation of diuretic renography, an important method for guiding the management of asymptomatic congenital hydronephrosis. METHODS Despite guidelines and consensus protocols, renographic procedures differ among centres, causing difficulties in comparison and controversy in the interpretation of results. Thus we comprehensively assessed published papers on the subject of diuretic renography. RESULTS Differential renal function (DRF) is a robust measure provided there is adequate background subtraction. Pitfalls are related to the drawing of regions of interest, particularly in infants, to estimating the interval during which DRF is calculated, and to an adequate signal‐to‐noise ratio. There is no definition of a ‘significant’ reduction in DRF. The classical variables of the diuretic renogram may not allow an estimate of the best drainage. Poor pelvic emptying may be apparent because the bladder is full and because the effect of gravity on drainage is incomplete. Estimating the drainage as residual activity rather than any parameter on the slope might be more adequate, especially if the time of frusemide administration is changed. Renal function and pelvic volume can influence the quality of drainage. Drainage may be better estimated using new tools. CONCLUSION Provided the investigation is standardized and potential pitfalls accounted for, the diuretic renogram provides valuable and reproducible quantitative information on DRF and drainage.

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“…The time period for assessing this uptake was earlier than the conventional time of 2 min, due to the use of the F0 protocol. It has been observed that this protocol can lead to very rapid transit through the kidney [5]. In the current study, peak times of the renogram following the heart peak were as low as 1.6 min.…”

Section: Derivation Of Background Subtraction Factors For Geometric Mmentioning

confidence: 40%

“…The limited time for assessment of uptake is due to the requirement that the measurement must be taken before the minimum transit time through the kidney [4]. In fact for centres using furosemide injection prior to or at the same time as injection, the transit times are even shorter, which means that this assessment needs to be brought still earlier, probably to around 1.5 min [5]. The short time period following injection during which the estimate of renal uptake needs to be made influences the accuracy with which RRF can be assessed.…”

Section: Introductionmentioning

confidence: 99%