Demonstration of Renal Mass Lesions by Early Dynamic Imaging during Bone Scintigraphy

Based upon the rapid early renal excretion of bone imaging radiopharmaceuticals, we performed a prospective study to determine the use of combining renal evaluation with routine bone scans in 79 consecutive patients with prostate cancer. The radionuclide renal scintigraphy consisted of a 1-minute sequence of 2.5-second frames with a bolus injection of 99mtechnetium-methylene diphosphonate followed by a series of 2-minute images for 24 minutes. Whole body bone scans were performed after a 3-hour delay. All patients had at least 1 confirmatory study with excretory urography (62), ultrasonography (49) or computerized tomography (30). Results were interpreted independently and compared. Ten studies were normal. Radionuclide renal scintigraphy was able to identify 45 of 49 cortical abnormalities (90 per cent) with a false positive rate of 4 per cent. Accuracy of renal cyst detection was only 47 per cent (15 of 32 cases). All acutely obstructed kidneys were identified correctly by radionuclide renal scintigraphy (5 of 5 cases). Of 12 chronically obstructed kidneys 8 (67 per cent) were identified correctly. The 4 missed kidneys were small and nonfunctioning, and they were diagnosed correctly as such but obstruction as the etiology of nonfunction was unidentifiable by radionuclide renal scintigraphy. The false positive rate of obstructive diagnosis by radionuclide renal scintigraphy was 24 per cent (4 of 17 cases). These findings demonstrate that renal evaluation combined with routine bone scanning is an effective screening procedure for renal complications of prostate cancer; no significant abnormalities were missed. The procedure is entirely free of morbidity and does not add to the radiation dose from the bone scan. Furthermore, it is cost-effective, since it avoids the routine need for 2 separate procedures at followup of patients with prostate cancer.

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The Benefits of Combining Early Radionuclide Renal Scintigraphy with Routine Bone Scans in Patients with Prostate Cancer

Narayan

Lillian

Hedgcock

et al. 1988

Journal of Urology

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Gamma Camera Renography with ⁹⁹Tc^m-MDP and ¹³¹I-Hippuran

Thomsen¹,

Jørgensen²,

Diemer³

1986

Acta Radiologica. Diagnosis

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Nineteen patients with urologic disorders referred to bone scintigraphy were evaluated with a dual radioisotope technique using simultaneous injection of 99Tcm-MDP and 131I-Hippuran. The MDP and Hippuran renograms showed in general the same pattern and there was no difference between the kidney function determined with the two radionuclides. The peak of the MDP curves occurred later and was less distinct than that of the Hippuran curves. The residual activity of the kidneys 20 min after the injection was higher on the MDP renograms compared with the Hippuran renograms. The early sequential MDP images were superior in quality to the Hippuran images and to the renal images obtained at bone scintigraphy. The early MDP images correlated well with the findings at urography performed in 12 patients, as all cases of radiologically diagnosed hydronephrosis, reduction of renal parenchyma and renal mass lesions became demonstrated. Renal calculi were only diagnosed at urography. In conclusion, MDP cannot replace Hippuran as a renal radionuclide agent, mainly due to its lower extraction ratio and the high bone uptake. However, an increased use of early dynamic renal imaging is recommended in urologic patients referred to bone scintigraphy as valuable information about renal function may be obtained by this procedure.

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Demonstration of Renal Mass Lesions by Early Dynamic Imaging during Bone Scintigraphy

Cited by 2 publications

References 7 publications

The Benefits of Combining Early Radionuclide Renal Scintigraphy with Routine Bone Scans in Patients with Prostate Cancer

The Benefits of Combining Early Radionuclide Renal Scintigraphy with Routine Bone Scans in Patients with Prostate Cancer

Gamma Camera Renography with ⁹⁹Tc^m-MDP and ¹³¹I-Hippuran

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Demonstration of Renal Mass Lesions by Early Dynamic Imaging during Bone Scintigraphy

Cited by 2 publications

References 7 publications

The Benefits of Combining Early Radionuclide Renal Scintigraphy with Routine Bone Scans in Patients with Prostate Cancer

The Benefits of Combining Early Radionuclide Renal Scintigraphy with Routine Bone Scans in Patients with Prostate Cancer

Gamma Camera Renography with 99Tcm-MDP and 131I-Hippuran

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Gamma Camera Renography with ⁹⁹Tc^m-MDP and ¹³¹I-Hippuran