Renal Scintigraphy in the Acute Care Setting

Nuclear medicine and the emergency department patient: an illustrative case-based approach

“…With the introduction of improved immunosuppressive therapy, graft and patient survival have significantly improved. Currently, 1-year survival rates for renal grafts are 80 % for mismatched transplants from deceased donor, 90 % for nonidentical living donors and 95 % for HLA-matched grafts [42][43][44]. The half-life of grafts from living related donors ranges between 13 and 24 years, depending on the match [42][43][44][45][46][47].…”

“…ATN is caused by prolonged ischemia, which is more common in cadaveric grafts, and will resolve spontaneously in 2 weeks [42][43][44][45][46][47][48][49][50][51]. On a Tc99m MAG3 study, the graft will demonstrate normal blood flow, prolonged parenchymal retention of the tracer and delayed cortical transit of tracer into the collecting system.…”

“…185 MBq of Tc-99m MAG3 is injected intravenously. Flow images are obtained over the first minute, followed by additional dynamic images for 30 min [42,43,52]. A static image is obtained after voiding.…”

SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0

“…Obtaining a diuretic renal scan to determine the presence or absence of obstruction while the patient is in the emergency room has been shown to direct patient management. 39,40,98,99 One study found that the scan changed the decision to admit or discharge the patient in 30% of cases. 99 …”

“…Pilot studies have shown that diuretic renal scintigraphy in the emergency room can have a substantial impact on the management of patients presenting with renal colic and a ureteral calculus documented by unenhanced CT. 39,40,98,99 Additional studies are needed to confirm these initial results and evaluate both the cost-effectiveness and the impact of diuretic renography on patient management and outcome.…”