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Clinical application of 99mTc-DTPA dynamic renal scintigraphy with consequent SPECT/CT imaging in patients with different nephrological conditions

By Boris

Volume 11, Issue 1

Original Article / Published: November 2023

DOI: https://doi.org/10.57045/jemis/1111123.pp17-28

T. Sofiyanski, S. Sergieva, M. Dimcheva, O. Gatsev, I. Saltirov

Department of Nuclear Medicine, Sofia Cancer Center, Sofia, Bulgaria
Clinic of Urology, Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria

Abstract

Introduction: Dynamic renal scintigraphy with 99mTechnetium diethylenetriaminepentaacetic acid (99mTc-DTPA) is a generally used imaging technique for evaluating renal function of patients with various nephro-urological conditions. Clinical application of SPECT/CT nephroscintigraphy has rarely been discussed.
Objective: The aim of the study was to evaluate the added value of SPECT/CT imaging to dynamic renal scintigraphy with 99mTcDTPA. Materials and Methods: Thirty two patients (66% female and 34% male) who underwent dynamic nephroscintigraphy with subsequent SPECT/CT with mean age 55.9±18.25 years was observed. The CT scan was performed with a low dose protocol. A dose of 185MBq (5mCi) 99mTc-DTPA was administered intravenously.
Results: Our analysis demonstrated impaired relative renal function in various degrees of left kidney in 18 patients (56%) and of right kidney in 14 patients (44%). SPECT/CT imaging revealed the specific cause, responsible for the renal dysfunction in the cases. The hybrid imaging demonstrated urolithiasis in 11 patients, postopertative strictures of ureter in 5 patients, diagnosed urological cancer in 4 patients, external compression of ureter from ovarian cyst in 1 patient and compression of ureter due to nephroptosis in 1 patient as a possible obstructive cause. In 10 patients congenital renal anomalies were the identified causes of impaired renal function – 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: The combination of conventional 99mTc-DTPA dynamic renal scintigraphy with subsequent SPECT/CT could provide not only functional but also anatomical information of the urinary tract, especially in the evaluation of obstructive uropathies and congenital renal abnormalities, that can change the clinical management

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Volume 11, Issue 1
Article [pdf]

Keywords:

99mTc-DTPA dynamic renal scintigraphy, SPECT/CT, uropathies,
nephropathies

How to cite this article:

T. Sofiyanski, S. Sergieva, M. Dimcheva, O. Gatsev, I. Saltirov.
Clinical application of 99mTc-DTPA dynamic renal scintigraphy
with consequent SPECT/CT imaging in patients with different
nephro-urological conditions. Journal of Endourology and
Minimally Invasive Surgery (Bulgaria), 2023; 11(1): 17-28

Corresponding author:

Teodor Sofiyanski, MD
Oncology Clinic Sofia, Department of Nuclear medicine
22„Andrei Saharov“ blvd.
Sofia 1784
e-mail: teodor.sofianski@gmail.com