Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens

CONTEXT AND OBJECTIVE: Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard. DESIGN AND SETTING: Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas. METHODS: Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in vivo renal uptake of 99mTc-DMSA was determined using the radioactivity of the syringe before the injection (measured using a dose calibrator) and the images of the syringe and kidneys, obtained from a scintillation camera. After surgery, the reference value for renal uptake of 99mTc-DMSA was determined by measuring the radioactivity of the nephrectomy specimen using the same dose calibrator. RESULTS: The ARU measurements were very similar to those obtained using the reference method, as determined by linear regression (r-squared = 0.96). CONCLUSION: ARU estimation using the proposed method before nephrectomy seems to be accurate and feasible for routine use.

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Main Authors: Lima,Mariana da Cunha Lopes de, Ramos,Celso Darío, Brunetto,Sérgio Quirino, Lima,Marcelo Lopes de, Ferreira,Ubirajara, Etchebehere,Elba Cristina Sá Camargo, Santos,Allan de Oliveira, Netto Júnior,Nelson Rodrigues, Camargo,Edwaldo Eduardo
Format: Digital revista
Language:English
Published: Associação Paulista de Medicina - APM 2008
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000300003
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spelling oai:scielo:S1516-318020080003000032008-08-11Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimensLima,Mariana da Cunha Lopes deRamos,Celso DaríoBrunetto,Sérgio QuirinoLima,Marcelo Lopes deFerreira,UbirajaraEtchebehere,Elba Cristina Sá CamargoSantos,Allan de OliveiraNetto Júnior,Nelson RodriguesCamargo,Edwaldo Eduardo 99mTc-DMSA Scintigraphy Nephrectomy Kidney cortex Nuclear medicine CONTEXT AND OBJECTIVE: Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard. DESIGN AND SETTING: Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas. METHODS: Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in vivo renal uptake of 99mTc-DMSA was determined using the radioactivity of the syringe before the injection (measured using a dose calibrator) and the images of the syringe and kidneys, obtained from a scintillation camera. After surgery, the reference value for renal uptake of 99mTc-DMSA was determined by measuring the radioactivity of the nephrectomy specimen using the same dose calibrator. RESULTS: The ARU measurements were very similar to those obtained using the reference method, as determined by linear regression (r-squared = 0.96). CONCLUSION: ARU estimation using the proposed method before nephrectomy seems to be accurate and feasible for routine use.info:eu-repo/semantics/openAccessAssociação Paulista de Medicina - APMSao Paulo Medical Journal v.126 n.3 20082008-05-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000300003en10.1590/S1516-31802008000300003
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language English
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author Lima,Mariana da Cunha Lopes de
Ramos,Celso Darío
Brunetto,Sérgio Quirino
Lima,Marcelo Lopes de
Ferreira,Ubirajara
Etchebehere,Elba Cristina Sá Camargo
Santos,Allan de Oliveira
Netto Júnior,Nelson Rodrigues
Camargo,Edwaldo Eduardo
spellingShingle Lima,Mariana da Cunha Lopes de
Ramos,Celso Darío
Brunetto,Sérgio Quirino
Lima,Marcelo Lopes de
Ferreira,Ubirajara
Etchebehere,Elba Cristina Sá Camargo
Santos,Allan de Oliveira
Netto Júnior,Nelson Rodrigues
Camargo,Edwaldo Eduardo
Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
author_facet Lima,Mariana da Cunha Lopes de
Ramos,Celso Darío
Brunetto,Sérgio Quirino
Lima,Marcelo Lopes de
Ferreira,Ubirajara
Etchebehere,Elba Cristina Sá Camargo
Santos,Allan de Oliveira
Netto Júnior,Nelson Rodrigues
Camargo,Edwaldo Eduardo
author_sort Lima,Mariana da Cunha Lopes de
title Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
title_short Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
title_full Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
title_fullStr Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
title_full_unstemmed Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
title_sort estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens
description CONTEXT AND OBJECTIVE: Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard. DESIGN AND SETTING: Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas. METHODS: Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in vivo renal uptake of 99mTc-DMSA was determined using the radioactivity of the syringe before the injection (measured using a dose calibrator) and the images of the syringe and kidneys, obtained from a scintillation camera. After surgery, the reference value for renal uptake of 99mTc-DMSA was determined by measuring the radioactivity of the nephrectomy specimen using the same dose calibrator. RESULTS: The ARU measurements were very similar to those obtained using the reference method, as determined by linear regression (r-squared = 0.96). CONCLUSION: ARU estimation using the proposed method before nephrectomy seems to be accurate and feasible for routine use.
publisher Associação Paulista de Medicina - APM
publishDate 2008
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802008000300003
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