Nucl Med Mol Imaging.  2014 Dec;48(4):262-271. 10.1007/s13139-014-0284-2.

Tc-99m Hydroxymethylene Diphosphonate (HMDP) Renal Uptake as a Surrogate Marker of Postoperative Impairment of the Glomerular Filtration Rate in Renal Tumor Patients Following Nephron-Sparing Surgery

• Choi H
• Lee WW
• So Y
• Ha S
• Byun SS
• Kim SE

• KMID: 2313208
• DOI: http://doi.org/10.1007/s13139-014-0284-2

Abstract

PURPOSE
We investigated Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy findings in renal tumor patients from the perspective of postoperative renal dysfunction following nephron-sparing surgery (NSS).
METHODS
Forty-three renal tumor patients (M:F = 28:15, age 53.9+/-12.5 years) who had undergone Tc-99m HMDP scintigraphy after NSS were enrolled. The patients were divided into HMDP+ or HMDP- groups by visual assessment, and the asymmetric index (ASI) was calculated using a region-of-interest analysis. In 16 patients, the total and split glomerular filtration rate (GFR) was assessed using Tc-99m diethylenetriaminepentaacetic acid (DTPA) scintigraphy at baseline and at 3 and 6months post-NSS.
RESULTS
High Tc-99m HMDP uptake was observed in the operated kidneys, but this did not persist later than 7 days post-NSS. Split GFR of the operated kidneys at baseline (58.5+/-9.3 ml/min) was significantly reduced at 6 months post-NSS (40.1+/-5.9 ml/min, p<0.001) in only those who showed intense uptake of Tc-99m HMDP. Declines in both total GFR (p=0.010 and p=0.002 for 3 and 6 months, respectively) and split GFR of the operated kidneys (p<0.001 and p<0.001 for 3 and 6 months, respectively) were clearly evidenced at 3 and 6 months post-NSS only in patients with high Tc-99m HMDP in the operated kidneys. The ASI was negatively correlated with %change in the split GFR of these operated kidneys at 6 months post-NSS (rho =-0.578, p=0.0304).
CONCLUSION
Tc-99m HMDP uptake within 1 week following NSS is a surrogate marker of GFR impairment over 6 months post-NSS.

Keyword

Tc-99mphosphonate; Scintigraphy; Glomerular filtration rate; Nephrectomy

MeSH Terms

Biomarkers*
Glomerular Filtration Rate*
Humans
Kidney
Nephrectomy
Radionuclide Imaging