Nucl Med Mol Imaging.  2017 Dec;51(4):338-346. 10.1007/s13139-017-0491-8.

Quantitative Single-Photon Emission Computed Tomography/Computed Tomography for Glomerular Filtration Rate Measurement

Affiliations
  • 1Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea. wwlee@snu.ac.kr
  • 2Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea.
  • 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, South Korea.
  • 4Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.

Abstract

PURPOSE
We propose a quantitative Tc-99m diethylenetriaminepentaacetic acid (DTPA) single-photon emission computed tomography/computed tomography (SPECT/CT) for glomerular filtration rate (GFR) measurement.
METHODS
Quantitative SPECT/CT data obtained at 2-3 min post-Tc-99m DTPA injection (370 MBq) were used to determine % injected doses (%IDs) for individual kidneys. The reproducibility of %ID measurement was tested and compared with planar scintigraphy. Cr-51 ethylenediaminetetraacetic acid (EDTA) GFR was used as reference standard. Nine young volunteers, representing normal GFR, and ten older volunteers, reflecting impaired GFR, were enrolled. The established GFR equation derived from these volunteerswas applied to 19 renal tumor patients post-partial nephrectomy.
RESULTS
At 2-3 min, %ID was most reproducible with the highest intraclass correlation (ICC) (0.9379) and lowest % coefficient of variation (CV) (6.5259%), which were more reliable than the ICC (0.9368) and %CV (6.7689%) of planar scintigraphy. Cr-51 EDTA GFR (93.16 ± 24.81 ml/min) correlated significantly with %ID (7.66 ± 2.15%, r = 0.7906, p = 0.0001), yielding an equation: Cr-51 EDTA GFR (ml/min) = (%ID × 9.1462) + 23.0653. This equation revealed significant decreases in total and nephrectomized kidney GFR (p = 0.0012 and p < 0.0001, respectively) from preoperative to 3-month postoperative measurements.
CONCLUSIONS
Quantitative Tc-99m DTPA SPECT/CT produces reliable and clinically applicable %ID estimates that translate to the GFR of individual kidneys.

Keyword

Computed tomography; Cr-51 EDTA; Glomerular filtration rate; Single-photon emission computed tomography; Tc-99m DTPA

MeSH Terms

Edetic Acid
Glomerular Filtration Rate*
Humans
Kidney
Nephrectomy
Pentetic Acid
Radionuclide Imaging
Volunteers
Edetic Acid
Pentetic Acid
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