Evaluation of renal uptake on 111InCl3 bone marrow scintigraphy in patients with aplastic anemia and myelodysplastic syndrome

International Nuclear Information System (INIS)

Koizumi, Mitsuru; Goto, Masafumi; Nomura, Toshiharu; Watari, Tsutomu; Saito, Kenji

1993-01-01

High renal uptake on bone marrow scan with indium-111 chloride is often shown in patients with bone marrow abnormality. We evaluated the renal uptake on bone marrow scan in 27 cases of aplastic anemia, 20 cases of myelodysplastic syndrome (MDS) and 10 cases of other diseases. The high renal uptake was observed in patients not only with aplastic anemia but also with MDS. The renal uptake correlated with blood transfusion units, unsaturated iron binding capacity (UIBC), blood pool imaging and bone marrow uptake. The renal uptake correlated with UIBC better than with the blood transfusion units. Following mechanism of the renal uptake is proposed that frequent blood transfusion makes low UIBC, and the low UIBC causes the failure to chelate indium with transferrin. The fast blood clearance of un-chelated indium via kidneys is followed. Hypoplastic bone marrow may also play an important role for the high renal uptake because all patients with the high renal uptake could not be explained by above mentioned mechanism. Caution should be paid to the scans with the high renal uptake because both aplastic anemia and MDS patients show the high renal uptake. (author)

Myocardial uptake of Tc-99m MDP in chronic renal failure with cardiomyopathy

International Nuclear Information System (INIS)

Kim, Seung Eun; Sohn, Hyung Sun; Chung, Yong An; Park, Young Ha; Kim, Sung Hoon; Chung, Soo Kyo

2000-01-01

A uremic patient on hemodialysis, who had concurrent cardiomyopathy showed intense myocardial uptake of 99m Tc-methylene diphosphonate (MDP). The presumed cause of uptake in the myocardium is metastatic calcification due to hypercalcemia secondary to the renal failure. However, supplementary mechanism caused by cardiomyopathy should be considered. We describe a case with bone tracer uptake in the myocardium in the absence of infarction in a patient with chronic renal failure.=20

Measurement of renal function by calculation of fractional uptake of technetium-99m dimercaptosuccinic acid

International Nuclear Information System (INIS)

Beatovic, S.Lj.; Jaksic, E. D.; Hari, R. S.

2004-01-01

The purpose of this study was to set up normal values of the fractional uptake (FU) of technetium-99m dimercaptosuccinic acid in adults and in the pediatric population, as well as to evaluate the validity of this parameter at different levels of renal function. A total of 86 subjects was divided into seven groups. In group A there were 23 potential kidney donors and in group B, 18 children in remission after a first urinary tract infection. Another three groups consisted of patients with diabetes i.e. group C, seven patients with normal values of albuminuria, group D, 16 patients with microalbuminuria and group E, five patients with macroalbuminuria. In group F, there were ten patients with a well-functioning transplanted kidney and in group G, seven patients with suspected acute rejection. The procedure began with the quantification of the doses of 99m Tc-DMSA to be injected and the measurement of the empty syringe lying on the gamma camera collimator. Thereafter, four planar views of the kidneys were acquired three hours after the injection. The counts from the posterior and anterior views were subtracted for background and corrected for radioactive decay time and patient thickness. The FU was calculated by the geometric mean of counts per second from the posterior and anterior view. It was expressed as a fraction of the injected dose. The mean values of FU in healthy adults were 0.227 ± 0.077 for one kidney and 0.454 ± 0.146 for both kidneys. The mean values of FU for the left and right kidney were 0.225± 0.071 and 0.229 ± 0.079, respectively. In children, the mean values were 0.220 ± 0.092 for one kidney and 0.432 ± 0.094 for both kidneys. The highest values of FU of 0.322 ± 0.078 (0.644 ± 0.138 for both kidneys) were measured in group C. In group D, FU was 0.185 ± 0.065 (0.361 ± 0.125 for both kidneys) and in group E 0.082 ± 0.040 (0.163 ± 0.080 total). In patients with a transplanted kidney, fractional uptake was 0.162 ± 0.039 in group F and 0

Evaluation of renal uptake on [sup 111]InCl[sub 3] bone marrow scintigraphy in patients with aplastic anemia and myelodysplastic syndrome

Energy Technology Data Exchange (ETDEWEB)

Koizumi, Mitsuru; Goto, Masafumi; Nomura, Toshiharu; Watari, Tsutomu; Saito, Kenji (Dokkyo Univ. School of Medicine, Mibu, Tochigi (Japan))

1993-04-01

High renal uptake on bone marrow scan with indium-111 chloride is often shown in patients with bone marrow abnormality. We evaluated the renal uptake on bone marrow scan in 27 cases of aplastic anemia, 20 cases of myelodysplastic syndrome (MDS) and 10 cases of other diseases. The high renal uptake was observed in patients not only with aplastic anemia but also with MDS. The renal uptake correlated with blood transfusion units, unsaturated iron binding capacity (UIBC), blood pool imaging and bone marrow uptake. The renal uptake correlated with UIBC better than with the blood transfusion units. Following mechanism of the renal uptake is proposed that frequent blood transfusion makes low UIBC, and the low UIBC causes the failure to chelate indium with transferrin. The fast blood clearance of un-chelated indium via kidneys is followed. Hypoplastic bone marrow may also play an important role for the high renal uptake because all patients with the high renal uptake could not be explained by above mentioned mechanism. Caution should be paid to the scans with the high renal uptake because both aplastic anemia and MDS patients show the high renal uptake. (author).

Value of renal cortical scintigraphy in children with acute pyelonephritis

International Nuclear Information System (INIS)

Paul, A.K.; Miah, M.S.R.; Rahman, H.A.; Hasan, M.H.

2004-01-01

Purpose: Acute pyelonephritis is a major cause of morbidity in children with urinary tract infection and can result in irreversible renal scarring leading to hypertension and end-stage renal disease. Tc-99m-dimercaptosuccinic acid (DMSA) scintigraphy is the imaging modality of choice for the detection of acute pyelonephhfis and renal scarfing. This study evaluated the importance of renal cortical scintigraphy to identify children at risk from renal damage due to acute pyelonephritis. Methods: Forty-nine children (ages 9 months to 11 years) with urinary tract infection having positive urine culture were studied. A DMSA scan was performed within 72 hours of receiving antibiotic during acute infection. Single or multiple areas of varying degrees of diminished cortical uptake or diffusely decreased uptake in an enlarged kidney was considered for the diagnosis of acute pyelonephrifis. Follow-up scintigraphy was done at 6 months of initial scan in children with acute pyelonephritis documented by DMSA scan. Renal scarring was considered if the affected kidney shows cortical thinning or focal cortical defect with loss of volume or become small kidney. Children with known renal tract abnormalities were excluded from the study. RESULTS: Twenty-seven children (55%) wine considered acute pyelonephritis by DMSA scintigraphy and the abnormality was bilateral in 17(63%) cases and unilateral in 10(37%) cases. Among these 44 abnormal kidneys, scintigraphy showed solitary defect in 29 kidneys, multiple defects in 6 kidneys and diffuse decreased uptake in 9 kidneys. Of them, twenty children were available for follow-up evaluation and scintigraphy demonstrated complete recovery in 21 of 34 (62%) kidneys and renal scarfing in 13 of 34 (38%) kidneys. Renal scarring was found in 5 of 7 kidneys (71%) with diffuse decreased uptake, 2 of 5 kidneys (40%) with multiple cortical defect and 6 of 22 (27%) with single focal detect. Conclusion: The scintigraphic pattern of acute pyelonephritis

Evaluation of separate renal function by means of 99mTc-aprotinin uptake test

International Nuclear Information System (INIS)

Aprile, C.; Saponaro, R.; Villa, G.; Carena, M.; Chiari, G.; Salvadeo, A.; Lunghi, F.; Piazza, V.

1986-01-01

The possibility that relative kidney uptake of technetium-99m aprotinin (TcA) might be indicative of separate renal function was investigated in 89 patients who underwent both effective renal plasma flow (ERPFs) and glomerular filtration rate (GFR) determination. A reference group consisted of 27 healthy volunteers, studied only with TcA. The correlation with ERPFs (r = .73) was similar to that previously reported and confirmed. The correlation with GFR (r = .68) was better if a subgroup of renal units with TcA uptake lower than 16% (lower normal limit) was considered. Most likely, glomerular filtration is a limiting factor of the tubular uptake of TcA, and when GFR is reduced, both parameters decrease in the same manner, while if GFR is normal the two parameters are relatively independent. The correlation between TcA and GFR in 32 children was very similar to that found in adults. TcA uptake test seems to be a useful indicator of separate renal function, providing morphological information at, the same time

Reversible diminished renal sup(99m)Tc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis

Energy Technology Data Exchange (ETDEWEB)

Kremer Hovinga, T K; Beukhof, J R; Donker, A J.M.; Luyk, W H.J. van; Piers, D A

1984-03-01

A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. sup(99m)Tc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of /sup 131/I hippurate was preserved. Uptake of sup(99m)Tc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. This, caution must be taken when interpreting results of sup(99m)Tc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of /sup 99/Tc-DMSA.

Reversible diminished renal sup(99m)Tc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis

International Nuclear Information System (INIS)

Kremer Hovinga, T.K.; Beukhof, J.R.; Donker, A.J.M.; Luyk, W.H.J. van; Piers, D.A.

1984-01-01

A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. sup(99m)Tc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of 131 I hippurate was preserved. Uptake of sup(99m)Tc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. This, caution must be taken when interpreting results of sup(99m)Tc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of 99 Tc-DMSA. (orig.)

Accuracy of contrast-enhanced dual-energy MDCT for the assessment of iodine uptake in renal lesions.

Science.gov (United States)

Mileto, Achille; Marin, Daniele; Ramirez-Giraldo, Juan Carlos; Scribano, Emanuele; Krauss, Bernhard; Mazziotti, Silvio; Ascenti, Giorgio

2014-05-01

The objective of our study was to assess the accuracy of iodine-related attenuation and iodine quantification as imaging biomarkers of iodine uptake in renal lesions on a single-phase nephrographic image with dual-energy MDCT. Fifty-nine patients (41 men, 18 women; age range, 28-84 years) with 80 renal lesions underwent contrast-enhanced dual-energy CT during the nephrographic phase of enhancement. Renal lesions were characterized as enhancing or nonenhancing on color-coded iodine overlay maps using iodine-related attenuation (in Hounsfield units) and iodine quantification (in milligrams per milliliter). For iodine-related attenuation the iodine uptake thresholds of 15 and 20 HU were tested; a threshold of 0.5 mg/mL was used for iodine quantification. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of iodine-related attenuation and iodine quantification were calculated from chi-square tests of contingency with histopathology or imaging follow-up as the reference standard. The 95% CIs were calculated from binomial expression. Differences in sensitivity and specificity were assessed by means of McNemar analysis. A significant difference in sensitivity and specificity was found between iodine-related attenuation with the thresholds of 15 HU (sensitivity, 91.4%; specificity, 93.3%; PPV, 91.4%; NPV, 93.3%) and 20 HU (sensitivity, 77.1%; specificity, 100%; PPV, 100%; NPV, 84.9%) (p = 0.008) and between iodine quantification (sensitivity, 100%; specificity, 97.7%; PPV, 97.2%; NPV, 100%) and iodine-related attenuation with a threshold of 20 HU (p = 0.004). No significant difference in sensitivity and specificity was found between iodine quantification and iodine-related attenuation with a threshold of 15 HU. Contrast-enhanced dual-energy MDCT with iodine-related attenuation and iodine quantification allows accurate evaluation of iodine uptake in renal lesions on a single-phase nephrographic image.

In vitro comparison of renal handling and uptake of two somatostatin receptor-specific peptides labeled with indium-111

International Nuclear Information System (INIS)

Trejtnar, F.; Novy, Z.; Petrik, M.; Laznickova, A.; Melicharova, L.; Vankova, M.; Laznicek, M.

2008-01-01

Radiolabeled receptor-specific somatostatin analogs labeled with gamma- or beta-emitting radionuclides are useful for scintigraphic imaging and/or therapy of selected neuroendocrine tumors. However, significant renal uptake may result in radiotoxicological injury of the kidney and can limit clinical application of the agents. The aim of the study was to analyze renal handling, rate, and mechanism of renal accumulation of two somatostatin receptor-targeted peptides, [DOTA 0 , Tyr 3 , Thr 8 ]-octreotide (DOTA-TATE) and [DOTA 0 , 1-Nal 3 ]-octreotide (DOTA-NOC), labeled with indium-111 using in vitro methods. The perfused rat kidney and freshly isolated rat renal cells were used as experimental models. The perfusion was performed in a recirculation regimen at constant pressure with solution containing bovine albumin, erythrocytes, and a mixture of essential substrates. The renal cells were isolated from rat kidneys using two-phase collagenase perfusion. Accumulation studies were used to evaluate the renal uptake of the peptides and to compare their accumulation with that of passively or actively transported model drugs. The influence of selected inhibitors of receptor-mediated endocytosis and the inhibition of energy-dependent transport processes on the uptake were also investigated using isolated renal cells. The renal clearance of 111 In-DOTA-NOC in the perfused rat kidney was significantly lower than that of 111 In-DOTA-TATE. Reverse situation was found in the case of renal retention. Pretreatment of the perfused kidney with maleate markedly decreased the renal retention. 111 In-DOTA-NOC was accumulated in the isolated renal cells at a higher rate than 111 In-DOTA-TATE (ratio 3:1). The uptake of the radiopeptides in renal cells was higher than the uptake of not only the passively transported sucrose but also actively transported and accumulated methylglucose. The rank order of potency to inhibit the uptake by active endocytosis was approximately aprotinin

Renal uptake and retention of radiolabeled somatostatin, bombesin, neurotensin, minigastrin and CCK analogues: species and gender differences

Energy Technology Data Exchange (ETDEWEB)

Melis, Marleen [Department of Nuclear Medicine, Erasmus MC Rotterdam, 3015 CE Rotterdam (Netherlands)], E-mail: m.melis@erasmusmc.nl; Krenning, Eric P.; Bernard, Bert F.; Visser, Monique de; Rolleman, Edgar; Jong, Marion de [Department of Nuclear Medicine, Erasmus MC Rotterdam, 3015 CE Rotterdam (Netherlands)

2007-08-15

Introduction: During therapy with radiolabeled peptides, the kidney is most often the critical organ. Newly developed peptides are evaluated preclinically in different animal models before their application in humans. In this study, the renal retention of several radiolabeled peptides was compared in male and female rats and mice. Methods: After intravenous injection of radiolabeled peptides [somatostatin, cholecystokinin (CCK), minigastrin, bombesin and neurotensin analogues], renal uptake was determined in both male and female Lewis rats and C57Bl mice. In addition, ex vivo autoradiography of renal sections was performed to localize accumulated radioactivity. Results: An equal distribution pattern of renal radioactivity was found for all peptides: high accumulation in the cortex, lower accumulation in the outer medulla and no radioactivity in the inner medulla of the kidneys. In both male rats and mice, an increasing renal uptake was found: [{sup 111}In-DTPA]CCK8<[{sup 111}In-DTPA-Pro{sup 1},Tyr{sup 4}]bombesin{approx}[{sup 111}In-DTPA] neurotensin<[{sup 111}In-DTPA]octreotide<<[{sup 111}In-DTPA]MG0. Renal uptake of [{sup 111}In-DTPA]octreotide in rats showed no gender difference, and renal radioactivity was about constant over time. In mice, however, renal uptake in females was significantly higher than that in males and decreased rapidly over time in both genders. Moreover, renal radioactivity in female mice injected with [{sup 111}In-DTPA]octreotide showed a different localization pattern. Conclusions: Regarding the renal uptake of different radiolabeled peptides, both species showed the same ranking order. Similar to findings in patients, rats showed comparable and constant renal retention of radioactivity in both genders, in contrast to mice. Therefore, rats appear to be the more favorable species for the study of the renal retention of radioactivity.

Renal uptake and retention of radiolabeled somatostatin, bombesin, neurotensin, minigastrin and CCK analogues: species and gender differences

International Nuclear Information System (INIS)

Melis, Marleen; Krenning, Eric P.; Bernard, Bert F.; Visser, Monique de; Rolleman, Edgar; Jong, Marion de

2007-01-01

Introduction: During therapy with radiolabeled peptides, the kidney is most often the critical organ. Newly developed peptides are evaluated preclinically in different animal models before their application in humans. In this study, the renal retention of several radiolabeled peptides was compared in male and female rats and mice. Methods: After intravenous injection of radiolabeled peptides [somatostatin, cholecystokinin (CCK), minigastrin, bombesin and neurotensin analogues], renal uptake was determined in both male and female Lewis rats and C57Bl mice. In addition, ex vivo autoradiography of renal sections was performed to localize accumulated radioactivity. Results: An equal distribution pattern of renal radioactivity was found for all peptides: high accumulation in the cortex, lower accumulation in the outer medulla and no radioactivity in the inner medulla of the kidneys. In both male rats and mice, an increasing renal uptake was found: [ 111 In-DTPA]CCK8 111 In-DTPA-Pro 1 ,Tyr 4 ]bombesin∼[ 111 In-DTPA] neurotensin 111 In-DTPA]octreotide 111 In-DTPA]MG0. Renal uptake of [ 111 In-DTPA]octreotide in rats showed no gender difference, and renal radioactivity was about constant over time. In mice, however, renal uptake in females was significantly higher than that in males and decreased rapidly over time in both genders. Moreover, renal radioactivity in female mice injected with [ 111 In-DTPA]octreotide showed a different localization pattern. Conclusions: Regarding the renal uptake of different radiolabeled peptides, both species showed the same ranking order. Similar to findings in patients, rats showed comparable and constant renal retention of radioactivity in both genders, in contrast to mice. Therefore, rats appear to be the more favorable species for the study of the renal retention of radioactivity

A comparison of deconvolution and the Rutland-Patlak plot in parenchymal renal uptake rate.

Science.gov (United States)

Al-Shakhrah, Issa A

2012-07-01

Deconvolution and the Rutland-Patlak (R-P) plot are two of the most commonly used methods for analyzing dynamic radionuclide renography. Both methods allow estimation of absolute and relative renal uptake of radiopharmaceutical and of its rate of transit through the kidney. Seventeen patients (32 kidneys) were referred for further evaluation by renal scanning. All patients were positioned supine with their backs to the scintillation gamma camera, so that the kidneys and the heart are both in the field of view. Approximately 5-7 mCi of (99m)Tc-DTPA (diethylinetriamine penta-acetic acid) in about 0.5 ml of saline is injected intravenously and sequential 20 s frames were acquired, the study on each patient lasts for approximately 20 min. The time-activity curves of the parenchymal region of interest of each kidney, as well as the heart were obtained for analysis. The data were then analyzed with deconvolution and the R-P plot. A strong positive association (n = 32; r = 0.83; R (2) = 0.68) was found between the values that obtained by applying the two methods. Bland-Altman statistical analysis demonstrated that ninety seven percent of the values in the study (31 cases from 32 cases, 97% of the cases) were within limits of agreement (mean ± 1.96 standard deviation). We believe that R-P analysis method is expected to be more reproducible than iterative deconvolution method, because the deconvolution technique (the iterative method) relies heavily on the accuracy of the first point analyzed, as any errors are carried forward into the calculations of all the subsequent points, whereas R-P technique is based on an initial analysis of the data by means of the R-P plot, and it can be considered as an alternative technique to find and calculate the renal uptake rate.

The value of dynamic renal 99Tcm-diethylene triamine penta acetic acid imaging in rabbits with acute upper urinary tract obstruction

International Nuclear Information System (INIS)

Yan Jun; Li Xianfeng; Wang Jin; Li Sijin; Liu Jianzhong; Cheng Yan; Wu Zhifeng

2008-01-01

Objective: To research the degression of renal function of 99 Tc m -diethylene triamine pentaaceticacid ( 99 Tc m -DTPA) renal imaging in rabbits with acute upper urinary tract obstruction and its early recovery after relief. Methods: Twenty-four health rabbit models with left acute upper urinary tract obstruction were built up. 99 Tc m -DTPA renal imaging was performed before making model and after obstruction 1, 3, 5-7 and more than 8 weeks respectively and 4 weeks after relief of obstruction. Results: After obstnrction 1 and 3 weeks, 99 Tc m -DTPA imaging showed development in left renal. Values of glomemlar filtration rate (GFR) and uptake ratio decreased, while time to reach the peak increased. These are obviously different compared with those before obstruction (t=2.916, t=7.034, P 99 Tc m -DTPA imagingshowed cortex developert. Values of GFR and uptake ratio decreased obvious, while time to reach the peak increased obviously. These are obviously different compared with those before obstruction (t=6.722, t=7.470, t=3.678, P 99 Tc m -DTPA imaging showed no obvious development. In those rabbits with durations of 1-3 weeks obstructions, the renal function could almost recover within 4 weeks after relief of obstruction. GRF is 31.23 ± 14.4 (t=2.627, P 0.05). With obstruction of 5-7 weeks, the GRF and uptake ratio, could recover partly to some extent. But with obstruction for more than 8 weeks, the renal function could not recover. Conclusions: For the acute upper urinary tract obstruction, the renal function is most remarkable decreased in the early time, and can be restored after lelief. For long time obstruction, even if relieved, the renal function is not easily to restore. The dynamic renal imaging can reflect the extent of the renal damage and its recovery, and could be used as a reliable indicator. (authors)

Prediction of the overall renal tubular secretion and hepatic clearance of anionic drugs and a renal drug-drug interaction involving organic anion transporter 3 in humans by in vitro uptake experiments.

Science.gov (United States)

Watanabe, Takao; Kusuhara, Hiroyuki; Watanabe, Tomoko; Debori, Yasuyuki; Maeda, Kazuya; Kondo, Tsunenori; Nakayama, Hideki; Horita, Shigeru; Ogilvie, Brian W; Parkinson, Andrew; Hu, Zhuohan; Sugiyama, Yuichi

2011-06-01

The present study investigated prediction of the overall renal tubular secretion and hepatic clearances of anionic drugs based on in vitro transport studies. The saturable uptake of eight drugs, most of which were OAT3 substrates (rosuvastatin, pravastatin, pitavastatin, valsartan, olmesartan, trichlormethiazide, p-aminohippurate, and benzylpenicillin) by freshly prepared human kidney slices underestimated the overall intrinsic clearance of the tubular secretion; therefore, a scaling factor of 10 was required for in vitro-in vivo extrapolation. We examined the effect of gemfibrozil and its metabolites, gemfibrozil glucuronide and the carboxylic metabolite, gemfibrozil M3, on pravastatin uptake by human kidney slices. The inhibition study using human kidney slices suggests that OAT3 plays a predominant role in the renal uptake of pravastatin. Comparison of unbound concentrations and K(i) values (1.5, 9.1, and 4.0 μM, for gemfibrozil, gemfibrozil glucuronide, and gemfibrozil M3, respectively) suggests that the mechanism of the interaction is due mainly to inhibition by gemfibrozil and gemfibrozil glucuronide. Furthermore, extrapolation of saturable uptake by cryopreserved human hepatocytes predicts clearance comparable with the observed hepatic clearance although fluvastatin and rosuvastatin required a scaling factor of 11 and 6.9, respectively. This study suggests that in vitro uptake assays using human kidney slices and hepatocytes provide a good prediction of the overall tubular secretion and hepatic clearances of anionic drugs and renal drug-drug interactions. It is also recommended that in vitro-in vivo extrapolation be performed in animals to obtain more reliable prediction.

Renal Localization of 67Ga Citrate in Noninfectious Nephritis

International Nuclear Information System (INIS)

Lee, Kang Wook; Jeong, Min Soo; Rhee, Sunn Kgoo; Kim, Sam Yong; Shin, Young Tai; Ro, Heung Kyu

1992-01-01

67 Ga citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of 67 Ga citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal 67 Ga uptake in kidneys were unknown. We undertook a study to determine the clinical value of 67 Ga citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=background activity;1=faint uptake greater than background; 2=definite uptake, but less than lumbar vertebrae;3 same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 68(62%) patients with noninfectious nephritis showed grade 2 or higher 67 Ga renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake. 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal 67 Ga uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal 67 Ga uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, 67 Ga citrate scan is useful in predicting renal involvement.

Reducing renal uptake of 9Y- and 177Lu-labeled alpha-melanocyte stimulating hormone peptide analogues

International Nuclear Information System (INIS)

Miao Yubin; Fisher, Darrell R.; Quinn, Thomas P.

2006-01-01

Objective: The purpose of this study was to improve the tumor-to-kidney uptake ratios of 9 Y- and 177 Lu-[1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-Re-Cys 3,4,1 , D-Phe 7 , Arg 11 ]α-melanocyte stimulating hormone 3-13 {DOTA-Re(Arg 11 )CCMSH} through coupling a negatively charged glutamic acid (Glu) to the peptide sequence. Methods: A new peptide of DOTA-Re(Glu 2 , Arg 11 )CCMSH was designed, synthesized and labeled with 9 Y and 177 Lu. Pharmacokinetics of 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH was determined in B16/F1 murine melanoma-bearing C57 mice. Results: 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH exhibited significantly (P 9 Y- and 177 Lu-DOTA-Re(Arg 11 )CCMSH at 30 min and at 2, 4 and 24 h after dose administration. The renal uptake values of 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH were 28.16% and 28.81% of those of 9 Y- and 177 Lu-DOTA-Re(Arg 11 )CCMSH, respectively, at 4 h postinjection. 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH displayed higher tumor-to-kidney uptake ratios than 9 Y- and 177 Lu-DOTA-Re(Arg 11 )CCMSH at 30 min and at 2, 4 and 24 h after dose administration. The tumor-to-kidney uptake ratio of 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH was 2.28 and 1.69 times of 9 Y- and 177 Lu-DOTA-Re(Arg 11 )CCMSH, respectively, at 4 h postinjection. The 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH activity accumulation was low in normal organs except for kidney. Conclusions: Coupling a negatively charged amino acid (Glu) to the CCMSH peptide sequence dramatically reduced the renal uptake values and increased the tumor-to-kidney uptake ratios of 9 Y- and 177 Lu-DOTA-Re(Glu 2 , Arg 11 )CCMSH, facilitating their potential applications as radiopharmaceuticals for targeted radionuclide therapy of melanoma

Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition

DEFF Research Database (Denmark)

Kamper, A L; Thomsen, H S; Nielsen, S L

1990-01-01

function. Scintigrams of the kidneys showed an unaltered distribution of DMSA during treatment. GFR estimated by 51Cr-EDTA plasma clearance fell by 14% (P less than 0.01), but renal uptake of 99mTc-DMSA increased by 10% (P less than 0.01). It is concluded that DMSA in chronic renal failure is mainly taken......Glomerular filtration rate (GFR) and renal uptake of dimercaptosuccinic acid (DMSA) were measured in 31 patients with progressive chronic nephropathy before and immediately after the start of treatment with angiotensin converting enzyme (ACE) inhibitor in order to control adverse effects on kidney...

Determination of maximum physiologic thyroid uptake and correlation with 24-hour RAI uptake value

International Nuclear Information System (INIS)

Duldulao, M.; Obaldo, J.

2007-01-01

Full text: In hyperthyroid patients, thyroid uptake values are overestimated, sometimes approaching or exceeding 100%. This is physiologically and mathematically impossible. This study was undertaken to determine the maximum physiologic thyroid uptake value through a proposed simple method using a gamma camera. Methodology: Twenty-two patients (17 females and 5 males), with ages ranging from 19-61 y/o (mean age ± SD; 41 ± 12), with 24-hour uptake value of >50%, clinically hyperthyroid and referred for subsequent radioactive iodine therapy were studied. The computed maximum physiologic thyroid uptake was compared with the 24-hour uptake using the paired Student t-test and evaluated using linear regression analysis. Results: The computed physiologic uptake correlated poorly with the 24-hour uptake value. However, in the male subgroup, there was no statistically significant difference between the two (p=0.77). Linear regression analysis gives the following relationship: physiologic uptake (%) = 77.76 - 0.284 (24-hour RAI uptake value). Conclusion: Provided that proper regions of interest are applied with correct attenuation and background subtraction, determination of physiologic thyroid uptake may be obtained using the proposed method. This simple method may be useful prior to I-131 therapy for hyperthyroidism especially when a single uptake determination is performed. (author)

Renal Localization of {sup 67}Ga Citrate in Noninfectious Nephritis

Energy Technology Data Exchange (ETDEWEB)

Lee, Kang Wook; Jeong, Min Soo; Rhee, Sunn Kgoo; Kim, Sam Yong; Shin, Young Tai; Ro, Heung Kyu [Chungnam University College of Medicine, Deajeon (Korea, Republic of)

1992-07-15

{sup 67}Ga citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of {sup 67}Ga citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal {sup 67}Ga uptake in kidneys were unknown. We undertook a study to determine the clinical value of {sup 67}Ga citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=background activity;1=faint uptake greater than background; 2=definite uptake, but less than lumbar vertebrae;3 same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 68(62%) patients with noninfectious nephritis showed grade 2 or higher {sup 67}Ga renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake. 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal {sup 67}Ga uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal {sup 67}Ga uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, {sup 67}Ga citrate scan is useful in predicting renal involvement.

Studies on renal function in the elderly by analysis of radioisotope renal images

International Nuclear Information System (INIS)

Ohishi, Yukihiko

1990-01-01

This study was carried out to evaluate the potential of radionuclide renal imagings for examining senile renal function in a total of 178 subjects. Single photon emission computed tomography (SPECT) with Tc-99m-dimercaptosuccinic acid (Tc-DMSA) was performed in the senile group (60-87 years) and in the adult group to determine renal uptake rate of Tc-DMSA and renal volume. Renography studies with I-131 hippuran (n=100) and Tc-99m diethylentriaminepentaacetic acid (Tc-DTPA) (n=20) were also performed for deconvolution analysis. Mean transit time (MTT) was mainly assessed as one of the retention function parameters. Blood residual rates (R15%) at fifteen minutes were also investigated. Renal volume and renal uptake rate for healthy persons were significantly lower in the senile group (n=17) than the adult group (n=24), 205±50 ml vs 225±27 ml; and 22±5% vs 26±2%. I-133 hippuran renography in healthy persons (n=35) showed a tendency toward higher MTT values with aging; however, there was no significant difference among age groups. R15%, obtained by I-133 hippuran renograms, tended to be higher with aging in age groups of persons younger than 70 years. A decreased number of effective nephrons was considered to result in higher R15% values even when aged persons had normal MTT values of I-131 hippuran. Split renal function values for healthy persons, calculated by the two radionuclide imagings, were lower in the senile group than the adult group, suggesting the usefulness of radionuclide imagings in renal function examination. (N.K.)

Standardized uptake values of fluorine-18 fluorodeoxyglucose: the value of different normalization procedures

International Nuclear Information System (INIS)

Schomburg, A.; Bender, H.; Reichel, C.; Sommer, T.; Ruhlmann, J.; Kozak, B.; Biersack, H.J.

1996-01-01

While the evident advantages of absolute metabolic rate determinations cannot be equalled by static image analysis of fluorine-18 fluorodexyglucose positron emission tomographic (FDG PET) studies, various algorithms for the normalization of static FDG uptake values have been proposed. This study was performed to compare different normalization procedures in terms of dependency on individual patient characteristics. Standardized FDG uptake values (SUVs) were calculated for liver and lung tissue in 126 patients studied with whole-body FDG PET. Uptake values were normalized for total body weight, lean body mass and body surface area. Ranges, means, medians, standard deviations and variation coefficients of these SUV parameters were calculated and their interdependency with total body weight, lean body mass, body surface area, patient height and blood sugar levels was calculated by means of regression analysis. Standardized FDG uptake values normalized for body surface area were clearly superior to SUV parameters normalized for total body weight or lean body mass. Variation and correlation coefficients of body surface area-normalized uptake values were minimal when compared with SUV parameters derived from the other normalization procedures. Normalization for total body weight resulted in uptake values still dependent on body weight and blood sugar levels, while normalization for lean body mass did not eliminate the positive correlation with lean body mass and patient height. It is concluded that normalization of FDG uptake values for body surface area is less dependent on the individual patient characteristics than are FDG uptake values normalized for other parameters, and therefore appears to be preferable for FDG PET studies in oncology. (orig.)

Gallium-67-labeled lactam bridge-cyclized alpha-MSH peptides with enhanced melanoma uptake and reduced renal uptake.

Science.gov (United States)

Guo, Haixun; Gallazzi, Fabio; Miao, Yubin

2012-06-20

The purpose of this study was to examine the melanoma targeting and pharmacokinetic properties of (67)Ga-DOTA-GGNle-CycMSHhex {(67)Ga-1,4,7,10-tetraazacyclononane-1,4,7,10-tetraacetic acid-Gly-Gly-Nle-c[Asp-His-DPhe-Arg-Trp-Lys]-CONH2} and (67)Ga-NOTA-GGNle-CycMSHhex {(67)Ga-1,4,7-triazacyclononane-1,4,7-triacetic acid-Gly-Gly-Nle-c[Asp-His-DPhe-Arg-Trp-Lys]-CONH2} and compare with (67)Ga-DOTA-GlyGlu-CycMSH {(67)Ga-DOTA-Gly-Glu-c[Lys-Nle-Glu-His-DPhe-Arg-Trp-Gly-Arg-Pro-Val-Asp]} we previously reported. DOTA-GGNle-CycMSHhex and NOTA-GGNle-CycMSHhex were synthesized using fluorenylmethyloxy carbonyl (Fmoc) chemistry. The melanocortin-1 (MC1) receptor binding affinity of NOTA-GGNle-CycMSHhex was determined in B16/F1 melanoma cells and compared with DOTA-GGNle-CycMSHhex. The melanoma targeting and pharmacokinetic properties of (67)Ga-NOTA-GGNle-CycMSHhex and (67)Ga-DOTA-GGNle-CycMSHhex were determined in B16/F1 melanoma-bearing C57 mice. NOTA-GGNle-CycMSHhex and DOTA-GGNle-CycMSHhex displayed comparable MC1 receptor binding affinities (1.6 vs 2.1 nM) in B16/F1 melanoma cells. Both (67)Ga-NOTA-GGNle-CycMSHhex and (67)Ga-DOTA-GGNle-CycMSHhex exhibited dramatically enhanced melanoma uptake and reduced renal uptake than (67)Ga-DOTA-GlyGlu-CycMSH in B16/F1 melanoma-bearing C57 mice. Furthermore, (67)Ga-NOTA-GGNle-CycMSHhex exhibited more favorable radiolabeling conditions (>85% radiolabeling yields started at 37 °C), as well as higher tumor/kidney uptake ratios than (67)Ga-DOTA-GGNle-CycMSHhex at 0.5, 2, and 24 h postinjection. High melanoma uptake coupled with low renal uptake highlighted the potential of (67)Ga-NOTA-GGNle-CycMSHhex for melanoma imaging and therapy.

Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition

International Nuclear Information System (INIS)

Kamper, A.L.; Thomsen, H.S.; Nielsen, S.L.; Strandgaard, S.; Herlev Hospital

1990-01-01

Glomerular filtration rate (GFR) and renal uptake of dimercaptosuccinic acid (DMSA) were measured in 31 patients with progressive chronic nephropathy before and immediately after the start of treatment with angiotensin converting enzyme (ACE) inhibitor in order to control adverse effects on kidney function. Scintigrams of the kidneys showed an unaltered distribution of DMSA during treatment. GFR estimated by 51 Cr-EDTA plasma clearance fell by 14% (P 99m Tc-DMSA increased by 10% (P<0.01). It is concluded that DMSA in chronic renal failure is mainly taken up by the tubular cells from the peritubular capillaries since the uptake was unaffected by the acute decrease in GFR. (orig.)

Renal function study assessed by 99mTc-DMSA renal scintigraphy before and after PNL

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Okuno, Toshiyuki; Sugimura, Yoshiki; Yamakawa, Kensuke; Yanagawa, Makoto; Tajima, Kazuhiro; Tochigi, Hiromi; Kawamura, Juichi

1990-01-01

99m Tc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2±6.0% from 18.2±6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6±8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2±9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6±11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL. It is concluded that although renal function slightly decreased 4-8 weeks after PNL, it is expected to improve within one year after PNL. But in the case with a cold area on the renal image, the complete functional recovery would not be expected. 99m Tc-DMSA renal scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

The renal quantitative scintillation camera study for determination of renal function

International Nuclear Information System (INIS)

Thompson, I.M. Jr.; Boineau, F.G.; Evans, B.B.; Schlegel, J.U.

1983-01-01

The renal quantitative scintillation camera study assesses glomerular filtration rate and effective renal plasma flow based upon renal uptake of 99mtechnetium-iron ascorbate and 131iodine-hippuran, respectively. The method was compared to inulin, para-aminohippuric acid and creatinine clearance studies in 7 normal subjects and 9 patients with various degrees of reduced renal function. The reproducibility of the technique was determined in 15 randomly selected pediatric patients. The values of glomerular filtration rate and effective renal plasma flow were not significantly different from those of inulin and para-aminohippuric acid studies. The reproducibility of the technique was comparable to that of inulin and para-aminohippuric acid studies. Patient acceptance of the technique is excellent and the cost is minimal. Renal morphology and excretory dynamics also are demonstrated. The technique is advocated as a clinical measure of renal function

Late pancreatic metastasis of renal cell carcinoma with absence of FDG-uptake in PET-CT

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Elif Karadeli

2016-03-01

Full Text Available The primary tumors, which raise isolated pancreas metastases are frequently of renal origin, where colorectal cancer, melanoma, breast and lung cancers and sarcoma are the following causes of metastatic pancreas cancer . In this article, we present a case of pancreas-metastatic renal cell carcinoma with its radiological features, which did not exert anF-18 FDG-uptake in the whole-body positron emission tomography (PET. [Cukurova Med J 2016; 41(0.100: 92-94

Tc-99m glucoheptonate (GHA) renal uptake: Influence of biochemical and physiologic factors

International Nuclear Information System (INIS)

Lee, H.B.; Blaufox, M.D.

1984-01-01

Tc-99m-GHA is widely used for renal imaging but little is known about its handling by the kidney. Simultaneous single injection clearances of Tc-99m-GHA and I-125 Iothalamate were performed on 60 Sprague-Dawley female rats divided among six groups: I Control; II Dehydrated; III Mannitol infusion; IV Probenecid; V Alkaline urine (sodium bicarbonate); and VI Acid urine (ammonium chloride). Plasma concentration and urine excretion were followed during 80 minutes post injection. The livers and kidneys were removed and counted 120 minutes post injection. Total clearance of GHA was lower than Iothalamate in controls (0.90 +- 0.24 S.D. ml/min/100gr vs 1.47 +- 0.18, p < 0.005) but clearance of the protein free supernate was higher (1.67 +- 0.28 p=N.S.) raising a possibility of degree of tubular secretion. Unlike Tc-99m-Dimercaptosuccinic acid (DMSA) acidification of the urine appeared to have no effect on the amount of GHA in the urine (66.1 +- 6.35% Inj. dose vs 67.19 +- 6.05 p=n.s.) and hepatic uptake was minimal in all groups averaging less than 1%. Kidney uptake of GHA was 11.16 +- 1.53 (% Inj. dose) in controls. This varied slightly among groups but was markedly reduced by Probenecid blockade (4.08 +- 1.75, p < 0.0005). It appears that liver uptake of GHA is minimal, the non-protein bound fraction is freely filtered and its clearance correlates significantly with the GFR. Importantly renal accumulation of GHA is blocked by probenecid suggesting that it is actively concentrated in the proximal tubule by the enzyme system involved in PAH and Hippuran transport. It thus appears that measurement of renal function with GHA represents a different aspect of function than DMSA

The 64-MSCT study of relationship between renal corticomedullary differentiation, contrast between renal cortex and medulla, renal cortex and medulla CT peak value with the single renal function in hydronephrotic kidney

International Nuclear Information System (INIS)

Wang Yunhua; Hou Weiwei; Liu Ruihong; He Jianjun; Zhi Ke

2009-01-01

Objective: To study 64-MSCT perfusion imaging features about renal corticomedullary differentiation, contrast between renal cortex and medulla (CMC), renal cortex and medulla CT peak value in normal and hydronephrotic kidneys, and to explore the relationship between them and the unilateral renal function. Methods: Thirty-six patients with obstructive nephrohydrosis underwent 64-MSCT perfusion scanning. The split renal glomerular filtration rates (GFR) of their kidneys were measured by SPECT renal dynamic imaging. The 72 kidneys were divided into groups of normal renal function group, mild and severe renal impairment groups according to GFR. Renal corticomedullary differentiation on CT images was graded as clear, obscure, part clear. The CT intensity of cortex and medulla was measured in order to calculate contrast between renal cortex and medulla (CMC). Using Pearson correlation test, the correlation between them and renal GFR were examined. Results: (1) In the 24 kidneys of normal group, all kidneys showed clear CMD. In the 21 kidneys of mild renal impairment group, 14 kidneys showed clear CMD, 2 showed obscure CMD and 5 showed part clear of CMD. In the 27 kidneys of severe renal impairment group, 7 kidneys showed clear CMD, 5 showed obscure CMD and 15 showed part clear of CMD. (2)The CMC of normal group was 0.62 ± 0.20, while it was 0.52 ± 0.14 and 0.37 ± 0.11 for mild renal impairment group and severe renal impairment group CMC respectively. The CMC had positive linear correlation with GFR (r=0.536,P<0.05). (3) The renal cortex and medulla CT peak value of normal group were (133 ± 22) and (104 ± 16) HU; The renal cortex and medulla CT peak value of mild renal impairment group were (91 ± 29) and (76 ± 25) HU; The renal cortex and medulla CT peak value of severe renal impairment group were (68 ± 24) and (57 ± 21) HU(F=42.76 and 32.68,P<0.05). The renal cortex and medulla CT peak value had positive linear correlation with GFR (r=0.672 and 0.623, P<0

Bone scintigraphy in renal osteopathy

International Nuclear Information System (INIS)

Hermann, H.J.; Gahl, G.; Freie Univ. Berlin

1976-01-01

25 patients with chronic renal disease are investigated. In 16 cases with conservative treatment the bone scintigram showed pathological uptake according to the creatinine level, mainly in the joints of iliosacrum, hip, knee and ankles. In three patients increased uptake in the skull was found. The bone uptake found by scintigraphy was highly pronounced in the patients treated by dialysis. The most frequently involved regions were the joints of iliocacrum and hip, facial cranium, skull, pelvis and metatarsus. The count-rate ratio of cranium to chest was significantly increased in 6 patients. The investigations 6 months later showed in 4 cases a further increase compared with the first values. Count-rates of the skull were found to be comparable to the highly increased uptake in Paget's disease. Bone scintigraphy is a suitable method to estimate semiquantitatively the bone turnover in renal disease. (orig.) [de

Renal function maturation in children: is normalization to surface area valid?

International Nuclear Information System (INIS)

Rutland, M.D.; Hassan, I.M.; Que, L.

1999-01-01

Full text: Gamma camera DTPA renograms were analysed to measure renal function by the rate at which the kidneys took up tracer from the blood. This was expressed either directly as the fractional uptake rate (FUR), which is not related to body size, or it was converted to a camera-based GFR by the formula GFR blood volume x FUR, and this GFR was normalized to a body surface area of 1.73 m2. Most of the patients studied had one completely normal kidney, and one kidney with reflux but normal function and no large scars. The completely normal kidneys contributed, on average, 50% of the total renal function. The results were considered in age bands, to display the effect of age on renal function. The camera-GFR measurements showed the conventional results of poor renal function in early childhood, with a slow rise to near-adult values by the age of 2 years, and somewhat low values throughout childhood. The uptake values showed a different pattern, with renal function rising to adult equivalent values by the age of 4 months, and with children having better renal function than adults throughout most of their childhood. The standard deviations expressed as coefficients of variation (CV) were smaller for the FUR technique than the GFR (Wilcoxon rank test, P < 0.01). These results resemble recent published measurements of absolute DMSA uptake, which are also unrelated to body size and show early renal maturation. The results also suggest that the reason children have lower serum creatinine levels than adults is that they have better renal function. If this were confirmed, it would raise doubts about the usefulness of normalizing renal function to body surface area in children

Development and preclinical characterisation of 99mTc-labelled Affibody molecules with reduced renal uptake

International Nuclear Information System (INIS)

Ekblad, Torun; Karlstroem, Amelie Eriksson; Tran, Thuy; Orlova, Anna; Feldwisch, Joachim; Widstroem, Charles; Abrahmsen, Lars; Wennborg, Anders; Tolmachev, Vladimir

2008-01-01

Affibody molecules are low molecular weight proteins (7 kDa), which can be selected to bind to tumour-associated target proteins with subnanomolar affinity. Because of rapid tumour localisation and clearance from nonspecific compartments, Affibody molecules are promising tracers for molecular imaging. Earlier, 99m Tc-labelled Affibody molecules demonstrated specific targeting of tumour xenografts. However, the biodistribution was suboptimal either because of hepatobiliary excretion or high renal uptake of the radioactivity. The goal of this study was to optimise the biodistribution of Affibody molecules by chelator engineering. Anti-HER2 Z HER2:342 Affibody molecules, carrying the mercaptoacetyl-glutamyl-seryl-glutamyl (maESE), mercaptoacetyl-glutamyl-glutamyl-seryl (maEES) and mercaptoacetyl-seryl-glutamyl-glutamyl (maSEE) chelators, were prepared by peptide synthesis and labelled with 99m Tc. The tumour-targeting capacity of these conjugates was compared with each other and with the best previously available conjugate, 99m Tc-maEEE-Z HER2:342, in nude mice bearing SKOV-3 xenografts. The tumour-targeting capacity of the most promising conjugate, 99m Tc-maESE-Z HER2:342, was compared with radioiodinated Z HER2:342 . All novel conjugates demonstrated successful tumour targeting and a low degree of hepatobiliary excretion. The renal uptakes of serine-containing conjugates, 33±5, 68±21 and 71±10%IA/g, for 99m Tc-maESE-Z HER2:342 , 99m Tc-maEES-Z HER2:342 and 99m Tc-maSEE-Z HER2:342 , respectively, were significantly reduced in comparison with 99m Tc-maEEE-Z HER2:342 (102 ± 13%IA/g). For 99m Tc-maESE-Z HER2:342 , a tumour uptake of 9.6±1.8%IA/g and a tumour-to-blood ratio of 58±6 were reached at 4 h p.i. A combination of serine and glutamic acid residues in the chelator sequence confers increased renal excretion and relatively low renal uptake of 99m Tc-labelled Affibody molecules. In combination with preserved targeting capacity, this improved imaging of targets

Ultrasonographically determined renal values and comparisons to serum biochemistry renal variables in aged semi-captive cheetahs (Acinonyx jubatus).

Science.gov (United States)

Kirberger, Robert M; Tordiffe, Adrian S W

2017-11-06

Cheetahs in captivity have a high prevalence of chronic renal diseases. We ultrasonographically evaluated the renal volumes, a variety of renal dimensions, interarcuate artery resistive indices (RI) as well as aortic diameters and the length of the ventral aspect of the 6th lumbar vertebrae in 27 aged semi-captive anesthetized cheetahs. Renal size, dimensions and ratios were compared to urine specific gravity, serum creatinine and urea values. There were minimal differences for all values between left and right kidneys. Mean kidney length was 65.1 mm (range 55.2-76.9) with left kidney length ratios to L6 length being 1.60 (range 1.27-2.06) and to the aortic diameter 7.69 (range 4.54-10.72). Significant correlations between left renal length as well as length:L6 ratio to creatinine values were found ((r - 0.66) and (r - 0.60) respectively). The mean RI values of the different sedation/anesthetic protocols ranged from 0.46-0.55. Left renal length and L6 ventral vertebral body length as well as left kidney RI values should be routinely measured in all cheetah abdominal ultrasound examinations. These measurements, together with serum creatinine, urea and urine specific gravity values may be relatively sensitive indicators of early renal pathology in the absence of gross ultrasonographic changes.

Padronização do método para cálculo da captação renal absoluta do99mTc-DMSA em cria Standardization of a method to calculate absolute renal uptake of 99mTc-DMSA in children

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Carla Rachel Ono

2006-02-01

Full Text Available OBJETIVO: O trabalho teve por objetivo padronizar o método e estabelecer valores normais da captação renal absoluta do99mTc-DMSA em crianças. MATERIAIS E MÉTODOS: Vinte e duas crianças (idade de 7 meses a 10 anos; média de 4,5 anos sem doença renal prévia foram submetidas a cintilografia renal estática com 99mTc-DMSA. Dezoito apresentavam ultra-sonografia, uretrocistografia miccional, "clearance" de creatinina e padrão visual da cintilografia renal estática normais. Quatro crianças foram excluídas por não terem completado ou por apresentarem redução do "clearance" de creatinina. A captação absoluta de DMSA (DMSA-Abs foi calculada como a porcentagem da atividade administrada retida em cada rim após seis horas da administração do radiofármaco. RESULTADOS: Os valores de DMSA-Abs foram de 21,8% ± 3,2% para o rim direito e de 23,1% ± 3,3% para o rim esquerdo. Os valores da captação absoluta não mostraram correlação com a idade dos pacientes estudados, apesar da tendência de aumento do "clearance" de creatinina com a idade. CONCLUSÃO: A definição de valores normais da DMSA-Abs permite o emprego deste parâmetro na avaliação inicial e acompanhamento de doenças renais, principalmente em pacientes com acometimento bilateral ou com rim único (nos quais a função diferencial direita X esquerda tem valor limitado.OBJECTIVE: To standardize a method and determine normal values for absolute renal uptake of 99mTc-DMSA in children with normal creatinine clearance. MATERIALS AND METHODS: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years without clinical evidence of renal disease were studied using 99mTc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99mTc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance

Renal handling of technetium-99m DMSA: Evidence for glomerular filtration and peritubular uptake

International Nuclear Information System (INIS)

de Lange, M.J.; Piers, D.A.; Kosterink, J.G.; van Luijk, W.H.; Meijer, S.; de Zeeuw, D.; van der Hem, G.K.

1989-01-01

The finding of an enhanced excretion of [ 99m Tc]dimercaptosuccinic acid (DMSA) in patients with tubular reabsorption disorders prompted us to investigate the role of filtration in the renal handling of [ 99m Tc]DMSA. Our studies in human serum indicated that binding to serum proteins was approximately 90%. Chromatography of human urine and studies in rats showed that the complex was excreted unaltered into the urine. Renal extraction of [ 99m Tc]DMSA in a human volunteer was 5.8%. Continuous infusion of [ 99m Tc]DMSA in 13 individuals with normal renal function gave the following results (mean +/- s.d.): plasma clearance of [ 99m Tc]DMSA 34 +/- 4 ml/min, urinary clearance of [ 99m Tc]DMSA 12 +/- 3 ml/min. The calculated filtered load of [ 99m Tc]DMSA closely resembled the urinary clearance, whereas the plasma clearance was about three times faster. This indicates that peritubular uptake accounts for approximately 65% and filtration for approximately 35% of the renal handling of [ 99m Tc]DMSA

Cellular transport of l-arginine determines renal medullary blood flow in control rats, but not in diabetic rats despite enhanced cellular uptake capacity.

Science.gov (United States)

Persson, Patrik; Fasching, Angelica; Teerlink, Tom; Hansell, Peter; Palm, Fredrik

2017-02-01

Diabetes mellitus is associated with decreased nitric oxide bioavailability thereby affecting renal blood flow regulation. Previous reports have demonstrated that cellular uptake of l-arginine is rate limiting for nitric oxide production and that plasma l-arginine concentration is decreased in diabetes. We therefore investigated whether regional renal blood flow regulation is affected by cellular l-arginine uptake in streptozotocin-induced diabetic rats. Rats were anesthetized with thiobutabarbital, and the left kidney was exposed. Total, cortical, and medullary renal blood flow was investigated before and after renal artery infusion of increasing doses of either l-homoarginine to inhibit cellular uptake of l-arginine or N ω -nitro- l-arginine methyl ester (l-NAME) to inhibit nitric oxide synthase. l-Homoarginine infusion did not affect total or cortical blood flow in any of the groups, but caused a dose-dependent reduction in medullary blood flow. l-NAME decreased total, cortical and medullary blood flow in both groups. However, the reductions in medullary blood flow in response to both l-homoarginine and l-NAME were more pronounced in the control groups compared with the diabetic groups. Isolated cortical tubular cells displayed similar l-arginine uptake capacity whereas medullary tubular cells isolated from diabetic rats had increased l-arginine uptake capacity. Diabetics had reduced l-arginine concentrations in plasma and medullary tissue but increased l-arginine concentration in cortical tissue. In conclusion, the reduced l-arginine availability in plasma and medullary tissue in diabetes results in reduced nitric oxide-mediated regulation of renal medullary hemodynamics. Cortical blood flow regulation displays less dependency on extracellular l-arginine and the upregulated cortical tissue l-arginine may protect cortical hemodynamics in diabetes. Copyright © 2017 the American Physiological Society.

99mTc-HMDP Bone Uptake Quantification and Plasma Osteocalcin, PTH Levels in Hemodialysis Patients

International Nuclear Information System (INIS)

Kim, Euy Neyng; Sohn, Hyung Sun; Bang, Chan Young; Chung, Soo Kyo; Kim, Choon Yul; Shinn, Kyung Sub; Park, Chul Whee; Chang, Yoon Sik

1996-01-01

In this preliminary study, plasma osteocalcin, PTH level and Tc-99m-HMDP (hydro-xymetylene diphosphonate) bone uptake(BU) were measured in 14 patients with chronic end-stage renal failure who were on maintenance hemodialysis. The aim of this study was to determine the difference of bone uptake between renal failure patients and normal volunteers, and to determine the correlation between bone uptake and osteocalcin a sensitive and specific marker of osteoblastic activity and PTH-a important hormone of bone metabolism. There was a statistically significant increase in 180 minute uptake in the patient group when compared to the normal volunteers while there was no statistically significant difference in 20 minute uptake. Plasma osteocalcin and PTH levels were also significantly elevated compared to normal values. But the correlation between osteocalcin, PTH and 20 and 180 minute bone uptake was not significant. In conclusion, our preliminary study suggests that, in chronic renal failure patients, 180 minute Tc-99m-HMDP bone uptake is increased significantly without direct correlation with serum osteocalcin or PTH levels. It seems that further study is needed to evaluate other unknown factors that may influence the direct correlation between bone uptake and plasma osteocalcin and PTH in patients with chronic renal failure.

Reduction of {sup 68}Ga-PSMA renal uptake with mannitol infusion. Preliminary results

Energy Technology Data Exchange (ETDEWEB)

Matteucci, Federica; Caroli, Paola; Celli, Monica; Fantini, Lorenzo; Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine Unit, Meldola (Italy); Mezzenga, Emilio; Sarnelli, Anna [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Medical Physics Unit, Meldola (Italy); Di Iorio, Valentina [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Oncology Pharmacy, Meldola (Italy); Moretti, Andrea; Galassi, Riccardo [AUSL Romagna, Nuclear Medicine Unit, Forli (Italy); De Giorgi, Ugo [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Department of Medical Oncology, Meldola (Italy)

2017-12-15

Urea-based prostate-specific membrane antigen (PSMA) ligands labelled with {sup 68}Ga or {sup 177}Lu are new tracers with great potential for theranostic approaches in prostate cancer. However, clinical studies have shown that the kidneys are one of the off-target organs along with the salivary and lacrimal glands. In the kidneys, PSMA is physiologically expressed in the apical epithelium of the proximal tubules, and mannitol acts as an osmotic diuretic in these tubules. We investigated the potential of mannitol to reduce renal uptake of {sup 68}Ga-PSMA. Kidney uptake (SUVmax) was calculated in nine patients undergoing {sup 68}Ga-PSMA PET/CT at baseline (b-PET/CT) and after intravenous infusion of 500 ml of 10% mannitol (m-PET/CT). Two different infusion schemes for mannitol were used: (1) 500 ml mannitol was infused over 40 min after {sup 68}Ga-PSMA administration (A-infusion) and (2) 250 ml mannitol was infused over 15 min before and again after {sup 68}Ga-PSMA administration (B-infusion). In patients receiving the A-infusion, mean SUV{sub max} increased by 11.9% and 7.4% in the right and left kidney, respectively. In patients receiving the B-infusion, mean SUV{sub max} decreased by 24.3% and 22.4% in the right and left kidney, respectively. Our preliminary findings indicate that mannitol may play a role in reducing off-target {sup 68}Ga-PSMA renal uptake. Administration of the osmotic diuretic should be rapid and start before {sup 68}Ga-PSMA injection. These results warrant dosimetric studies in patients treated with {sup 177}Lu-PSMA to find the best scheme for mannitol administration. (orig.)

Uses and limitations of renal scintigraphy in renal transplantation monitoring

International Nuclear Information System (INIS)

Heaf, J.G.; Iversen, J.

2000-01-01

The value of thrice weekly technetium-99m mercaptoacetyltriglycine renography after renal transplantation was investigated in 213 consecutive transplants. A grading system was used: 0 = normal renogram; 1 = normal uptake, reduced excretion; 2 = normal uptake, flat excretion curve; 3 = rising curve; 4 = reduced rate of uptake, rising curve and reduced absolute uptake; 5 = minimal uptake. The initial renogram grade (RG) was primarily a marker of ischaemic damage, being poorer with cadaver donation, long cold ischaemia (>24 h), and high donor and recipient age. High primary RG predicted primary graft non-function, long time to graft function, low discharge Cr EDTA clearance and low 1- and 5-year graft survival. Discharge RG predicted late (>6 months) graft loss. RG was highly correlated (P<0.001) with creatinine and creatinine clearance, and changes in RG were correlated with changes in renal function. A change in RG of 0.5 was non-specific, while a change of 1 or more predicted clinical complications in 95% of cases. The negative predictive value was low (58%). RG change antedated clinical diagnosis in only 38% of cases, and in only 14% of acute rejections did an RG change of 1 or more antedate a rising creatinine. RG did not contribute to the differential diagnosis between acute rejection, acute tubulointerstitial nephropathy and cyclosporine toxicity. In conclusion, an initial renography after transplantation is valuable as it measures ischaemic damage and predicts duration of graft non-function and both short and long-term graft survival. A review of the literature suggests that the indication for serial scintigraphic monitoring for functioning grafts is less certain: the diagnostic specificity is insufficient for it to be the definitive investigation for common diagnostic problems and it does not give sufficient advance warning of impending problems. (orig.)

Influences of renal stone surgeries on renal function; Evaluation of renal function with sup 99m Tc-DMSA renal scintigraphy

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Katayama, Yasushi (Niigata Univ. (Japan). School of Medicine)

1991-10-01

From 1984 to 1990, {sup 99m}Tc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94{+-}5.60%) was significantly lower than that of PNL (-0.06{+-}3.92%), pyelolithotomy (-4.08{+-}4.79%) (p<0.01) and ESWL (-7.72{+-}3.87%) (p<0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80{+-}4.21% nephrolithotomy 4.67{+-}4.73%, pyelolithotomy -1.46{+-}5.39% and ESWL -2.02{+-}4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possibility of deterioration of renal function after ESWL was suggested. (author).

Renal function study by sup(99m)Tc-DMSA renal scintigraphy in non-obstructive upper urinary tract infection

International Nuclear Information System (INIS)

Kawamura, Juichi; Itoh, Hitoshi; Wang, Pan-Chin; Hosokawa, Shinichi; Yoshida, Osamu

1979-01-01

Kidney function study was carried out in 90 patients with non-obstructive upper urinary tract infection using sup(99m)Tc-DMSA (dimercaptosuccinic acid) renal scintigraphy. sup(99m)Tc-DMSA renal scintigram demonstrated well pyelonephritic cortical lesions which were not easily visualized on IVP. A variety of sup(99m)Tc-DMSA renal uptake paralleled the grading of pyelonephritic changes in IVP, however, there was a discrepancy between some of grade II pyelonephritic changes in reflux kidneys and DMSA renal uptake. This may be partly attributed to hydrodynamic effects of VUR in addition to inflammatory changes. The severity of reflux and changes in pelviocaliceal system on VCG also paralleled DMSA renal uptake in reflux kidneys. A ratio of sup(99m)Tc-DMSA renal uptake in the healthy side to that in pathological side was observed in 23 cases with VUR before and after the anti-VUR operation was performed. In patients with more than 3.5 of preoperative DMSA uptake ratio, there were few increments postoperatively in kidney functions of the pathological side, while the contralateral healthy kidney showed a compensatory increase in kidney function. This DMSA renal uptake ratio between healthy and pathological side seems to be one of predictable determinants for postoperative recovery of the pathological side. Thus, by comparing the DMSA uptake between right and left kidney in the chronic course or pre- and postoperative periods, an effect of renal function in the pathological side on that in the healthy side was investigated from the point of renal counterbalance. (author)

Study to improve the precision of calculation of split renal clearance by gamma camera method using 99mTc-MAG3

International Nuclear Information System (INIS)

Mimura, Hiroaki; Tomomitsu, Tatsushi; Yanagimoto, Shinichi

1999-01-01

Both fundamental and clinical studies were performed to improve the precision with which split renal clearance is calculated from the relation between renal clearance and the total renal uptake rate by using 99m Tc-MAG 3 , which is mainly excreted into the proximal renal tubules. In the fundamental study, the most suitable kidney phantom threshold values for the extracted renal outline were investigated with regard to size, radioactivity, depth of the kidney phantom, and radioactivity in the background. In the clinical study, suitable timing to obtain additional images for making the ROI and the standard point for calculation of renal uptake rate were investigated. The results indicated that, although suitable threshold values were distributed from 25% to 45%, differences in size, solution activity, and the position of the phantom or BG activity did not have significant effects. Comparing 1-3 min with 2-5 min as the time for additional images for ROI, we found that renal areas using the former time showed higher values, and the correlation coefficient of the regression formula improved significantly. Comparison of the timing for the start of data acquisition with the end of the arterial phase as a standard point of calculating renal uptake rate showed improvement in the latter. (author)

Simple technique for measuring relative renal blood flow

International Nuclear Information System (INIS)

Shames, D.M.; Korobkin, M.

1976-01-01

To determine whether externally monitored early renal uptake of 131 I-hippurate is proportional to renal blood flow, the renal uptake of 131 -hippurate at 1 to 2 min after injection was compared with the renal accumulation of radioactive carbonized microspheres in dogs. A renal artery catheter equipped with a balloon was used to decrease renal blood flow unilaterally. One minute after the intravenous injection of 100 μCi of 131 I-hippurate, about 1 μCi of either 85 Sr- or 95 Nb-labeled carbon microspheres was injected into the left ventricle. Radioactivity was measured over both kidneys. The total radioactivity within each kidney region of interest was corrected for background and integrated over the 1 to 2 min interval after injection. Thirteen measurements of relative renal blood flow were made for seven dogs. The dogs were then killed and both kidneys were excised and counted for the radioactivity of the microspheres. The 1 to 2-min relative renal uptake of 131 I-hippurate correlated well with relative microsphere uptake, suggesting that relative renal blood flow can be simply determined from the external measurements of renal uptake of 131 I-hippurate

Quantitative renal scintigraphy: anatomo-clinical and biological correlation (concerning 51 mercury 197 renal scintigraphs)

International Nuclear Information System (INIS)

Pinganaud, J.-M.

1976-01-01

To find out whether the renal mercury uptake measurement in urology is a satisfactory way to judge the separate functional value of the kidneys the records of 51 patients were examined. The exploration took place as follows: - injection of 300 μCi 197 HgCl 2 , - measurement of the radioactivity fixed on each kidney, three days later, by means of a gamma camera. Of these 51 uptake measurements only one result appears inconsistent by excess. All the others agree perfectly with comparative observations. On the whole a close correlation is found between the renal mercury uptake measurement and the various clinical, urographic and anatomical data obtained on this group of patients. The method seems to be ideal because reliable, harmless and repeatable. Where dosimetry is concerned an injected dose of 300μCi delivers 9mrad to each kidney, 6mrad to the ovaries. By way of comparison it is interesting to note that an intraveinous urograph with 5 exposures delivers 500mrad to the ovaries. It is considered safe to repeat the examination 3 to 4 times on one patient [fr

Applying standardized uptake values in gallium-67-citrate single-photon emission computed tomography/computed tomography studies and their correlation with blood test results in representative organs.

Science.gov (United States)

Toriihara, Akira; Daisaki, Hiromitsu; Yamaguchi, Akihiro; Yoshida, Katsuya; Isogai, Jun; Tateishi, Ukihide

2018-05-21

Recently, semiquantitative analysis using standardized uptake value (SUV) has been introduced in bone single-photon emission computed tomography/computed tomography (SPECT/CT). Our purposes were to apply SUV-based semiquantitative analytic method for gallium-67 (Ga)-citrate SPECT/CT and to evaluate correlation between SUV of physiological uptake and blood test results in representative organs. The accuracy of semiquantitative method was validated using an National Electrical Manufacturers Association body phantom study (radioactivity ratio of sphere : background=4 : 1). Thereafter, 59 patients (34 male and 25 female; mean age, 66.9 years) who had undergone Ga-citrate SPECT/CT were retrospectively enrolled in the study. A mean SUV of physiological uptake was calculated for the following organs: the lungs, right atrium, liver, kidneys, spleen, gluteal muscles, and bone marrow. The correlation between physiological uptakes and blood test results was evaluated using Pearson's correlation coefficient. The phantom study revealed only 1% error between theoretical and actual SUVs in the background, suggesting the sufficient accuracy of scatter and attenuation corrections. However, a partial volume effect could not be overlooked, particularly in small spheres with a diameter of less than 28 mm. The highest mean SUV was observed in the liver (range: 0.44-4.64), followed by bone marrow (range: 0.33-3.60), spleen (range: 0.52-2.12), and kidneys (range: 0.42-1.45). There was no significant correlation between hepatic uptake and liver function, renal uptake and renal function, or bone marrow uptake and blood cell count (P>0.05). The physiological uptake in Ga-citrate SPECT/CT can be represented as SUVs, which are not significantly correlated with corresponding blood test results.

Prognostic value of 99mTc-MAG3 renal scintigraphy for the one-year outcome after kidney transplantation

International Nuclear Information System (INIS)

Guignard, R.; Rossi, M.; Mariano-Goulart, D.; Barbotte, E.

2009-01-01

Because of the increasing use of marginal grafts, it remains a significant difference in terms of transplants half-life between living donor or cadaver donor. The main objective of this study was to assess the prognostic value of various isotopic parameters available on the same day than surgery for the one-year outcome after kidney transplantation. A retrospective study of 100 patients, who received a renal allograft at the University Hospital of Montpellier between 1999 and 2006, and who performed 99m Tc-MAG 3 renal scintigraphy within 72 h after transplantation, was performed. Measurement of various isotopic parameters was performed for angiographic and tubular phases, over three different regions of interest. According to judgment criteria, namely the success or not of transplantation after the first year, previously obtained results were statistically compared. The results of our study confirmed the importance of vascular parameters, especially the Kirchner index, with a good correlation with renal function one year after transplantation. As expected by the physiological models, a well-perfused graft had the most chances of short-term survival. Kirchner index has a negative predictive value of more than 90% for the one-year success after transplantation (V.P.P. = 75%). Parameters assessing more specifically nephronic functional reserve (such as tubular function slope or uptake on perfusion peaks report) are independent risk factors for the failure during the first three months. (authors)

In vivo estimation of renal volume using a rotating gamma camera for sup(99m)Tc-dimercaptosuccinic acid renal imaging

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Kawamura, J; Itoh, H; Yoshida, O; Fujita, T; Torizuka, K

1984-03-01

The in vivo renal volume was determined using SPECT for sup(99m)Tc-DMSA renal imaging. The total renal volume was derived by summing the DMSA distribution volumes of the transaxial slices in the whole kidney. In 20 healthy subjects the renal volume in the right kidney was 220 ml for men and 195.2 ml for women, while that in the left kidney was 213 ml for men and 193.7 ml for women. Differences in those values were not statistically significant. A good correlation was found between renal volumes in both kidneys and body surface area. In 106 kidneys including solitary and pathological kidneys, individual renal volume correlated well with individual DMSA renal uptake rate which demonstrates cortical functioning mass, depending on the cortical blood flow. Thus, SPECT enables an accurate noninvasive means of estimating in vivo functioning renal volume.

Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine

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Rolleman, Edgar J.; Valkema, Roelf; Jong, Marion de; Kooij, Peter P.M.; Krenning, Eric P. [Department of Nuclear Medicine, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam (Netherlands)

2003-01-01

As scintigraphy with [{sup 111}In-DTPA{sup 0}]octreotide has become a standard technique in analysing somatostatin receptor-receptor positive lesions such as neuroendocrine tumours, a logical next step is peptide receptor radionuclide therapy (PRRT). Initial studies on PRRT were performed with high doses of [{sup 111}In-DTPA{sup 0}]octreotide, and recently other radionuclides coupled to other somatostatin analogues have been used for this purpose. However, the dose delivered to the kidney is a major dose-limiting factor. Amino acid solutions have previously been used to reduce renal uptake of radioactivity, but these solutions have some disadvantages, i.e. their hyperosmolarity and their propensity to cause vomiting and metabolic changes. In this study we tested various amino acid solutions in patients receiving [{sup 111}In-DTPA{sup 0}]octreotide PRRT in order to assess their safety and their capacity to inhibit the renal uptake of radioactivity. Patients served as their own non-infused control. Renal radioactivity at 24 h following the injection of [{sup 111}In-DTPA{sup 0}]octreotide was inhibited by (1) a commercially available amino acid solution (AA) (21%{+-}14%, P<0.02), (2) by 25 g (17%{+-}9%, P<0.04), 50 g (15%{+-}13%, P<0.04) or 75 g of lysine (44%{+-}11%, P<0.001) and (3) by a combination of 25 g of lysine plus 25 g of arginine (LysArg) (33%{+-}23%, P<0.01). Fluid infusion alone (500, 1,000 or 2,000 ml of saline/glucose) did not change renal uptake of radioactivity. In patients studied with 75 g of lysine (Lys75) and LysArg, serum potassium levels rose significantly. Maximal potassium levels were within the toxic range (6.3, 6.7 and 6.8 mmol/l) in three out of six patients infused with Lys75, whereas with LysArg the highest concentration measured was 6.0 mmol/l. Electrocardiographic analysis did not reveal significant changes in any of the patients. Vomiting occurred in 50% of patients infused with AA, but in only 6% of patients receiving no amino acid

Efficient uptake of blood-borne BK and JC polyomavirus-like particles in endothelial cells of liver sinusoids and renal vasa recta.

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Jaione Simon-Santamaria

Full Text Available Liver sinusoidal endothelial cells (LSECs are specialized scavenger cells that mediate high-capacity clearance of soluble waste macromolecules and colloid material, including blood-borne adenovirus. To explore if LSECs function as a sink for other viruses in blood, we studied the fate of virus-like particles (VLPs of two ubiquitous human DNA viruses, BK and JC polyomavirus, in mice. Like complete virions, VLPs specifically bind to receptors and enter cells, but unlike complete virions, they cannot replicate. 125I-labeled VLPs were used to assess blood decay, organ-, and hepatocellular distribution of ligand, and non-labeled VLPs to examine cellular uptake by immunohisto- and -cytochemistry. BK- and JC-VLPs rapidly distributed to liver, with lesser uptake in kidney and spleen. Liver uptake was predominantly in LSECs. Blood half-life (∼1 min, and tissue distribution of JC-VLPs and two JC-VLP-mutants (L55F and S269F that lack sialic acid binding affinity, were similar, indicating involvement of non-sialic acid receptors in cellular uptake. Liver uptake was not mediated by scavenger receptors. In spleen, the VLPs localized to the red pulp marginal zone reticuloendothelium, and in kidney to the endothelial lining of vasa recta segments, and the transitional epithelium of renal pelvis. Most VLP-positive vessels in renal medulla did not express PV-1/Meca 32, suggesting location to the non-fenestrated part of vasa recta. The endothelial cells of these vessels also efficiently endocytosed a scavenger receptor ligand, formaldehyde-denatured albumin, suggesting high endocytic activity compared to other renal endothelia. We conclude that LSECs very effectively cleared a large fraction of blood-borne BK- and JC-VLPs, indicating a central role of these cells in early removal of polyomavirus from the circulation. In addition, we report the novel finding that a subpopulation of endothelial cells in kidney, the main organ of polyomavirus persistence, showed

Albumin uptake by renal lymphatics with and without obstruction of the renal vein

International Nuclear Information System (INIS)

Threefoot, S.A.; Pearson, J.E. Jr.; Georgiardis, A.

1989-01-01

Experiments involving injection of radio-iodinated albumin into the left renal arteries or left ureters of dogs indicate that the renal lymphatics are capable of a major contribution in returning to the circulation albumin (or other large molecules) escaping from renal capillaries. I-131-albumin was injected into the jugular vein of controls or into the left renal artery or in retrograde manner into the left ureter of female dogs. Experimental groups included those with no obstruction, occlusion of left renal veins or left renal lymphatics, or both. Collections were made from the right femoral artery, both renal veins, thoracic duct and both ureters at frequent intervals for 2 to 4 hours. Data analysis included I-131 concentration, specific activity, rate of recovery and selected ratios. After renal arterial injection, the percentage of I131 recovered in thoracic duct lymph of dogs without renal venous obstruction was 5 to 10 times that recovered in those that received injections into the jugular vein. In dogs with renal venous obstruction, recovery from the thoracic duct was 10 to 1,000 times that in control dogs. Most of the differences occurred during the first hour, after which time as recirculation and redistribution occurred the rates of appearance in thoracic duct lymph in each group were similar. The differences in the ratios of concentration in thoracic duct lymph to concentration in femoral arterial blood were also much greater when the renal vein was obstructed than in dogs with no obstruction. The greater return of albumin through the thoracic duct in those with impeded renal venous outflow was probably related to both sequestered concentration and increased intrarenal pressure

Study of acute renal insufficiency and chronic renal insufficiency using radioisotopes

International Nuclear Information System (INIS)

Raynaud, C.

1976-01-01

Radioisotopic renal function tests are of assistance to diagnose and follow-up the course of renal insufficiency. The radioisotopic renogram is useful in assessing the response to therapy of child obstructive uropathies and evaluating renal transplant function. The renal scan is helpful, in an emergency service, to differenciate chronic renal insufficiency from acute renal insufficiency. Hg renal uptake test provides informations on physiopathological problems. Among them, the following problems are emphasized: evolution of a nonfunctioning kidney, control of the success of a reparative surgery and of bilateral obstructive uropathies with unilateral symptoms [fr

Sequential Scintigraphy in Renal Transplantation

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Winkel, K. zum; Harbst, H.; Schenck, P.; Franz, H. E.; Ritz, E.; Roehl, L.; Ziegler, M.; Ammann, W.; Maier-Borst, W. [Institut Fuer Nuklearmedizin, Deutsches Krebsforschungszentrum, Heidelberg, Federal Republic of Germany (Germany)

1969-05-15

Based on experience gained from more than 1600 patients with proved or suspected kidney diseases and on results on extended studies with dogs, sequential scintigraphy was performed after renal transplantation in dogs. After intravenous injection of 500 {mu}Ci. {sup 131}I-Hippuran scintiphotos were taken during the first minute with an exposure time of 15 sec each and thereafter with an exposure of 2 min up to at least 16 min.. Several examinations were evaluated digitally. 26 examinations were performed on 11 dogs with homotransplanted kidneys. Immediately after transplantation the renal function was almost normal arid the bladder was filled in due time. At the beginning of rejection the initial uptake of radioactive Hippuran was reduced. The intrarenal transport became delayed; probably the renal extraction rate decreased. Corresponding to the development of an oedema in the transplant the uptake area increased in size. In cases of thrombosis of the main artery there was no evidence of any uptake of radioactivity in the transplant. Similar results were obtained in 41 examinations on 15 persons. Patients with postoperative anuria due to acute tubular necrosis showed still some uptake of radioactivity contrary to those with thrombosis of the renal artery, where no uptake was found. In cases of rejection the most frequent signs were a reduced initial uptake and a delayed intrarenal transport of radioactive Hippuran. Infarction could be detected by a reduced uptake in distinct areas of the transplant. (author)

Inhibitory Effect of Crizotinib on Creatinine Uptake by Renal Secretory Transporter OCT2.

Science.gov (United States)

Arakawa, Hiroshi; Omote, Saki; Tamai, Ikumi

2017-09-01

Crizotinib, a tyrosine kinase inhibitor, exhibits some cases of an increase in serum creatinine levels. Creatinine is excreted by not only glomerular filtration but also active secretion by organic cation transporters such as organic cation transporter 2 (OCT2). In the present study, we evaluated in vitro inhibitory effect of crizotinib on OCT2 by directly measuring creatinine uptake by OCT2. Coincubation of crizotinib reduced uptake of [ 14 C]creatinine by cultured HEK293 cells expressing OCT2 (HEK293/OCT2) in a concentration-dependent manner with IC 50 values of 1.58 ± 0.24 μM. Preincubation or both preincubation and coincubation (preincubation/coincubation) with crizotinib showed stronger inhibitory effect on [ 14 C]creatinine uptake compared with that in coincubation alone with IC 50 values of 0.499 ± 0.076 and 0.347 ± 0.040 μM, respectively. These IC 50 values of crizotinib on [ 3 H]N-methyl-4-phenylpyridinium acetate uptake by OCT2 were 10-20 times higher than those of [ 14 C]creatinine uptake. Furthermore, preincubation of crizotinib inhibited creatinine uptake by OCT2 in an apparently competitive manner. In conclusion, crizotinib at a clinically relevant concentration has the potential to inhibit creatinine transport by OCT2, suggesting an increase of serum creatinine levels in clinical use. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Value of downstream circulation in renal artery stenosis with arterial hypertension: comparison between color Doppler flow and digital renal angiography in 123 patients

International Nuclear Information System (INIS)

Grataloup, C.; Challande, P.; Plainfosse, M.C.; Girerd, X.; Belattar, K.; Plouin, P.F.

1996-01-01

Digital renal angiography and color Doppler flow were compared for diagnosis of renal artery stenosis in 123 hypertensive patients with a prevalence of renal artery stenosis ≥75% of 21 %. Only color Doppler flow signs found downstream from the stenosis could be quantified. A rising time (RT) >0.07 s was the best marker for renal artery stenosis ≥ 75 % according to a receiver operating characteristic curve with a specificity of 97 %, a sensitivity of 88 %, a positive predictive value of 86 %, a negative predictive value of 98 % and an accuracy of 96 %. Digital renal angiography and color Doppler flow findings for renal artery lesions were classified into 4 degrees with agreement for 86 % of the kidneys. (authors). 13 refs., 5 figs., 8 tabs

Value of renal scintigraphy with captopril test in the exploration of renovascular hypertension: Case report

International Nuclear Information System (INIS)

Ghfir, I.; Berehou, F.Z.; Ben Rais, N.

2007-01-01

Introduction Dynamic renal scintigraphy with 99m Tc-DTPA and captopril test is a non-invasive functional method for the diagnosis of renovascular hypertension. It allows differentiating between hypertension induced by renal arterial stenosis from primary arterial hypertension with an incidental stenosis. Case report A 14-year-old girl, without previous medical history, developed a severe arterial hypertension with cephalalgia and ears buzzing. Auscultation revealed a murmur in the left lumbar pit. Renal angiography objectified a stenosis of the infra renal aorta due to a circumferential parietal thickening associated to renal arteries stenosis more marked in the left side. Dynamic renal scintigraphy after administration of captopril highlighted a marked collapse of the rate of tracer uptake exceeding 40% on the left side with an increase in the time of collecting on the right side testifying a frankly positive test prevailing on the left. A transluminal angioplasty of the left renal artery and a revascularization surgery on the right side were carried out. The evolution was marked by an improvement of blood pressure figures. Discussion Dynamic renal scintigraphy using 99m Tc-DTPA with captopril test constitutes a non-invasive process with a low dosimetry for the patients. Its principal goal is to affirm the role of renovascular stenosis in the origin of arterial hypertension and to determine which hypertensive patients with renal arterial stenosis can be treated successfully by surgical or endoscopic revascularization of the kidney. (authors)

Evaluation of renal function in children with vesicoureteral reflux

International Nuclear Information System (INIS)

Hioki, Takuichi

1993-01-01

Renal uptake rate was calculated by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy in 100 kidneys from 58 patients with pediatric vesicoureteral reflux (VUR) to assess kidney function quantitatively for treatment selection and surgical timing. The conservatively treated group consisted of 42 patients (75 kidneys) who underwent DMSA renal scintigraphy twice at intervals of 2 years during their management. The surgically treated group consisted of 16 patients (25 kidneys) who underwent DMSA renal scintigraphy before and 2 years after surgery, Urine samples were collected at the time of initial DMSA renal scintigraphy for the simultaneous measurement of β 2 -microglobulin (β 2 -MG), α 1 -microglobulin and N-acetyl-β-glucosaminidase. Renal uptake ratio of DMSA did not differ in VUR grades during a 2-year follow-up period in the conservative group. In the age group of patients aged 2 or less, renal uptake ratio decreased 2 years later, with significant difference with that in the other age groups. According to VUR grade, there was no significant difference in DMSA renal kidney ratios between the conservative group and the surgical group. According to age, significant difference in renal uptake ratio was observed between the two groups; i.e., patients aged 2 or less had a significantly decreased renal uptake ratio in the conservative group than the surgical group. However, the renal uptake ratio did not differ in the other age groups. For patients aged 2 or less, surgery was considerd necessary to prevent reflux when urinary β 2 -MG indexes are increased. For those aged 3 years or more, on the other hand, conservative treatment was considered optimal regardless of VUR grades; surgery was considered recommended in the case of repeated urinary infection and decreased renal function. (N.K.)

Normative ultrasound values of renal parenchymal thickness among ...

African Journals Online (AJOL)

Objective: To determine the ultrasound normative values of renal parenchymal thickness (RPT) among adults and correlate them with age ... Methods: This was a prospective clinic based study involving 310 normal adults (135 males and 175 females) scanned at ... kidneys and subjects in which three RPT measurements.

Comparison of FDG-PET/CT images between chronic renal failure patients on hemodialysis and controls.

Science.gov (United States)

Toriihara, Akira; Kitazume, Yoshio; Nishida, Hidenori; Kubota, Kazunori; Nakadate, Masashi; Tateishi, Ukihide

2015-01-01

The whole-body 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) distribution in chronic renal failure (CRF) patients on hemodialysis would be different from that in subjects with normal renal function, because they lack urinary FDG excretion and remain in a constant volume overload. We evaluated the difference in the physiological uptake pattern of FDG between chronic renal failure patients on hemodialysis and control subjects. The subjects for this retrospective study consisted of 24 chronic renal failure patients on hemodialysis (HD group) and 24 age- and sex-matched control subjects (NC group). Standardized uptake values normalized by the body weight (SUVbw), ideal body weight (SUVibw), lean body mass (SUVlbm), and body surface area (SUVbsa) in the cerebellum, lungs, liver, gluteal muscles and subcutaneous fat, spleen, thoracolumbar spine, thoracic and abdominal aorta, and right atrium were calculated in positron emission tomography/computed tomography (PET/CT) images. SUVbw in the gluteal muscles, subcutaneous fat, spleen and right atrium was significantly higher in the HD group as compared to that in the NC group (p chronic renal failure patients on hemodialysis show significantly higher physiological FDG uptake in the soft tissues, spleen and blood pool.

Comparison of FDG-PET/CT images between chronic renal failure patients on hemodialysis and controls

Science.gov (United States)

Toriihara, Akira; Kitazume, Yoshio; Nishida, Hidenori; Kubota, Kazunori; Nakadate, Masashi; Tateishi, Ukihide

2015-01-01

The whole-body 2-deoxy-2-[18F]fluoro-D-glucose (FDG) distribution in chronic renal failure (CRF) patients on hemodialysis would be different from that in subjects with normal renal function, because they lack urinary FDG excretion and remain in a constant volume overload. We evaluated the difference in the physiological uptake pattern of FDG between chronic renal failure patients on hemodialysis and control subjects. The subjects for this retrospective study consisted of 24 chronic renal failure patients on hemodialysis (HD group) and 24 age- and sex-matched control subjects (NC group). Standardized uptake values normalized by the body weight (SUVbw), ideal body weight (SUVibw), lean body mass (SUVlbm), and body surface area (SUVbsa) in the cerebellum, lungs, liver, gluteal muscles and subcutaneous fat, spleen, thoracolumbar spine, thoracic and abdominal aorta, and right atrium were calculated in positron emission tomography/computed tomography (PET/CT) images. SUVbw in the gluteal muscles, subcutaneous fat, spleen and right atrium was significantly higher in the HD group as compared to that in the NC group (p chronic renal failure patients on hemodialysis show significantly higher physiological FDG uptake in the soft tissues, spleen and blood pool. PMID:25973341

Regulation of Dopamine Uptake by Vasoactive Peptides in the Kidney

Directory of Open Access Journals (Sweden)

N. L. Rukavina Mikusic

2016-01-01

Full Text Available Considering the key role of renal dopamine in tubular sodium handling, we hypothesized that c-type natriuretic peptide (CNP and Ang-(1-7 may regulate renal dopamine availability in tubular cells, contributing to Na+, K+-ATPase inhibition. Present results show that CNP did not affect either 3H-dopamine uptake in renal tissue or Na+, K+-ATPase activity; meanwhile, Ang-(1-7 was able to increase 3H-dopamine uptake and decreased Na+, K+-ATPase activity in renal cortex. Ang-(1-7 and dopamine together decreased further Na+, K+-ATPase activity showing an additive effect on the sodium pump. In addition, hydrocortisone reversed Ang-(1-7-dopamine overinhibition on the enzyme, suggesting that this inhibition is closely related to Ang-(1-7 stimulation on renal dopamine uptake. Both anantin and cANP (4-23-amide did not modify CNP effects on 3H-dopamine uptake by tubular cells. The Mas receptor antagonist, A-779, blocked the increase elicited by Ang-(1-7 on 3H-dopamine uptake. The stimulatory uptake induced by Ang-(1-7 was even more pronounced in the presence of losartan, suggesting an inhibitory effect of Ang-(1-7 on AT1 receptors on 3H-dopamine uptake. By increasing dopamine bioavailability in tubular cells, Ang-(1-7 enhances Na+, K+-ATPase activity inhibition, contributing to its natriuretic and diuretic effects.

99mTc-DMSA assessment of unilateral renal function: comparative study of two methods

International Nuclear Information System (INIS)

Llamas, J.M.; Torres, M.; Mallol, J.; Latre, J.M.; Martinez Paredes, M.; Carreras, J.L.

1987-01-01

Results obtained with two different methods of assessing unilateral renal function by measuring the percentage of relative uptake following the administration of a tracing dose of Tc 99m -DMSA are compared in a sample of 40 patients with various conditions. As a reference test, I 131 -hippurate 1'-2' relative uptake, corrected by normalized background and attenuation, was employed. Tc 99m -DMSA relative uptake was determined at 24 hours using the following methods: 1) Percentage of accumulated counts over each renal area in relation to the total, for two minutes, corrected by normalized background and attenuation. 2) Percentage of accumulated counts over each renal area in relation to the total, obtained from the geometrical mean value of accumulated counts in AP and PA projections. A correlation analysis between the two methods, and between these and the reference test, were performed. Good correlations among them (r=0,98 between double-image DMS and Hippurate; p<0,001 in all cases) were found. (author)

Research on the uptake of technetium-labelled dimercaptosuccinic acid

International Nuclear Information System (INIS)

Moretti, J.L.; Dumery, J.P.; Meignan, M.; Wirquin, E.; Escaig, F.; Galle, P.

1976-01-01

Owing to the relatively strong urinary excretion of DMSA (20 to 25% of the injected dose in 24 hours) its renal uptake values are only truly significant in the absence of a urine retention syndrome which is detected by a previous study with sup(99m)Tc DTPA. In other cases the uptake measurement can be used to judge the functional value of each kidney separately and to estimate loss of functional capacity and compensative hypertrophies. For all the diseases explored the results obtained agree well with those of other functional explorations (creatinine clearance, separate urinary urea concentration). Moreover DMSA gives results similar to those obtained with mercury chloride. Neither its intrarenal metabolism nor its exact intracellular uptake site are yet known. A fuller knowledge of these points should improve the interpretation of the results [fr

Anatomical and embryological considerations of renal vein abnormalities: The value of preoperative CT

International Nuclear Information System (INIS)

Hruby, W.; Hoelti, W.

1986-01-01

Renal vein abnormalities are an uncommon kind of vascular abnormality. The distribution in the general population is 1.5%-2.5% in unselected pathologic material. In 354 autopsies we have seen six cases of renal vein abnormalities; in 215 cases of major retroperitoneal surgery, seven renal vein abnormalities; and in 4,500 patients who underwent CT examinations of the retroperitoneal areas, 36 cases of atypical renal vein anatomy. The radiologist must be familiar with embryologic details to understand the development of renal vein abnormalities. The authors discuss the value of preoperative diagnosis for preventing a surgical disaster in major retroperitoneal surgery

Physiological and tumoral uptake of 68Ga-DOTATATE. Standardized uptake values and challenges in interpretation

International Nuclear Information System (INIS)

Kuyumcu, Serkan; Oezkan, Zeynep Goezde; Sanli, Yasemin; Yilmaz, Ebru; Mudun, Ayse; Adalet, Isik; Unal, Seher

2013-01-01

The objective of this study is to determine the range of standardized uptake value (SUV) max of 68Ga-DOTA-tyr3-octreotate (DOTATATE) in normal organs and tumoral lesions and establish uptake unrelated to neuroendocrine tumors (NET). One hundred and twenty patients (57 men, 63 women), who underwent 68 Ga-DOTATATE positron emission tomography (PET)/CT imaging in our institution were analyzed. Patients were indicated for 68 Ga-DOTATATE PET/CT imaging to detect primary tumor or metastasis of suspected or previously known NET, to determine somatostatin receptor (SSTR) positivity and to detect occult source of ectopic Cushing syndrome. Normal range of uptake was calculated for the organs that were proven to have no pathology by either conventional radiological imaging or clinical follow-up, using SUV max as a semiquantitative measure. Uptake and tumor to background (T/B) ratios of tumoral lesions in liver, pancreas, bone, brain and lymph nodes were calculated. Uptakes due to lesions unrelated to NET were also documented. Significant uptake was found in spleen, kidneys, adrenal glands, liver and pituitary gland with mean SUV max of 24.67, 14.30, 13.73, 9.12 and 9.74 respectively. Uptake was measured separately for the pancreatic head and body separately, however, besides a slightly heterogeneous uptake; the difference was not statistically significant. Uptake in the tumoral lesions had high (T/B) ratios with mean SUV max of 28.72, 25.21, 18.28, 34.73 and 12.59 for liver, pancreas, bone, brain and lymph nodes, respectively. Incidental benign tumoral lesions were detected in 3 patients (2.5%) which were meningioma and fibrous dysplasia demonstrating significant and breast fibroadenoma demonstrating mild 68 Ga-DOTATATE uptake. Non-neoplastic processes were detected in 4 patients (14.1%), including postsurgical inflammation, reactive lymph nodes, arthritis and demonstrated faint to mild 68 Ga-DOTATATE uptake, with the exception of significant uptake in accessory spleen. 68 Ga

Decreased bone uptake of technetium-99m polyphosphate in thalassemia major

International Nuclear Information System (INIS)

Valdez, V.A.; Jacobstein, J.G.

1980-01-01

Bone scans were performed with Tc-99m stannous polyphosphate on four patients with thalassemia major. Three of the scans show generalized decrease in skeletal uptake of the radiopharmaceutical, associated with renal enlargement and markedly increased renal radioactivity. The skeletal findings are consistent with the known bone abnormalities in thalassemia major, which are secondary to the extensive marrow hyperplasia and include loss of trabeculae and cortical thinning with consequent loss of bone mass. The increased renal uptake is probably due in part to the increased renal excretion (secondary to the poor bone uptake) and in part to the tubular dilatation and renal enlargement associated with thalassemia major. In addition, the presence of excessive amounts of iron in these patients may play a role in both the skeletal and renal findings

Dynamic renal scintigraphy of dissecting aneurysm of abdominal aorta

International Nuclear Information System (INIS)

Tsukamoto, Eriko; Itoh, Kazuo; Furudate, Masayori

1990-01-01

Dynamic renal scintigraphy on 15 patients with dissecting aneurysm of abdominal aorta extending below the renal arteries were retrospectively studied. The results were reviewed and classified into 3 types according to perfusion images and parenchymal tissue uptake: Type A--symmetric perfusion and parenchymal tissue uptake; Type B--asymmetrical perfusion and parenchymal tissue uptake; Type C--delayed perfusion of one kidney and symmetric parenchymal tissue uptake. The number of patients who showed Type A, Type B, and Type C were 3 cases, 6 cases, and 6 cases, respectively. In all Type A and 3 of Type B, perfusion of bilateral renal arteries was mainly from true lumen. In the remaining 3 cases of Type B, 2 had one renal artery obstructed with thrombus; 1 had a deformity of one kidney (the blood supply was mainly from a false lumen), suggestive of renal infarction. On the other hand, in all 6 Type C cases, the renal artery where perfusion was delayed was apparently supplied from false lumen. It is suggested in this retrospective study that the findings in Type C, where delayed perfusion of one kidney and symmetric parenchymal tissue uptake were found, were due to the presence of delayed flow through the false lumen; and therefore, specific to cases where the main blood supply of one renal artery from false lumen. (author)

Value of a simple technique for the measurement of total renal function and each kidney functions without requiring blood or urine samples

International Nuclear Information System (INIS)

Meyers, A.; Chachati, A.; Godon, J.P.; Rigo, P.

1985-01-01

The determination of renal uptake of 99m Tc DTPA and of 131 I Hippuran (as a percentage of the administred dose) at a time interval 1-3 minutes after tracer injection, is a rapid, accurate method for the measurement of total renal function and each kidney functions. Its clinical validity has been confirmed [fr

Diagnostic value of multidetector computed tomography for renal sinus fat invasion in renal cell carcinoma patients

International Nuclear Information System (INIS)

Kim, Cherry; Choi, Hyuck Jae; Cho, Kyoung-Sik

2014-01-01

Objective: Although renal sinus fat invasion has prognostic significance in patients with renal cell carcinomas (RCCs), there are no previous studies about the value of multidetector computed tomography (MDCT) about this issue in the current literature. Materials and methods: A total of 863 consecutive patients (renal sinus fat invasion in 110 patients (12.7%)) from single institutions with surgically-confirmed renal cell carcinoma who underwent MDCT between 2010 and 2012 were included in this study. The area under the curves (AUCs) of the receiver operating characteristic (ROC) analysis was used to compare diagnostic performance. Reference standard was pathologic examination. Weighted κ statistics were used to measure the level of interobserver agreement. Multivariate logistic regression model was used to find the predictors for renal sinus fat invasion. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by two reviewers who reached consensus regarding tumor size, decreased perfusion, tumor margin, vessel displacement, and lymph node metastasis. The reference standard was pathologic evaluation. Results: The AUCs of the ROC analysis were 0.881 and 0.922 for axial-only images and 0.889 and 0.902 for combined images in both readers. The AUC of tumor size was 0.884, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusion: MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC but suffers from a relatively low PPV related to low prevalence of renal sinus fat invasion. Applying tumor size alone we could get similar diagnostic performance to those of radiologists. Tumor size, fat infiltration with a nodular appearance, and

Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI.

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Bush, N C; Keays, M; Adams, C; Mizener, K; Pritzker, K; Smith, W; Traylor, J; Villanueva, C; Snodgrass, W T

2015-06-01

2011 American Academy of Pediatrics guidelines recommended renal-bladder ultrasound (RBUS) as the only evaluation after febrile urinary tract infection (FUTI) in infants aged 2-24 months. We determined the sensitivity, specificity, and false negative rate of RBUS to identify DMSA-detected renal damage in this age group as well as in older children. Consecutive patients referred to pediatric urology with a history of FUTI underwent DMSA ≥ 3 months after FUTI. Abnormal RBUS was defined as: Society of Fetal Urology hydronephrosis grades I-IV; hydroureter ≥ 7 mm; renal scar defined as focal parenchymal thinning; and/or size discrepancy ≥ 1 cm between kidneys. Abnormal DMSA was presence of any focal uptake defects and/or split renal function 24 months. RBUS had poor sensitivity (34%) and low positive predictive value (47%) to identify patients with renal damage. 99/149 (66%) children with renal damage on DMSA had normal RBUS. After FUTI, 66% of children with reduced renal function and/or renal cortical defects found by DMSA scintigraphy had a normal RBUS. Since abnormal DMSA may correlate with increased risk for VUR, recurrent FUTI and renal damage, our data suggest RBUS alone will fail to detect a significant proportion of patients at risk. The data suggest that imaging after FUTI should include acute RBUS and delayed DMSA, reserving VCUG for patients with abnormal DMSA and/or recurrent FUTI. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Value of T2-weighted MR imaging in differentiating low-fat renal angiomyolipomas from other renal tumors

International Nuclear Information System (INIS)

Choi, Hyuck Jae; Kim, Jeong Kon; Kim, Mi-Hyun; Cho, Kyoung-Sik; Ahn, Hanjong; Kim, Choung-Soo

2011-01-01

Background: Accurate preoperative diagnosis of fat scanty angiomyolipomas is an important clinical issue. By evaluating the low signal intensity of angiomyolipomas in MR T2-weighted images the diagnostic accuracy can be elevated. Purpose: To retrospectively assess the usefulness of T2-weighted MR imaging for differentiating low-fat angiomyolipomas (AMLs) from other renal tumors. Material and Methods: We retrospectively evaluated 71 patients with surgically proven renal masses (10 AMLs, 57 renal cell carcinomas [RCCs], and four oncocytomas), all of which showed no visible fat as well as gradual enhancement patterns on contrast-enhanced CT. Signal intensity was measured in each renal mass and in the spleen on T2-weighted images, and each signal intensity ratio (SIR) was calculated; SIR values were then compared in the AML and non-AML groups. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the two parameters for differentiating the two groups. Results: The SIR values (77 ± 24% vs. 162 ± 79%, p = 0.002) were significantly lower in the AML than in the non-AML group. The area under the ROC curve was 0.926 for SIR. The sensitivity and specificity in the diagnosis of AMLs were 90% and 90.2%, using SIR cut-off of 92.5%. Conclusion: Signal intensity measurements on T2-weighted MR images can differentiate AML from non-AML in the kidney

Renal blood flow and metabolism after cold ischaemia

DEFF Research Database (Denmark)

Henriksen, J H; Petersen, H K

1984-01-01

Peroperative measurements of renal blood flow (RBF), renal O2-uptake, and renal venous lactate/pyruvate (L/P) ratio were performed before and after a period of 30-71 min of hypothermic (10-15 degrees C) renal ischaemia in nine patients, undergoing surgery for renal calculi. Before ischaemia, RBF.......01) immediately after re-established perfusion and 36% (P less than 0.02) 30 min later. In one additional patient, who had a short warm ischaemia (8 min), the flow pattern was the same. As arterial pressure remained constant, the reduced RBF signifies an increased renal vascular resistance. Renal O2-uptake...... and renal venous L/P ratio were almost constant, indicating no significant anaerobic processes being involved in the flow response. None of the patients showed any signs of reactive hyperaemia. It is concluded that hypothermic renal ischaemia may be followed by an increased renal vascular resistance even...

Comparison of measurement of 99mTc-MAG3 plasma clearance by single plasma sample and renal uptake ratio

International Nuclear Information System (INIS)

Ushijima, Yo; Sugihara, Hiroki; Okuyama, Chio; Okitsu, Sigeyuki; Nii, Takeshi; Nishida, Takuji; Okamoto, Kunio; Maeda, Tomoho

1997-01-01

Measurement of 99m Tc-MAG 3 plasma clearance based on one-compartment model (MPC method) is a non-invasive method using the renal uptake ratio. We evaluated the clinical usefulness of this method, compared with effective renal plasma flow (ERPF) using 123 I-OIH and two single-plasma sample methods using 99m Tc-MAG 3 (Russell method and Bubeck method). The ratio of 99m Tc-MAG 3 clearance to ERPF was 1.00±0.26. MPC method correlated well with Russell and Bubeck methods (r=0.904, r=0.897). We conclude that MPC method is a suitable replacement for single-plasma sample method in routine clinical use. (author)

Effect of region assignment on relative renal blood flow estimates using radionuclides

International Nuclear Information System (INIS)

Harris, C.C.; Ford, K.K.; Coleman, R.E.; Dunnick, N.R.

1984-01-01

To determine the value of the initial phase of the Tc-99m DTPA renogram in the direct estimation of relative renal blood flow in dogs, the ratios of the slopes of renal time-activity curves were compared with the ratios of measured blood flow. Radionuclide results were dependent on region-of-interest (ROI) and background ROI assignment, and correlated well with measured relative flow only with a maximum renal outline region. Curve slope ratios correlated well with measured flow ratios with and without background correction, while 1- to 2-minute uptake ratios correlated well only when corrected for background

Prognostic factors in neonatal acute renal failure

International Nuclear Information System (INIS)

Chevalier, R.L.; Campbell, F.; Brenbridge, A.N.

1984-01-01

Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis

Prognostic factors in neonatal acute renal failure

Energy Technology Data Exchange (ETDEWEB)

Chevalier, R.L.; Campbell, F.; Brenbridge, A.N.

1984-08-01

Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis.

Retrospective study of renal images on whole bone scanning

International Nuclear Information System (INIS)

Yanagisawa, Munetoshi; Machida, Toyohei; Miki, Makoto; Ohishi, Yukihiko; Ueda, Masataka

1978-01-01

One hundred and twenty-seven cases were surveyed by sup(99m)Tc-pyrophosphate at Jikei hospital. Renal images on whole-bone scanning were observed in all cases; 75% of all renal images were normal and 25% were abnormal. Thirteen percent of these abnormal images were symmetric and 87% were asymmetric. Four of the symmetric renal images were bilaterally bad. Three of the four bilaterally bad renal images involved prostate carcinomas with general metastases and the last involved serious bilateral hydronephrosis. The reason for the high percentage of asymmetric renal images was that the materials involved many urogenital cases. Asymmetric renal images other than the urogenital cases, were recognised in 8% of all cases. This percentage is consistent with Hattner's report. Unilateral abnormal renal images involved 8 hydronephrosis cases, 2 unilateral nonfunctioning kidneys and one malrotation kidney. Among the hydronephrosis cases, serious cases gave low uptake and mild cases gave high uptake. The reason for this phenomenon was, presumably, that there were differences in renal uptake, renal excretion and renal pelvic accumulation. In nine cases, one kidney was not visualized on whole-bone scanning, 8 of them involved nephrectomy and the remainining one unilateral nonfunctioning kidney. Six cases presented locally abnormal renal images on whole-bone scanning, three of them suffered renal cell carcinomas and the rest renal solitary cyst. Eighty-eight percent of the abnormal renal images agreed with IVP findings. The renal images of whole-bone scanning faithfully reflected the original renal lesion. Two cases of renal carcinoma and renal solitary cyst recognized on whole-bone scanning are presented, to indicate the usefulness of renal images on whole-bone scanning. (auth.)

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.

Science.gov (United States)

Choi, Hongyoon; Lee, Won Woo; So, Young; Ha, Seunggyun; Byun, Seok-Soo; Kim, Sang Eun

2014-12-01

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). 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 6 months post-NSS. 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 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 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). Tc-99m HMDP uptake within 1 week following NSS is a surrogate marker of GFR impairment over 6 months post-NSS.

In vivo imaging of cellular proliferation in renal cell carcinoma using 18F-fluorothymidine PET

International Nuclear Information System (INIS)

Wong, Peter K.; Lee, Sze Ting; Murone, Carmel; Eng, John; Lawrentschuk, Nathan; Berlangieri, Salvatore University; Pathmaraj, Kunthi; O’Keefe, Graeme J.; Sachinidis, John; Byrne, Amanda J.; Bolton, Damien M.; Davis, Ian D.; Scott, Andrew M.

2014-01-01

The ability to measure cellular proliferation non-invasively in renal cell carcinoma may allow prediction of tumour aggressiveness and response to therapy. The aim of this study was to evaluate the uptake of 18F-fluorothymidine (FLT) PET in renal cell carcinoma (RCC), and to compare this to 18F-fluorodeoxyglucose (FDG), and to an immunohistochemical measure of cellular proliferation (Ki-67). Twenty seven patients (16 male, 11 females; age 42-77) with newly diagnosed renal cell carcinoma suitable for resection were prospectively enrolled. All patients had preoperative FLT and FDG PET scans. Visual identification of tumour using FLT PET compared to normal kidney was facilitated by the use of a pre-operative contrast enhanced CT scan. After surgery tumour was taken for histologic analysis and immunohistochemical staining by Ki-67. The SUVmax (maximum standardized uptake value) mean±SD for FLT in tumour was 2.59±1.27, compared to normal kidney (2.47±0.34). The mean SUVmax for FDG in tumour was similar to FLT (2.60±1.08). There was a significant correlation between FLT uptake and the immunohistochemical marker Ki-67 (r=0.72, P<0.0001) in RCC. Ki-67 proliferative index was mean ± SD of 13.3%±9.2 (range 2.2% - 36.3%). There is detectable uptake of FLT in primary renal cell carcinoma, which correlates with cellular proliferation as assessed by Ki-67 labelling index. This finding has relevance to the use of FLT PET in molecular imaging studies of renal cell carcinoma biology

Evaluation of malignant and benign renal lesions using diffusion-weighted MRI with multiple b values

International Nuclear Information System (INIS)

Erbay, Gurcan; Koc, Zafer; Karadeli, Elif; Kuzgunbay, Baris; Goren, M. Resit; Bal, Nebil

2012-01-01

Background: Limited data are available regarding the use of diffusion-weighted (DW) magnetic resonance imaging (MRI) with multiple b values for characterization of renal lesions. Purpose: To demonstrate and compare the diagnostic performance of DW-MRI with multiple b values for renal lesion characterization. Material and Methods: Sixty-three lesions (36 malignant, 27 benign) in 60 consecutive patients (48 men, 12 women; age 60 ± 12.5 years) with solid/cystic renal lesion diagnosed after MRI were included prospectively. Single-shot echo-planar DW abdominal MRI (1.5T) was obtained using seven b values with eight apparent diffusion coefficient (ADC) maps. Contrast-to-noise ratios (CNRs), signal intensities, lesion ADCs, and lesion/normal parenchyma ADC ratios were analyzed. Receiver-operating characteristic analysis was performed. Results: The mean signal intensities of malignant lesions (at b0, 50, and 200 s/mm 2 ) were significantly lower than those of benign lesions (P 2 . ADC with all b values could better distinguish between benign and malignant lesions. A 1.35 x 10 -3 mm 2 /s threshold ADC value permitted this distinction with 85.2% sensitivity and 65.6% specificity. The lesion/normal parenchyma ADC ratio was more effective than the lesion ADC. Conclusion: In addition to the ADC value, the signal intensity curve on DW images using multiple b values could be helpful for differentiation of malignant and benign renal lesions

Value-based integrated (renal) care: setting a development agenda for research and implementation strategies.

Science.gov (United States)

Valentijn, Pim P; Biermann, Claus; Bruijnzeels, Marc A

2016-08-02

Integrated care services are considered a vital strategy for improving the Triple Aim values for people with chronic kidney disease. However, a solid scholarly explanation of how to develop, implement and evaluate such value-based integrated renal care services is limited. The aim of this study was to develop a framework to identify the strategies and outcomes for the implementation of value-based integrated renal care. First, the theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim were united into one overarching framework through an iterative process of key-informant consultations. Second, a rapid review approach was conducted to identify the published research on integrated renal care, and the Cochrane Library, Medline, Scopus, and Business Source Premier databases were searched for pertinent articles published between 2000 and 2015. Based on the framework, a coding schema was developed to synthesis the included articles. The overarching framework distinguishes the integrated care domains: 1) type of integration, 2) enablers of integration and the interrelated outcome domains, 3) experience of care, 4) population health and 5) costs. The literature synthesis indicated that integrated renal care implementation strategies have particularly focused on micro clinical processes and physical outcomes, while little emphasis has been placed on meso organisational as well as macro system integration processes. In addition, evidence regarding patients' perceived outcomes and economic outcomes has been weak. These results underscore that the future challenge for researchers is to explore which integrated care implementation strategies achieve better health and improved experience of care at a lower cost within a specific context. For this purpose, this study's framework and evidence synthesis have set a developmental agenda for both integrated renal care practice and research. Accordingly, we plan further work to develop an implementation

Eigenimage filtering in the assessment of renal artery stenosis

International Nuclear Information System (INIS)

Windham, J.P.; Potvin, W.J.; Zhang, Y.; Farison, J.B.; Clarke, H.S.; Low, L.R.

1986-01-01

An image-filtering technique is applied in the evaluation of 13 dogs with surgically induced unilateral renal artery stenosis. A mathematical model representing first transit renal flow and glomerular filtration of Tc-99m DTPA is used to generate normal signature templates for vascular flow and cortex uptake from normal kidneys. These signatures are used to generate two weighting vectors where normal vascular flow and cortex uptake are desired processes and cortex uptake and vascular flow are interfering processes, respectively. From weighting vectors and kidney signature vectors, two indices are generated for quantitative analysis. Results of the study demonstrate that the technique is useful for evaluation of renal artery stenosis

Multivariate analysis of various factors affecting background liver and mediastinal standardized uptake values

International Nuclear Information System (INIS)

Kuruva, Manohar; Mittal, Bhagwant Rai; Abrar, Mohammed Labeeb; Kashyap, Raghava; Bhattacharya, Anish

2012-01-01

Standardized uptake value (SUV) is the most commonly used semi-quantitative PET parameter. Various response assessment criteria grade the tumor uptake relative to liver or mediastinal uptake. However various factors can affect the background SUV values. This prospective study was carried out to assess the variability of liver and mediastinal SUVs normalized to lean body mass (SUL-L, SUL-M), body surface area (SUB-L, SUB-M), and body weight (SUW-L, SUW-M) and their dependence on various factors which can affect SUV values. Eighty-eight patients who underwent F-18 FDG PET/CT for various oncological indications were prospectively included in this study. SUVs of liver and mediastinum were calculated by ROIs drawn as suggested by Wahl, et al., in PERCIST 1.0 criteria. Multivariate linear regression analysis was done to assess for the various factors influencing the SUVs of liver and mediastinum. Factors assessed were age, sex, weight, blood glucose level, diabetic status, and uptake period. A P value less than 0.01 was considered significant. SUL-L, SUL-M, SUB-L, SUB-M, SUW-L, SUW-M were not affected significantly by age, sex, blood glucose levels, diabetic status. The uptake period had a statistically significant effect on SUL-L (P = 0.007) and SUW-L (P = 0.008) with a progressive decrease with increasing uptake time. Body weight showed a statistically significant effect on SUW-L (P = 0.001) while SUL-L and SUB-L were not dependent on weight. SUB-L was least dependent on weight (P = 0.851) when compared with SUL-L (P = 0.425). However SUL-L was also not affected statistically significantly by variations in body weight (P = 0.425). Mediastinal SUVs were not significantly affected by any of the factors. As mediastinal SUVs are not affected significantly by any of the factors, it can be considered as background when wide variations occur in uptake times or weight of the patient when comparing two PET/CT studies to evaluate response

Correlation between differential renal uptake of 99mTc-MAG3 and 99mTc-DMSA

International Nuclear Information System (INIS)

Obaldo, J.M.; Gruenwald, F.; Menzel, C.; Biersack, H.J.

1994-01-01

We reviewed the quantitative indices obtained from sequential 99m Tc-MAG3 and 99m Tc-DMSA imaging studies performed in 134 patients with a variety of renal disorders in order to determine the correlation between the measured differential renal function using these two agents. Overall correlation was high with r=.86 and the derived regression equation was R.F. DMSA =8.2+0.84 (R.F. MAG3 ), where F.F. is the relative function. Highly divergent values for differential function were obtained however in some subjects. Patients with renal obstructive disorders had a correlation coefficient of.81 which was lower than those with nonobstructive pathologies (r=.95). Although relative kidney function measured using 99m Tc-MAG3 and 99m Tc-DMSA correlate significantly, certain patients such as those with renal obstruction may necessitate quantitation using different renal parameters. (orig.) [de

Normal Hg uptake values in children under 4 years old

International Nuclear Information System (INIS)

Raynaud, C.

1976-01-01

At birth the child's kidney is anatomically and functionally immature and the Hg uptake rate is only a quarter that of an adult. At 12 months this value is already 3/4 that of the adult and the final normal mature values are reached between 3 and 4 years. A curve of normal values for children below 4 years old is proposed, though being based on a small number of measurements only it must be taken as provisional [fr

In-vivo imaging of cellular proliferation in renal cell carcinoma using 18F-fluorothymidine (FLT) PET

International Nuclear Information System (INIS)

Wong, P.; Lee, S. T.; Eng, J.; Berlangieri, S. U.; Pathmaraj, K.; O'Keefe, G. J.; Lawrentschuk, N.

2009-01-01

Full text:Background: The ability to measure cellular proliferation non-invasively in renal cell carcinoma may allow prediction of tumour aggressiveness and response to therapy. The aim of this study was to evaluate the uptake of 18F-fluorothymidine (FLT) in renal cell carcinoma, and to compare this to 18F-fluorodeoxyglucose (FDG), and to an immunohistochemical measure of cellular proliferation (Ki-67). Methods: Twenty seven patients (16 men, 11 women; age 42-77) with newly diagnosed renal cell carcinoma suitable for resection were prospectively enrolled. All patients had preoperative FLT and FDG PET scans. After surgery tumour was taken for histologic analysis and immunohistochemical staining by Ki-67. Results: The mean SUVmax (maximum standardized uptake value) ± SD for FLT in tumour was 2.53 ± 1.26, compared to normal kidney (2.47 ± 0.34). The mean SUVmax for FDG in tumour was similar to FLT (2.60 ± 1.08). Visual identification of tumour using FLT PET compared to normal kidney was facilitated by the use of a pre-operative contrast enhanced CT scan. There was a significant correlation between FLT uptake and the immunohistochemical marker Ki-67 (r=0.624, p=0.0008) in RCC. Ki-67 labelling index was mean ± SD of 13.3% ± 9.2 (range 2.2% to 36.3%). Conclusion: There is detectable uptake of FLT in primary renal cell carcinoma, which correlates with cellular proliferation as assessed by Ki-67 labelling index. This finding has relevance to the use of FLT PET in molecular imaging studies of renal cell carcinoma biology.

Quantitation in planar renal scintigraphy: which μ value should be used?

International Nuclear Information System (INIS)

Hindie, E.; Jeanguillaume, C.; Galle, P.; Prigent, A.

1999-01-01

The attenuation coefficient value μ used by different authors for quantitation in planar renal scintigraphy varies greatly, from the theoretical value of 0.153 cm -1 (appropriate for scatter-free data) down to 0.099 cm -1 (empirical value assumed to compensate for both scatter and attenuation). For a 6-cm-deep kidney, such variations introduce up to 30% differences in absolute measurement of kidney activity. Using technetium-99m phantom studies, we determined the μ values that would yield accurate kidney activity quantitation for different energy windows corresponding to different amounts of scatter, and when using different image analysis approaches similar to those used in renal quantitation. With the 20% energy window, it was found that the μ value was strongly dependent on the size of the region of interest (ROI) and on whether background subtraction was performed: the μ value thus varied from 0.119 cm -1 (loose ROI, no background subtraction) to 0.150 cm -1 (kidney ROI and background subtraction). When using data from an energy window that could be considered scatter-free, the μ value became almost independent of the image analysis scheme. It is concluded that: (1) when performing background subtraction, which implicitly reduces the effect of scatter, the μ value to be used for accurate quantitation is close to the theoretical μ value; (2) if the acquired data were initially corrected for scatter, the appropriate μ value would then be the theoretical μ value, whatever the image analysis scheme. (orig.)

Reference values for fluorine-18-fluorodeoxyglucose and fluorine-18-sodium fluoride uptake in human arteries

DEFF Research Database (Denmark)

Blomberg, Björn A; Thomassen, Anders; de Jong, Pim A

2017-01-01

OBJECTIVE: Reference values of fluorine-18-fluorodeoxyglucose (F-FDG) and fluorine-18-sodium fluoride (F-NaF) uptake in human arteries are unknown. The aim of this study was to determine age-specific and sex-specific reference values of arterial F-FDG and F-NaF uptake. PARTICIPANTS AND METHODS...

Incidental colonic focal FDG uptake on PET/CT: can the maximum standardized uptake value (SUVmax) guide us in the timing of colonoscopy?

NARCIS (Netherlands)

van Hoeij, F. B.; Keijsers, R. G. M.; Loffeld, B. C. A. J.; Dun, G.; Stadhouders, P. H. G. M.; Weusten, B. L. A. M.

2015-01-01

In patients undergoing F-18-FDG PET/CT, incidental colonic focal lesions can be indicative of inflammatory, premalignant or malignant lesions. The maximum standardized uptake value (SUVmax) of these lesions, representing the FDG uptake intensity, might be helpful in differentiating malignant from

Automatic quantitative renal scintigraphy

International Nuclear Information System (INIS)

Valeyre, J.; Deltour, G.; Delisle, M.J.; Bouchard, A.

1976-01-01

Renal scintigraphy data may be analyzed automatically by the use of a processing system coupled to an Anger camera (TRIDAC-MULTI 8 or CINE 200). The computing sequence is as follows: normalization of the images; background noise subtraction on both images; evaluation of mercury 197 uptake by the liver and spleen; calculation of the activity fractions on each kidney with respect to the injected dose, taking into account the kidney depth and the results referred to normal values; edition of the results. Automation minimizes the scattering parameters and by its simplification is a great asset in routine work [fr

Value of contrast-enhanced 3D MR angiography of the renal arteries

International Nuclear Information System (INIS)

Hany, T.F.; Pfammatter, T.; Schmidt, M.; Leung, D.A.; Debatin, J.F.

1997-01-01

Purpose: To determine the value of gadolinium-enhanced, three-dimensional breath-hold Magnetic Resonance Angiography (MRA) in the assessment of the aorta and renal arteries in comparison to conventional arteriography (CA). Patients and methods: 49 patients were evaluated with both CA and 3D MRA. 0.3 mmol/kg BW gadolinium-DTPA was administered intravenously in a bolus, using an automated injector. A test bolus method was used for timing of the bolus and beginning of the data acquisition. The intraaterial CA was used as the gold standard. Results: MRA-based assessment of renal artery stenosis was identical with CA in 31 of 45 stenoses (68.8%). Senstivity and specificity for assessment of renal arterial disease by MRA were 84% and 96%; for clinically relevant lesions they amounted to 90% and 98%. Conclusion: The presented contrast-enhanced 3D MRA technique allows for the reliable assessment of renal arterial morphology and pathology. (orig.) [de

Comparison of conventional renal clearance values with differently evaluated results of radioisotope nephrography

International Nuclear Information System (INIS)

Grebe, S.F.; Weise, M.; Berghaeuser, H.; Faengewisch, G.L.; Temme, H.

1981-01-01

81 patients with renal anormalities or renal disorders of different genesis and severity with and without restricted renal functions were investigated by means of the classical PAH- and inulin-clearance. Furthermore a radioisotope nephrography was carried out after application of I 131-Hippuran followed by Cr 51-EDTA. In addition the activity reduction was measured above the shoulder, as well as the activity in serum samples and urine samples gained 30 min after application. A comparison of the clearance values found with those of conventional clearance resulted in poor correlation for I 131-Hippuran (r = 0.54) and no correlation for Cr 51-EDTA. Of the many parameters of the radioisotope nephrogram curves only the following are able to give sufficient quantitative functional results: The parameters connected with the rise of the curve between the 48sup(rh) and 120sup(rh) s and those connected with the slope of the secant. This is also true for the value of activity measured in the urine. (orig.) [de

Prognostic value of worsening renal function in outpatients with chronic heart failure.

Science.gov (United States)

Pimentel, Rodrigo; Couto, Marta; Laszczyńska, Olga; Friões, Fernando; Bettencourt, Paulo; Azevedo, Ana

2014-09-01

Renal function impairment predicts poor survival in heart failure. Attention has recently shifted to worsening renal function, based mostly on serum creatinine and estimated glomerular filtration rate. We assessed the prognostic effect of worsening renal function in ambulatory heart failure patients. Data from 306 ambulatory patients were abstracted from medical files. Worsening renal function was based on the change in estimated glomerular filtration rate, serum creatinine and urea within 6 months of referral. Prognosis was assessed by the composite endpoint all-cause death or heart failure hospitalization, censored at 2 years. Hazard ratios were estimated for worsening renal function, adjusted for sex, age, diabetes, New York Heart Association class, left ventricular systolic dysfunction, medications and baseline renal function. The agreement among definitions was fair, with kappa coefficients generally not surpassing 0.5. Worsening renal function was associated with poor outcome with adjusted hazard ratios (95% confidence interval) of 3.2 (1.8-5.9) for an increase of serum creatinine >0.3mg/dl; 2.2 (1.3-3.7) for an increase in serum urea >20mg/dl and 1.9 (1.1-3.3) for a decrease in estimated glomerular filtration rate >20%, independent of baseline renal function. The 2-year risk of death/heart failure hospitalization was approximately 50% in patients with an increase in serum creatinine or in serum urea; this positive predictive value was higher than for decreasing estimated glomerular filtration rate. In conclusion, worsening renal function was significantly associated with a worse outcome. Different definitions identified different patients at risk and increasing creatinine/urea performed better than decreasing estimated glomerular filtration rate. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Difference in long-term prognostic value of renal function between ischemic and non-ischemic mild heart failure

NARCIS (Netherlands)

Smilde, TDJ; Hillege, HL; Navis, G; Voors, AA; Brouwer, J; van Veldhuisen, DJ

2006-01-01

Introduction: Renal function is one of the strongest prognostic markers in patients with chronic heart failure, but it has been suggested that this might be due to (local, i.e. renal) vascular atherosclerosis. The aim of the present study is to evaluate the prognostic value of renal function in both

Localisation and mechanism of renal retention of radiolabelled somatostatin analogues

Energy Technology Data Exchange (ETDEWEB)

Melis, Marleen; Krenning, Eric P.; Bernard, Bert F.; Jong, Marion de [Erasmus MC, Department of Nuclear Medicine, Rotterdam (Netherlands); Barone, Raffaella [UCL, Centre of Nuclear Medicine and Laboratory of PET, Brussels (Belgium); Visser, Theo J. [Erasmus MC, Department of Internal Medicine, Rotterdam (Netherlands)

2005-10-01

Radiolabelled somatostatin analogues, such as octreotide and octreotate, are used for tumour scintigraphy and radionuclide therapy. The kidney is the most important critical organ during such therapy owing to the reabsorption and retention of radiolabelled peptides. The aim of this study was to investigate in a rat model both the localisation and the mechanism of renal uptake after intravenous injection of radiolabelled somatostatin analogues. The multi-ligand megalin/cubilin receptor complex, responsible for reabsorption of many peptides and proteins in the kidney, is an interesting candidate for renal endocytosis of these peptide analogues. For localisation studies, ex vivo autoradiography and micro-autoradiography of rat kidneys were performed 1-24 h after injection of radiolabelled somatostatin analogues and compared with the renal anti-megalin immunohistochemical staining pattern. To confirm a role of megalin in the mechanism of renal retention of [{sup 111}In-DTPA]octreotide, the effects of three inhibitory substances were explored in rats. Renal ex vivo autoradiography showed high cortical radioactivity and lower radioactivity in the outer medulla. The distribution of cortical radioactivity was inhomogeneous. Micro-autoradiography indicated that radioactivity was only retained in the proximal tubules. The anti-megalin immunohistochemical staining pattern showed a strong similarity with the renal [{sup 111}In-DTPA]octreotide ex vivo autoradiograms. Biodistribution studies showed that co-injection of positively charged d-lysine reduced renal uptake to 60% of control. Sodium maleate reduced renal [{sup 111}In-DTPA]octreotide uptake to 15% of control. Finally, cisplatin pre-treatment of rats reduced kidney uptake to 70% of control. Renal retention of [{sup 111}In-DTPA]octreotide is confined to proximal tubules in the rat kidney, in which megalin-mediated endocytosis may play an important part. (orig.)

Infarction of renal transplant with extrarenal excretion of Tc-99m MAG3 demonstrated by renal scintigraphy

International Nuclear Information System (INIS)

Lim, Seok Tae; Kim, Min Woo; Sohn, Myung Hee

2003-01-01

A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later. Tc-99m MAG 3 renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m MAG 3 caused by acute renal artery thrombosis

Antenatal glucocorticoid treatment alters Na+ uptake in renal proximal tubule cells from adult offspring in a sex-specific manner

OpenAIRE

Su, Yixin; Bi, Jianli; Pulgar, Victor M.; Figueroa, Jorge; Chappell, Mark; Rose, James C.

2015-01-01

We have shown a sex-specific effect of fetal programming on Na+ excretion in adult sheep. The site of this effect in the kidney is unknown. Therefore, we tested the hypothesis that renal proximal tubule cells (RPTCs) from adult male sheep exposed to betamethasone (Beta) before birth have greater Na+ uptake than do RPTCs from vehicle-exposed male sheep and that RPTCs from female sheep similarly exposed are not influenced by antenatal Beta. In isolated RPTCs from 1- to 1.5-yr-old male and femal...

Renal transport and metabolism of nicotinic acid

International Nuclear Information System (INIS)

Schuette, S.; Rose, R.C.

1986-01-01

Renal metabolism and brush-border transport of nicotinic acid were studied in renal cortical slices and brush-border membrane vesicles exposed to a physiological concentration of vitamin (2.2-3.5 microM). Vesicle transport of [ 3 H]nicotinic acid was found to be Na+ dependent and concentrative. The presence of a Na+ gradient resulted in a fivefold increase in the rate of nicotinic acid uptake over that observed with mannitol and caused a transient nicotinic acid accumulation two- to fourfold above the equilibrium value. The effects of membrane potential, pH, and elimination of Na+-H+ exchange were also studied. Cortical slices and isolated tubules exposed to 2.2 microM [ 14 C]nicotinic acid took up vitamin and rapidly metabolized most of it to intermediates in the Preiss-Handler pathway for NAD biosynthesis; little free nicotinic acid was detectable intracellularly. The replacement of Na+ with Li+ in the bathing medium reduced total accumulation of 14 C label primarily as a result of reduced nicotinic acid uptake. Cortical tissue concentrated free nicotinic acid only when the involved metabolic pathways were saturated by levels of nicotinic acid far in excess of what occurs in vivo

Introduction of Renal Key Performance Indicators Associated with Increased Uptake of Peritoneal Dialysis in a Publicly Funded Health Service.

Science.gov (United States)

Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Holt, Stephen G; Smith, Gillian; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

2017-01-01

♦ BACKGROUND: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies. ♦ METHODS: A KPI data collection and bench-marking program was established in 2012 by the Victorian Department of Health and Human Services, with data provided monthly by all renal units in Victoria using a purpose-designed website portal. A KPI Working Group was responsible for analyzing data each quarter and ensuring indicators remained accurate and relevant and each KPI had clear definitions and targets. We present a prospective, observational study of all dialysis patients in Victoria over a 4-year period following the introduction of the renal KPI program, with descriptive analyses to evaluate the proportion of patients using home therapies as well as home dialysis modality survival. ♦ RESULTS: Following the introduction of the KPI program, the net growth of dialysis patient numbers in Victoria remained stable over 4 years, at 75 - 80 per year (approximately 4%). However, unlike the previous decade, about 40% of this growth was through an increase in home dialysis, which was almost exclusively peritoneal dialysis (PD). The increase was identified particularly in the young (20 - 49) and the elderly (> 80). Disappointingly, however, 67% of these incident patients ceased PD within 2 years of commencement, 46% of whom transferred to SHD. ♦ CONCLUSIONS: Introduction of a KPI program

Attenuation correction for renal scintigraphy with 99mTc - DMSA: comparison between Raynaud and the geometric mean methods

International Nuclear Information System (INIS)

Argenta, J.; Brambilla, C.R.; Marques da Silva, A.M.

2009-01-01

The evaluation of the index of renal function (IF) requires soft-tissue attenuation correction. This paper investigates the impact over the IF, when attenuation correction is applied using the Raynaud method and the geometric mean method in renal planar scintigraphy, using posterior and anterior views. The study was conducted with Monte Carlo simulated images of five GSF family voxel phantoms with different relative uptakes in each kidney from normal (50% -50%) to pathological (10% -90%). The results showed that Raynaud method corrects more efficiently the cases where the renal depth is close to the value of the standard phantom. The geometric mean method showed similar results to the Raynaud method for Baby, Child and Golem. For Helga and Donna models, the errors were above 20%, increasing with relative uptake. Further studies should be conducted to assess the influences of the standard phantom in the correcting attenuation methods. (author)

Attenuation correction for renal scintigraphy with 99mTc-DMSA: analysis between Raynaud and the geometric mean methods

International Nuclear Information System (INIS)

Argenta, Jackson; Brambilla, Claudia R.; Silva, Ana Maria M. da

2010-01-01

The evaluation of the index of renal function (IF) requires soft-tissue attenuation correction. This paper investigates the impact over the IF, when attenuation correction is applied using the Raynaud method and the Geometric Mean method in renal planar scintigraphy, using posterior and anterior views. The study was conducted with Monte Carlo simulated images of five GSF family voxel phantoms with different relative uptakes in each kidney from normal (50% -50%) to pathological (10% -90%). The results showed that Raynaud method corrects more efficiently the cases where the renal depth is close to the value of the standard phantom. The geometric mean method showed similar results to the Raynaud method for Baby, Child and Golem. For Helga and Donna models, the errors were above 20%, increasing with relative uptake. Further studies should be conducted to assess the influences of the standard phantom in the correcting attenuation methods. (author)

Pre- and Post-operative cortical function of the kidney with staghorn calculi assessed by sup(99m)Tc-DMSA renal scintigraphy

International Nuclear Information System (INIS)

Kawamura, Juichi

1982-01-01

sup(99m)Tc-DMSA renal scintigraphy consisting of the cortical image and DMSA renal uptake was used to assess the pre- and post-operative renal function in 39 patients with staghorn calculi or complicated calculi occupying more than 2 major calices. Extended pyelolithotomy was performed on 14 patients, nephrolithotomy on 14 patients, pyelolithotomy combined with nephrotomy on 7 patients, and partial nephrectomy on 4 patients. Nine out of 14 patients who underwent pyelolithotomy and 4 out of 14 patients who underwent nephrolithotomy showed an increase or no change in the postoperative DMSA renal uptake in the diseased kidney. However, there was no increase in the postoperative DMSA renal uptake in the patients who underwent pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight percent of the preoperative DMSA renal uptake in the diseased kidney seems to be the absolute level for predicting a postoperative recovery of the kidney function. The contralateral kidney function can affect the postoperative recovery of the function in the operative side. It seems to be hard to expect an increment in the DMSA renal uptake postoperatively when the ratio of DMSA renal uptake in the operative side to the total DMSA renal uptake is less than 20%. At least 6 months of the follow-up period is necessary for the evaluation of the kidney function in the operative side. DMSA renal scintigraphy is a useful modality to assess pre- and post-operative kidney function in nephrolithiasis from the point of both morphological and functional changes in the renal cortex. (author)

The predictive value of renal vascular resistance for late renal allograft loss

NARCIS (Netherlands)

de Vries, APJ; van Son, WJ; van der Heide, JJH; Ploeg, RJ; Navis, G; de Jong, PE; Gans, ROB; Bakker, SJL; Gansevoort, RT

The renal artery resistance index (RI), assessed by Doppler ultrasonography, was recently identified as a new risk marker for late renal allograft loss. This finding requires confirmation since RI in that study was not measured at predetermined time points and ultrasonography is operator-dependent.

The predictive value of renal vascular resistance for late renal allograft loss

NARCIS (Netherlands)

de Vries, A. P. J.; van Son, W. J.; Homan van der Heide, J. J.; Ploeg, R. J.; Navis, G.; de Jong, P. E.; Gans, R. O. B.; Bakker, S. J. L.; Gansevoort, R. T.

2006-01-01

The renal artery resistance index (RI), assessed by Doppler ultrasonography, was recently identified as a new risk marker for late renal allograft loss. This finding requires confirmation since RI in that study was not measured at predetermined time points and ultrasonography is operator-dependent.

Value of radioactive iodine uptake and thyroid imaging in diagnosis of painless thyroiditis

International Nuclear Information System (INIS)

Zhang Rusen; Feng Yong; Hu Yingjian; He Hongyuan

2010-01-01

Objective: To evaluate clinical value of radioactive iodine uptake and thyroid imaging in diagnosis of painless thyroiditis (PT). Methods: Seventy cases of PT patients, 50 cases of GD patients and 50 cases of healthy persons were retrospectively analyzed by using radioactive iodine uptake, thyroid imaging and serological examination. Results: PT group radioactive iodine uptake rate was significantly lower than the control group, GD group was significantly higher than the control group, PT group and the GD group difference was significant (F=64.88, P<0.01). Thyroid image of PT group is not clear, or no to be seen, thyroid image of GD group can be clearly visible. Conclusion: Radioactive iodine uptake and thyroid imaging play an irreplaceable role in the identification of PT and GD, and the method is simple and effective too. (authors)

Value of scintimetry compared with histomorphology, parathormone assay, densitometry and radiology in renal osteopathy

Energy Technology Data Exchange (ETDEWEB)

Lingg, G.; Nebel, G.; Dorr, S.

1982-01-01

The value of scintimetry is compared with histomorphology, parathormone assay, densitometry and radiology in renal osteopathy. The distribution of sup(99m)Tc-Sn-MDP in the thigh was estimated according to two different indices in 60 normal patients, 21 patients undergoing haemodialysis and one who had had a renal transplant. Deviation of the indices in these patients from the normal are significant. The indices were correlated with respect to their accuracy in detecting renal osteopathy with histomorphometry (as the reference method), radiological diagnosis, densitometry, parathormone assay and other laboratory tests. Accuracy of the method is high and, like histomorphometry, is over 9O%.

Defining PET standardized uptake value threshold for tumor delineation with metastatic lymph nodes in head and neck cancer

International Nuclear Information System (INIS)

Suzuki, Osamu; Nishiyama, Kinji; Morimoto, Masahiro; Nakajima, Aya; Nakamura, Satoaki; Yoshino, Kunitoshi; Hashiguchi, Hajime; Tanaka, Kanji

2012-01-01

Hot spots of F-18 fluorodeoxyglucose positron emission tomograms are variable in size according to window settings of standardized uptake values. The purpose of this study was to determine the standardized uptake value threshold that represents the target volume. Sixty-three patients who underwent fluorodeoxyglucose positron emission tomographic computed tomography and were diagnosed as having head and neck cancer with cervical lymphadenopathy were studied. The horizontal and vertical diameters of metastatic lymph nodes (LN-CT) were measured at the center of computed tomographic images. Of the corresponding nodes, the maximal standardized uptake value (SUVmax) and standardized uptake value profiles along the central horizontal and vertical axes were calculated on positron emission tomographic images (LN-PET). On the standardized uptake value profiles, the standardized uptake value levels (SUVeq) where the size of LN-PET was equivalent to the diameters of LN-CT were obtained. The regression formula between SUVeq and SUVmax was obtained. The regression formula of SUVeq was validated in subsequent 30 positron emission tomographic computed tomography studies. The mean horizontal and vertical diameters of LN-CT were 14.9 and 16.4 mm, respectively. SUVmax ranged from 1.88 to 9.07, and SUVeq was between 1.16 and 6.42. The regression formula between SUVeq and SUVmax was as follows: SUVeq =1.21+0.34 x SUVmax (coefficient of correlation: R=0.69). The validation study resulted in a good correlation between the volume of lymph nodes on computed tomography and positron emission tomographic computed tomography (R 2 =0.93). The formula with a relatively high coefficient of correlation is considered to indicate that SUVeq is not constant, but is a complex of an absolute standardized uptake value and is proportional to SUVmax. (author)

Impact of Renal Failure on F18-FDG PET/CT Scans.

Science.gov (United States)

Kode, Vishwajit; Karsch, Holly; Osman, Medhat M; Muzaffar, Razi

2017-01-01

The current guidelines for 2-deoxy-2-[18F]fluoro-d-glucose PET/CT scanning do not address potential inaccuracies that may arise due to patients with renal failure. We report a retrospective analysis of standard uptake values (SUVs) in patients with and without renal failure in order to warrant a protocol adjustment. Patients were matched based on age, gender, and BMI all of which are potential effectors on observed SUV. Thirty patients were selected with clinically diagnosed renal failure, of which 12 were on dialysis. All 30 patients had age, gender, and BMI control matches. Blood urea nitrogen and creatinine levels were measured within 1 month of the scan to assess renal failure. PET/CT scans for both the renal failure patients and controls were performed 60 min after FDG injection. SUVs were measured by placing circular regions of interest in the right hepatic lobe (LSUV) and left psoas muscle (PSUV). For the 30 renal failure patients, the mean LSUV was 2.77 (SD = 0.57) and PSUV was 1.43 (SD = 0.30) while the controls had mean LSUV 2.74 (SD = 0.50) and PSUV 1.42 (SD = 0.37). The SUVs from both the liver and psoas muscle were not significantly different between the renal failure patients and the normal controls with p values >0.05. In addition, dialysis and gender also had no effect on SUVs. Our data suggest that renal failure patients do not require an adjustment in protocol and the standard protocol times should remain.

Prognostic value of tumor-to-blood standardized uptake ratio in patients with resectable non-small-cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Shin, Seung Hyeon; Pak, Kyoung June; Kim, In Joo [Dept. of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan(Korea, Republic of); Kim, Bum Soo; Kim, Seong Jang [Dept. of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

2017-09-15

Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUVmax). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery.

Prognostic value of tumor-to-blood standardized uptake ratio in patients with resectable non-small-cell lung cancer

International Nuclear Information System (INIS)

Shin, Seung Hyeon; Pak, Kyoung June; Kim, In Joo; Kim, Bum Soo; Kim, Seong Jang

2017-01-01

Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUVmax). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery

Bilateral renal metastasis of 261-265huerthle cell thyroid cancer with discordant uptake between I-131 sodium iodide and F-18 FDG

Energy Technology Data Exchange (ETDEWEB)

Claimon, Apichaya; Suh, Min Seok; Cheon, Gi Jeong; Lee, Dong Soo; Chung, June Key [Dept. of Nuclear Medicine, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, E. Edmund [Dept. of Radiological Sciences, University of California, Irvine (United States)

2017-09-15

Renal metastasis of thyroid cancer is extremely rare. We report the case of a 62-year-old woman with Hürthle cell thyroid cancer (HCTC) with lungs, bones, and bilateral kidneys metastases. The renal metastatic lesions were clearly demonstrated by {sup 131}I whole body scan (WBS) with SPECT/CT. However, they exhibited false-negative results in {sup 18}F-FDG PET/CT, kidney ultrasonography, and contrast-enhanced CT scan. The findings imply that tumors have low glucose metabolism and are able to accumulate radioiodine, which is not commonly found in the relatively aggressive nature of HCTC. The patient received two sessions of 200 mCi {sup 131}I therapy within 6 months duration. There was complete treatment response as evaluated by the second post-therapeutic {sup 131}I SPECT/CT and serum thyroglobulin. To our knowledge, renal metastasis from HCTC with positive {sup 131}I but negative {sup 18}F-FDG uptake has not been reported in the literature. This case suggests that {sup 131}I SPECT/CT is useful for lesion localization and prediction of {sup 131}I therapy response.

Diagnostic criteria of 99mTc-diethylenetriaminepentaacetic acid captopril renal scan for the diagnosis of renovascular hypertension by unilateral renal artery stenosis

International Nuclear Information System (INIS)

Choi, Seung Jin; Hong, Il Ki; Chang, Jae Won; Park, Su Kil; Moon, Dae Hyuk

2004-01-01

We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. The study group consisted of 24 patients (m/f = 16/8, age: 39±18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with 99m Tc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ≤ 38); 92% and 50% (BCfun≥ 1 %); 92% and 75% (CBren≥ 1), and 90% and 60% (CNren≥ 1), respectively. Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis

Renal function assessed by 99mTc-DMSA scintigraphy before and after percutaneous nephrostolithotripsy (PNL)

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Kitano, Tokio; Nakagawa, Tsuyoshi; Yamaguchi, Nobuo; Kawamura, Juichi

1988-01-01

99m Tc-DMSA scintigraphy was carried out in 43 patients with unilateral renal stones before and after PNL. This study was repeated about one year after PNL in 12 patients. DMSA renal uptake was calculated two hours after injection of 99m Tc-DMSA. The study was performed using the dual type gamma camera. The renal function was assessed by the formula : 99m Tc-DMSA renal uptake of the operated side/ 99m Tc-DMSA renal uptake of the contralateral side. The change (ratio before/after PNL) x 100 was regarded as the percent change of renal function. Local abnormalities in the 99m Tc-DMSA renal scintigram after PNL were observed in 15 patients. The renal function decreased significantly to 95.8 ± 8.7 % from the base line 4 - 8 weeks after PNL. The renal function improved significantly to 98.6 ± 14.7 % from 92.1 ± 11.9 % in 12 patients about one year after PNL. It is concluded that although the renal function slightly decreased 4 - 8 weeks after PNL, it is expected to improve within 1 year after PNL. 99M Tc-DMSA scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

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Samia Rafael Yamashita

2015-02-01

Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

Renal blood flow and metabolism after cold ischaemia: peroperative measurements in patients with calculi

DEFF Research Database (Denmark)

Petersen, H K; Henriksen, Jens Henrik Sahl

1984-01-01

Peroperative measurements of renal blood flow (RBF), renal O2-uptake, and renal venous lactate/pyruvate (L/P) ratio were performed before and after a period of 30-71 min of hypothermic (10-15 degrees C) renal ischaemia in nine patients, undergoing surgery for renal calculi. Before ischaemia, RBF.......01) immediately after re-established perfusion and 36% (P less than 0.02) 30 min later. In one additional patient, who had a short warm ischaemia (8 min), the flow pattern was the same. As arterial pressure remained constant, the reduced RBF signifies an increased renal vascular resistance. Renal O2-uptake...... and renal venous L/P ratio were almost constant, indicating no significant anaerobic processes being involved in the flow response. None of the patients showed any signs of reactive hyperaemia. It is concluded that hypothermic renal ischaemia may be followed by an increased renal vascular resistance even...

Paediatric renal length measurements from ultrasound and DMSA scans: does clinical practice reflect theoretical normal values?

International Nuclear Information System (INIS)

Que, L.; Rutland, M.D.; Hassan, I.M.

1999-01-01

Full text: Renal length measurement is a routine part of ultrasound examination in children and those results are plotted on a normogram style graph, so that each child's results are compared to a normal range (mean ± 2 S.D.). Renal length measurements from the posterior oblique views of dimercaptosuccinic acid (DMSA) scans in our department have not always correlated well with the ultrasound measurements on the same patients. Renal lengths from the DMSA scans of 120 patients with apparently normal kidneys were recorded and used to generate a normogram of renal length at different ages (0.5-7 years). This DMSA normogram was compared to the ultrasound (US) normogram used in the Paediatric Radiology Department, and it showed slight differences in renal lengths (3-8 mm), but that the US normogram had smaller coefficients of variation (US = 6.6%, NM 8.3%), implying a 'tighter' normal range. 39 of these patients had DMSA and ultrasound measurements of renal length within 3 months, and these were studied first by calculating the mean and CV values for different age groups, and then by plotting individual renal lengths on the appropriate normograms. The measured data produced much greater variability in the ultrasound measurements than the DTPA measurements, and the individual points produced 4/78 (5.1%) abnormal results for DMSA, but 21/78 (26.9%) abnormal results for ultrasound. Thus, in routine clinical use, using patients with apparently normal kidneys, ultrasound was unable to match the 'normal range' set by their current normogram, but the nuclear medicine showed 5.1% of values outside the normal (DMSA) range, which was completely appropriate for a range of ± 2 standard deviations

The value of scintimetry compared with histomorphology, parathormone assay, densitometry and radiology in renal osteopathy

International Nuclear Information System (INIS)

Lingg, G.; Nebel, G.; Dorr, S.; Allgemeines Krankenhaus Barmbek, Hamburg

1982-01-01

The value of scintimetry compared with histomorphology, parathormone assay, densitometry and radiology in renal osteopathy. The distribution of sup(99m)Tc-Sn-MDP in the thigh was estimated according to two different indices 60 normal patients, 21 patients undergoing haemodialysis and one who had had a renal transplant. Deviation of the indices in these patients from the normal are significant. The indices were correlated with respect to their accuracy in detecting renal osteopathy with histomorphometry (as the reference method), radiological diagnosis, densitometry, parathormone assay and other laboratory tests. Accuracy of the method is high and, like histomorphometry, is over 9O%. (orig.) [de

A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy

International Nuclear Information System (INIS)

Jung, Jo sung; Lee, Sang Mi; Kim, Han Jo; Jang, Si-Hyong; Lee, Jeong Won

2014-01-01

We report the case of a 46-year-old woman with acute febrile symptom who had multiple pulmonary nodules and a renal mass. She underwent 18 F-fluorode-oxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to find a hidden malignancy and the cause of her fever. FDG PET/CT images demonstrated a renal mass and multiple lung nodules with intense FDG uptake, which was suspicious of a renal malignancy with multiple pulmonary metastatic lesions. CT-guided biopsies of the pulmonary and renal lesions only showed chronic inflammatory infiltrates without evidence of malignancy. She was diagnosed with septic pulmonary embolism from a renal abscess. One month after antibiotic treatment, the follow-up chest and abdomen CT showed improvement of the lung and renal lesions. This is the first case demonstrating the FDG PET/CT finding of septic pulmonary embolism associated with renal abscess in the published literature. (author)

Normal Uptake of 11C-Acetate in Pancreas, Liver, Spleen, and Suprarenal Gland in PET

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Bogdan Malkowski

2017-01-01

Full Text Available Purpose. C11-Acetate is radiotracer being considered an alternative to 18F-fluorodeoxyglucose. Evaluation of C11-acetate biodistribution in human parenchymal organs is described. Methods and Materials. 60 consecutive patients referred to C11-acetate PET CT suspected of renal or prostate cancer relapse with negative results (no recurrent tumor were included in the study. Acquisition from the base of skull to upper thigh was made 20 min after i.v. injection of 720 MBq of C11-acetate. The distribution was evaluated by measuring the uptake in pancreas (uncinate process and body separately, liver, spleen, and left suprarenal gland. Clinical data of included patients showed no abnormalities in these organs. Results. Biodistributions of C11-acetate radiotracer were compared in different organs. Standardized uptake values of 11C-acetate were significantly higher in pancreatic parenchyma (SUV mean 6,4 than in liver (SUV mean 3,3, spleen (SUV mean 4,5, or suprarenal gland (SUV mean 2,7 tissues. No significant difference was found between pancreatic head (SUV mean 6,4 and body (SUV mean 5,9 uptake. In case of all aforementioned organs, there were no differences either between both sexes or between formerly diagnosed tumors (renal and prostate. Conclusions. Evaluation of C11-acetate uptake differences in parenchymal organs will allow establishing normal patterns of distribution. High pancreatic uptake may be used in quantitative assessment of organ function in diffuse nonneoplastic pathology.

[The value of serum free light chain in differential diagnosis of monoclonal gammopathy of renal significance].

Science.gov (United States)

Li, C; Wen, Y B; Li, H; Su, W; Li, J; Cai, J F; Chen, L M; Li, X M; Li, X W

2017-08-08

Objective: To investigate the value of serum free light chain (FLC) in differential diagnosis of monoclonal gammopathy of renal significance (MGRS). Methods: Forty-nine hospitalized patients who underwent renal biopsy in Peking Union Medical College Hospital between January 2013 and December 2015 were included. Monoclonal gammopathy was detected by serum protein electrophoresis (SPE), serum immunofixation electrophoresis (IFE), urine IFE and serum FLC. All patients were classified as MGRS ( n =32) and monoclonal gammopathy of undetermined significance (MGUS) ( n =17). Results: Renal lesions in MGRS subgroup included light chain amyloidosis ( n =24, 75.0%), light chain deposition disease ( n =7, 21.9%), and fibrillary glomerulopathy ( n =1, 3.1%). Renal diseases in MGUS subgroup included membranous nephropathy ( n =10), focal segmental glomerulosclerosi (FSGS) ( n =3), diabetic glomerulopathy ( n =1), Henoch-Schonlein purpura nephritis ( n =1), anti-GBM disease concurrent with membranous nephropathy ( n =1) and glomerulomegaly ( n =1). Positive number of SPE, serum IFE, urine IFE and abnormal number of serum FLC ratio in MGRS subgroup were 12, 16, 23 and 30, respectively. Positive number of SPE, serum IFE, urine IFE and abnormal number of serum FLC ratio in MGUS subgroup were 11, 17, 6 and 3, respectively. MGRS and MGUS subgroups differed significantly in positive rate of serum IFE ( P value for MGRS, which was helpful for differential diagnosis of patients who had contraindication to renal biopsy.

Inhibiting aerobic glycolysis suppresses renal interstitial fibroblast activation and renal fibrosis.

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Ding, Hao; Jiang, Lei; Xu, Jing; Bai, Feng; Zhou, Yang; Yuan, Qi; Luo, Jing; Zen, Ke; Yang, Junwei

2017-09-01

Chronic kidney diseases generally lead to renal fibrosis. Despite great progress having been made in identifying molecular mediators of fibrosis, the mechanism that governs renal fibrosis remains unclear, and so far no effective therapeutic antifibrosis strategy is available. Here we demonstrated that a switch of metabolism from oxidative phosphorylation to aerobic glycolysis (Warburg effect) in renal fibroblasts was the primary feature of fibroblast activation during renal fibrosis and that suppressing renal fibroblast aerobic glycolysis could significantly reduce renal fibrosis. Both gene and protein assay showed that the expression of glycolysis enzymes was upregulated in mouse kidneys with unilateral ureter obstruction (UUO) surgery or in transforming growth factor-β1 (TGF-β1)-treated renal interstitial fibroblasts. Aerobic glycolysis flux, indicated by glucose uptake and lactate production, was increased in mouse kidney with UUO nephropathy or TGF-β1-treated renal interstitial fibroblasts and positively correlated with fibrosis process. In line with this, we found that increasing aerobic glycolysis can remarkably induce myofibroblast activation while aerobic glycolysis inhibitors shikonin and 2-deoxyglucose attenuate UUO-induced mouse renal fibrosis and TGF-β1-stimulated myofibroblast activation. Furthermore, mechanistic study indicated that shikonin inhibits renal aerobic glycolysis via reducing phosphorylation of pyruvate kinase type M2, a rate-limiting glycolytic enzyme associated with cell reliance on aerobic glycolysis. In conclusion, our findings demonstrate the critical role of aerobic glycolysis in renal fibrosis and support treatment with aerobic glycolysis inhibitors as a potential antifibrotic strategy. Copyright © 2017 the American Physiological Society.

Use of quantitative SPECT/CT reconstruction in 99mTc-sestamibi imaging of patients with renal masses.

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Jones, Krystyna M; Solnes, Lilja B; Rowe, Steven P; Gorin, Michael A; Sheikhbahaei, Sara; Fung, George; Frey, Eric C; Allaf, Mohamad E; Du, Yong; Javadi, Mehrbod S

2018-02-01

Technetium-99m ( 99m Tc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with 99m Tc-sestamibi. Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions. The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions. Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal 99m Tc-sestamibi and other SPECT/CT exams. With robust

Resistant Hypertension, Time-Updated Blood Pressure Values and Renal Outcome in Type 2 Diabetes Mellitus.

Science.gov (United States)

Viazzi, Francesca; Piscitelli, Pamela; Ceriello, Antonio; Fioretto, Paola; Giorda, Carlo; Guida, Pietro; Russo, Giuseppina; De Cosmo, Salvatore; Pontremoli, Roberto

2017-09-22

Apparent treatment resistant hypertension (aTRH) is highly prevalent in patients with type 2 diabetes mellitus (T2D) and entails worse cardiovascular prognosis. The impact of aTRH and long-term achievement of recommended blood pressure (BP) values on renal outcome remains largely unknown. We assessed the role of aTRH and BP on the development of chronic kidney disease in patients with T2D and hypertension in real-life clinical practice. Clinical records from a total of 29 923 patients with T2D and hypertension, with normal baseline estimated glomerular filtration rate and regular visits during a 4-year follow-up, were retrieved and analyzed. The association between time-updated BP control (ie, 75% of visits with BP hypertension. BP control is not associated with a more-favorable renal outcome in aTRH. The relationship between time-updated BP and renal function seems to be J-shaped, with optimal systolic BP values between 120 and 140 mm Hg. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Clinical studies of renal morphological changes with aging

International Nuclear Information System (INIS)

Hosokawa, Shin-ichi; Kawamura, Juichi; Tomoyoshi, Tadao; Yoshida, Osamu

1980-01-01

We studied the change of renal shape due to development and aging by using sup(99m)Tc-DMSA renal scintigraphy. In pediatric age group, the angle between renal longitudinal axis and the lumbar vertebrae is small but becomes larger with aging. The renal size grows with aging in the adult age group, and becomes largest. In geriatric age group it decreases with aging. The stability of renal position is marked in the adult age group, but in the pediatric and geriatric age group it seemed unstable. Renal contour is smooth in the pediatric and adult age group but unsmooth in the geriatric. sup(99m)Tc-DMSA renal image shows diffusely homogeneous renal uptake in the pediatric and adult age groups but not homogeneous in the geriatric. (author)

[Carbon monoxide tests in a steady state. Uptake and transfer capacity, normal values and lower limits].

Science.gov (United States)

Ramonatxo, M; Préfaut, C; Guerrero, H; Moutou, H; Bansard, X; Chardon, G

1982-01-01

The aim of this study was to establish data which would best demonstrate the variations of different tests using Carbon Monoxide as a tracer gas (total and partial functional uptake coefficient and transfer capacity) to establish mean values and lower limits of normal of these tests. Multivariate statistical analysis was used; in the first stage a connection was sought between the fractional uptake coefficient (partial and total) to other parameters, comparing subjects and data. In the second stage the comparison was refined by eliminating the least useful data, trying, despite a small loss of material, to reveal the most important connections, linear or otherwise. The fractional uptake coefficients varied according to sex, also the variation of the partial alveolar-expired fractional uptake equivalent (DuACO) was largely a function of respiratory rate and tidal volume. The alveolar-arterial partial fractional uptake equivalent (DuaCO) depended more on respiratory frequency and age. Finally the total fractional uptake coefficient (DuCO) and the transfer capacity corrected per liter of ventilation (TLCO/V) were functions of these parameters. The last stage of this work, after taking account of the statistical observations consistent with the facts of these physiological hypotheses led to a search for a better way of approaching the laws linking the collected data to the fractional uptake coefficient. The lower limits of normal were arbitrarily defined, separating those 5% of subjects deviating most strongly from the mean. As a result, the relationship between the lower limit of normal and the theoretical mean value was 90% for the partial and total fractional uptake coefficient and 70% for the transfer capacity corrected per liter of ventilation.

The anesthetics influence (ethilic-eter and urethane) on renal radiopharmaceuticals

International Nuclear Information System (INIS)

Muramoto, E.; Achando, S.S.; Araujo, E.B. de; Hamada, H.S.; Silva Valente Goncalves, R. da; Pereira, N.P.S. de; Silva, C.P.G. da.

1990-01-01

A comparative study was done using anesthetics like ether ethilic and urethane, in rats (Wistar). A significative variation was observed in the results obtained when renal radiopharmaceuticals were investigated. Using urethane, the renal uptake increase progressivelly due to the inhibition of the renal filtration and it starts to recuperate when the anesthetic effect was eliminated. Using ether ethilic the radiopharmaceuticals are quickly eliminated from the kidneys (tubular or glomerular filtration), showing that the renal function was protected. (author) [pt

The changes of 18F-FDG uptake and ADC value of the normal endometrium during the menstrual cycle

International Nuclear Information System (INIS)

Seko, Ayumi; Kanasaki, Shuzou; Kitahara, Sawako; Murata, Kiyoshi; Tatsumi, Mitsuaki; Hayashida, Kohei; Sakashita, Yoko; Hamanaka, Yasuyo

2007-01-01

We evaluated the normal endometrium of reproductive age using positron emission tomography (PET)/CT and Diffusion-weighted MR imaging. 18 F-fluorodeoxyglucose (FDG) uptake and apparent diffusion coefficient (ADC) value were classified according to the menstrual cycle. On PET/CT, FDG uptake was significant high at the menstrual and ovulatory phase. On diffusion-weighted imaging (DWI), ADC value was significant low at the menstrual phase. (author)

Prognostic value of 18F-fludeoxyglucose uptake in 287 patients with head and neck squamous cell carcinoma

DEFF Research Database (Denmark)

Rasmussen, Jacob H; Vogelius, Ivan R; Fischer, Barbara M

2015-01-01

BACKGROUND: The prognostic value of 18F-Fludeoxyglucose (FDG) uptake could be due to its association with already known clinical risk factors. METHODS: Correlation between FDG uptake metrics and other known risk factors from 287 patients were analyzed. Time to any failure was analyzed using Cox p...

Cutoff value of thyroid uptake of (99m)Tc-pertechnetate to discriminate between Graves' disease and painless thyroiditis: a single center retrospective study.

Science.gov (United States)

Uchida, Toyoyoshi; Suzuki, Ruriko; Kasai, Takatoshi; Onose, Hiroyuki; Komiya, Koji; Goto, Hiromasa; Takeno, Kageumi; Ishii, Shinya; Sato, Junko; Honda, Akira; Kawano, Yui; Himuro, Miwa; Yamada, Emiko; Yamada, Tetsu; Watada, Hirotaka

2016-01-01

Thyroid uptake of (99m)Tc-pertechnetate is a useful way to determine the cause of thyrotoxicosis. In daily clinical practice, (99m)Tc-pertechnetate uptake is used to discriminate between Graves' disease and painless thyroiditis when clinical information is not enough to make the distinction. However, since the optimal cutoff value of (99m)Tc-pertechnetate uptake has not yet been elucidated, our aim was to determine this value. We recruited patients with thyrotoxicosis in whom (99m)Tc-pertechnetate uptake was measured in clinical settings between 2009 and 2013. Three experienced endocrinologists (who were blinded to the value of (99m)Tc-pertechnetate uptake and initial treatment) diagnosed the cause of thyrotoxicosis based on thyrotropin, free triiodothyronine, free thyroxine, and thyrotropin receptor antibody levels, and by ultrasound findings and using images of thyroid uptake of (99m)Tc-pertechnetate without the actual values. Ninety-four patients diagnosed as having Graves' disease or painless thyroiditis were finally included. According to the diagnosis, the optimal cutoff value of (99m)Tc-pertechnetate uptake was determined by receiver operating characteristics analysis. A cutoff value of 1.0% provided optimal sensitivity and specificity of 96.6% and 97.1%, respectively. Then, its validity was confirmed in 78 patients with confirmed Graves' disease or painless thyroiditis diagnosed at another institute. Applying this cutoff value to the patients with thyrotoxicosis revealed positive and negative predictive values for Graves' disease of 100% and 88.9%, respectively. In conclusion, a cutoff value for (99m)Tc-pertechnetate uptake of 1.0% was useful to discriminate between Graves' disease and painless thyroiditis.

The application of 99mTc-EC renal dynamic imaging in urinary system calculus

International Nuclear Information System (INIS)

Dai Ruqi; Li Shiyun; Liu Xueshu; Huang Wei

2002-01-01

Objective: To evaluate the clinical value of 99m Tc-EC renal dynamic imaging (RDI) for diagnosis of urinary system calculus. Methods: 135 case with confirmed urinary system calculus by ultrasound and IVP were examined by 99m Tc-EC renal dynamic imaging and to analyze the degree of hydronephrosis and the remaining renal function. The quantitative indexes used were effective renal plasma flow (ERPF) and peak uptake rate (PUR). Results: RDI almost accorded with IVP in renal calculus complicated by mild and moderate hydronephrosis cases. On other cases of the severe hydronephrosis and serious renal insufficiency, RDI was more sensitive than IVP which had no excretion in 6 patients with hydronephrosis. ERPF and PUR showed the remaining function of the morbid kidney more accurately than other methods. In severe and mild hydronephrosis the ERPF were 84.3 ± 49 ml/min and 202.2 ± 52.4 ml/min, the PUR were 20.4 ± 11.5% and 48.5 ± 13.6% respectively. Conclusion: RDI can correctly reflect the degree of hydronephrosis and the remaining function of the morbid kidney in urinary system calculus, which would be helpful for the clinical surgical planning

Utility of indium-111 labelled autologous platelets in the diagnosis of renal graft rejection

International Nuclear Information System (INIS)

Martin-Comin, J.; Roca, M.; Grino, J.M.; Paradell, C.; Caralps, A.

1982-01-01

The usefulness of In-111 labelled autologous platelets in the diagnosis of renal graft rejection was studied. The method is based on imaging of the graft area at 4, 24, 48 and 72 hours after the injection of the labelled cells. The study was done in 21 renal cadaveric transplant recipients: control group: four patients without evidence of rejection. No platelet uptake was observed in any of them. Study group: in 13 patients with acute rejection and 1 with chronic rejection graft tracer uptake was seen. In the 3 others with a non-immunological sudden impairment of renal function, no activity was detected in graft area. Changes in renal platelet trapping correlated with response to antirejection therapy

The value of the renal resistive index in the measurement of renal perfusion before and after extracorporal shock wave lithotripsy in correlation to the scintigraphy, to the magnetic resonance perfusion imaging and to big-endothelin values

International Nuclear Information System (INIS)

Palwein-Prettner, L.

1999-07-01

Purpose: the goal of this study was to evaluate effects of extracorporeal shock wave lithotripsy (ESWL) on the renal perfusion using the resistive index (RI), perfusion scintigraphy, magnetic resonance (MR) perfusion imaging and plasma big-endothelin (big-ET-1) values. Method/materials: In 21 patients divided in 3 age-groups the RI was measured before and 1,3,6 and 24 hours after ESWL. Big-ET-1, a potent vasoconstrictor peptid was correlated with the RI values. The RI and Big-ET-1 results was compared to the results of the MR perfusion imaging and the scintigraphy, the gold-standard method. Results: The RI of the treated kidneys increased significantly from 0,64±0,05 to 0,72±0,08 after the ESWL (p<0,001) and in the untreated kidneys from 0,63±0,05 to 0,68±0,09 (p=0,003). The hightest age group shows the most significant increase. The Big-ET-values also increased only in this age group significantly from 0,78±0,24 fmol/l to 1,58±0,52 fmol/l. In the scintigraphy the decrease of the renal plasma flow (RPF) in this age group was most significant. The MR perfusion Imaging shows in all age groups significant decrease (p<0,001). Conclusion: we conclude that the ESWL causes considerable renal parenchymal damage only in the elderly patients. The following changes in renal perfusion were measured very sensitively with the RI which had a good correlation to the results of the perfusion scintigraphy and the MR perfusion imaging. Further studies with larger series have to evaluate these results. (author)

Hepatic uptake of technetium-99m diphosphonate in thalassemia major

International Nuclear Information System (INIS)

Levy, H.M.; Smith, R.

1986-01-01

Two cases of thalassemia major are presented in which bone scintigraphy demonstrated diffuse hepatic uptake of Tc-99m diphosphonate. Although abnormal splenic and renal uptake of Tc-99m phosphates has been reported in patients with thalassemia major, hepatic uptake has not been reported previously. This scintigraphic finding is presumably due to increased iron deposition in the liver, resulting from increased iron turnover and retention in these patients and from multiple previous blood transfusions

Renal function after prolonged hypotensive anesthesia and surgery in dogs with reduced renal mass.

Science.gov (United States)

Stone, E A; Rawlings, C A; Finco, D R; Crowell, W A

1981-10-01

The effect of prolonged hypotensive anesthesia and surgery on renal function was studied in 8 dogs with decreased renal mass. Renal mass was reduced by unilateral nephrectomy and ligation of 4 of the 6 terminal renal artery branches of the opposite kidney. One week after reduction in renal mass, the dogs were azotemic with a serum urea nitrogen (SUN) value of 65.8 +/- 11.5 mg/dl. Glomerular filtration rate, as estimated by 14C-inulin clearance, was 0.66 +/- 0.19 ml/kg of body weight/hour. A mean arterial pressure of less than 75 mm of Hg was maintained for 4 hours in dogs given 2.3 +/- 0.7% halothane. An exploratory laparotomy lasting 1 hour was performed. The day after the hypotensive episode, 3 dogs began vomiting, became dehydrated, and had SUN values greater than 100 mg/dl. The SUN values returned to base-line values after the dogs were rehydrated. Eight days after the hypotensive episode, 14C-inulin clearance decreased 15.2 +/- 8.2% (P less than 0.005) compared with base-line clearance values. Light microscopic and electron microscopic observations of the kidneys did not demonstrate acute renal failure. Prolonged hypotensive anesthesia can cause a decrease in renal function, and may cause prerenal uremia and/or acute renal failure.

Clinical value of renal images obtained incidentally to bone scintigraphy

International Nuclear Information System (INIS)

Ohishi, Y.; Machida, T.; Miki, M.; Kido, A.; Tanaka, A.

1982-01-01

Various studies were made on 400 renal (including 325 clinical cases) observed during whole-body bone scintigraphy using 99mTc-MDP. Asymmetrical renal images in bone scintigrams were obtained from 40% of the urologic patients and 7.5% of the nonurologic patients. Out of the asymmetrical images of the urologic patients, 50% provided nonvisualized kidneys and 35% showed unilateral renal high accumulation. It can be said from the above that renal images incidentally obtained during whole-body bone scintigraphy should not be overlooked

Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

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Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

2008-12-15

The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) {sup 99m}Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

International Nuclear Information System (INIS)

Brader, Peter; Riccabona, Michael; Schwarz, Thomas; Seebacher, Ursula; Ring, Ekkehard

2008-01-01

The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) 99m Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

Baseline Tumor Lipiodol Uptake after Transarterial Chemoembolization for Hepatocellular Carcinoma: Identification of a Threshold Value Predicting Tumor Recurrence.

Science.gov (United States)

Matsui, Yusuke; Horikawa, Masahiro; Jahangiri Noudeh, Younes; Kaufman, John A; Kolbeck, Kenneth J; Farsad, Khashayar

2017-12-01

The aim of the study was to evaluate the association between baseline Lipiodol uptake in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with early tumor recurrence, and to identify a threshold baseline uptake value predicting tumor response. A single-institution retrospective database of HCC treated with Lipiodol-TACE was reviewed. Forty-six tumors in 30 patients treated with a Lipiodol-chemotherapy emulsion and no additional particle embolization were included. Baseline Lipiodol uptake was measured as the mean Hounsfield units (HU) on a CT within one week after TACE. Washout rate was calculated dividing the difference in HU between the baseline CT and follow-up CT by time (HU/month). Cox proportional hazard models were used to correlate baseline Lipiodol uptake and other variables with tumor response. A receiver operating characteristic (ROC) curve was used to identify the optimal threshold for baseline Lipiodol uptake predicting tumor response. During the follow-up period (mean 5.6 months), 19 (41.3%) tumors recurred (mean time to recurrence = 3.6 months). In a multivariate model, low baseline Lipiodol uptake and higher washout rate were significant predictors of early tumor recurrence ( P = 0.001 and Baseline Lipiodol uptake and washout rate on follow-up were independent predictors of early tumor recurrence. A threshold value of baseline Lipiodol uptake > 270.2 HU was highly sensitive and specific for tumor response. These findings may prove useful for determining subsequent treatment strategies after Lipiodol TACE.

Bone scan appearance of renal osteodystrophy in diabetic chronic renal failure patients

International Nuclear Information System (INIS)

So, Young; Hyun, In Young; Lee, Dong Soo; Ahn, Curie; Chung, June-Key; Kim, Suhnggwon; Lee, Myung Chul; Lee, Jung Sang; Koh, Chang-Soon

1998-01-01

To investigate Tc-99m methylenediphosphonate (MDP) bone scan appearance in diabetic chronic renal failure patients, we compared the bone scan images of chronic renal failure patients with and without diabetes. The number of patients studied was 134, of whom 43 had diabetes. Two nuclear medicine physicians read Tc-99m MDP bone scan images and for six areas - the axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction, and sternum - assigned a score of either 1 or 0. The sums of scores were compared. We also performed multivariate analysis including sex, age, and serum creatinine level using analysis of covariance. DM group patients scored significantly lower (2.01±0.95) than those of the non-DM group (3.26±1.16). Analysis of covariance revealed that the lower DM group score was independent of sex, age, and serum creatinine level. The bone scans of diabetic chronic renal failure patients showed less Tc-99m MDP uptake than those of non-diabetic patients. Thus, diagnosing renal osteodystrophy in diabetic chronic renal failure patients on bone scan images could be difficult. (author)

Prognostic value of renal fractional flow reserve in blood pressure response after renal artery stenting (PREFER study).

Science.gov (United States)

Kądziela, Jacek; Januszewicz, Andrzej; Prejbisz, Aleksander; Michałowska, Ilona; Januszewicz, Magdalena; Florczak, Elżbieta; Kalińczuk, Łukasz; Norwa-Otto, Bożena; Warchoł, Ewa; Witkowski, Adam

2013-01-01

The aim of our study was to determine a potential relationship between resting translesional pressures ratio (Pd/Pa ratio), renal fractional flow reserve (rFFR) and blood pressure response after renal artery stenting. Thirty five hypertensive patients (49% males, mean age 64 years) with at least 60% stenosis in angiography, underwent renal artery stenting. Translesional systolic pressure gradient (TSPG), Pd/Pa ratio (the ratio of mean distal to lesion and mean proximal pressures) and hyperemic rFFR - after intrarenal administration of papaverine - were measured before stent implantation. Ambulatory blood pressure measurements (ABPM) were recorded before the procedure and after 6 months. The ABPM results were presented as blood pressure changes in subgroups of patients with normal (≥ 0.9) vs. abnormal (renal artery stenting. Median changes of 24-h systolic/diastolic blood pressure were comparable in patients with abnormal vs. normal Pd/Pa ratio (-4/-3 vs. 0/2 mm Hg; p = NS) and with abnormal vs. normal rFFR (-2/-1 vs. -2/-0.5 mm Hg, respectively). Physiological assessment of renal artery stenosis using Pd/Pa ratio and papaverine- induced renal fractional fl ow reserve did not predict hypertension response after renal artery stenting.

Value of renal scintigraphy with captopril test in the exploration of renovascular hypertension: Case report; Apport de la scintigraphie renale avec test au captopril dans l'exploration de l'hypertension arterielle renovasculaire: a propos d'un cas

Energy Technology Data Exchange (ETDEWEB)

Ghfir, I.; Berehou, F.Z.; Ben Rais, N. [Centre Hospitalier Universitaire de Rabat, Hopital Ibn-Sina, Service de Medecine Nucleaire (Morocco)

2007-08-15

Introduction Dynamic renal scintigraphy with {sup 99m}Tc-DTPA and captopril test is a non-invasive functional method for the diagnosis of renovascular hypertension. It allows differentiating between hypertension induced by renal arterial stenosis from primary arterial hypertension with an incidental stenosis. Case report A 14-year-old girl, without previous medical history, developed a severe arterial hypertension with cephalalgia and ears buzzing. Auscultation revealed a murmur in the left lumbar pit. Renal angiography objectified a stenosis of the infra renal aorta due to a circumferential parietal thickening associated to renal arteries stenosis more marked in the left side. Dynamic renal scintigraphy after administration of captopril highlighted a marked collapse of the rate of tracer uptake exceeding 40% on the left side with an increase in the time of collecting on the right side testifying a frankly positive test prevailing on the left. A transluminal angioplasty of the left renal artery and a revascularization surgery on the right side were carried out. The evolution was marked by an improvement of blood pressure figures. Discussion Dynamic renal scintigraphy using {sup 99m}Tc-DTPA with captopril test constitutes a non-invasive process with a low dosimetry for the patients. Its principal goal is to affirm the role of renovascular stenosis in the origin of arterial hypertension and to determine which hypertensive patients with renal arterial stenosis can be treated successfully by surgical or endoscopic revascularization of the kidney. (authors)

The anti-epileptic drug substance vigabatrin inhibits taurine transport in intestinal and renal cell culture models

DEFF Research Database (Denmark)

Plum, Jakob Munk; Nøhr, Martha Kampp; Hansen, Steen H

2014-01-01

, such evidence does not preclude the involvement of other transporters. The aim of the present study was, therefore, to investigate if vigabatrin interacts with taurine transport. The uptake of taurine was measured in intestinal human Caco-2 and canine MDCK cell monolayers in the absence or presence of amino...... acids such as GABA and vigabatrin. Vigabatrin inhibits the uptake of taurine in Caco-2 and MDCK cells to 34±3 and 53±2%, respectively, at a concentration of 30mM. In Caco-2 cells the uptake of vigabatrin under neutral pH conditions is concentration-dependent and saturable with a Km-value of 27mM (log......Km is 1.43±0.09). In conclusion, the present study shows that vigabatrin was able to inhibit the uptake of taurine in intestinal and renal cell culture models. Furthermore, uptake of vigabatrin in Caco-2 cells under neutral pH conditions was concentration-dependent and saturable and suggesting...

Evaluation of renal function using 99mTc-MAG3

International Nuclear Information System (INIS)

Takayama, Teruhiko; Aburano, Tamio; Shuke, Noriyuki

1993-01-01

The utility of 99m Tc-mercaptoacetyltriglycine (MAG3) was studied clinically. In the renography obtained with 99m Tc-MAG3, the abdominal aorta and the common iliac arteries were clearly visualized in the vascular phase. Due to less background activity and high target to background ratio, the quality of 99m Tc-MAG3 image was superior to that of 123 I-OIH or 99m Tc-DTPA image. The parameters on the renogram including T max , T 2/3 , and T 1/2 were compared. The correlation of T max and T 2/3 or T 1/2 were not significant between 99m Tc-MAG3 and 123 I-OIH. Another parameter of C 20 /C max , where C 20 and C max are renal activities at 20 min after injection and at T max respectively, showed an excellent correlation between 99m Tc-MAG3 and 123 I-OIH. Using C 20 /C max , pattern of renogram can be characterized numerically. Concerning the relation between C 20 /C max and renogram pattern, standard renogram pattern showed the C 20 /C max value of less than 0.4, while hypofunctioning pattern showed more than 0.5. The correlation coefficient between the renal uptake of 99m Tc-MAG3 and 123 I-OIH was 0.880 with a correlation plot: 'Y=1.16X-0.043', where X and Y represent renal uptake of 99m Tc-MAG3 and 123 I-OIH, respectively. It can be concluded that 99m Tc-MAG3 is a useful renal imaging agent as an alternative to 123 I-OIH, in order to evaluate the proximal tubular function and calculate ERPF. (author)

A clinical study on localized renal damage from percutaneous nephroureterolithotomy

International Nuclear Information System (INIS)

Chiba, Yutaka; Orikasa, Seiichi

1988-01-01

To study the localized renal damage from percutaneous nephroureterolithotomy (PNL), 3 divided DMSA renal scintigraphy in 41 renal units and dynamic CT in 17 renal units were performed. 1) Localized renal damages corresponding to the nephrostomy tract estimated by 3 divided DMSA renal scintigraphy were almost recovered by 6 months after PNL in most cases. But in 17 of the 41 renal units (41 %), the postoperative renal scintigram showed low uptake or cold area at the nephrostomy tract. 2) In several cases which showed cold area in postoperative renal scintigram, dynamic CT showed linear or diffuse low density area with sclerotic cortical deformity at the posterior wall of the kidney. These results indicate that an anatomically proper site of the puncture and a smaller nephrostomy size are mandatory to minimize localized renal damage from PNL. (author)

Extraosseous uptake of 99sup(m)technetium methylene diphosphonate

International Nuclear Information System (INIS)

Sty, J.R.; Kun, L.; Casper, J.; Babbitt, D.P.

1980-01-01

A child with a ganglioneuroblastoma and tumor uptake of 99 sup(m)technetium methylene diphosphate ( 99 sup(m)Tc-MDP) is presented. After surgical removal of an encapsulated tumor and radiation therapy, an interval bone scan demonstrated the same presurgical abnormality. Awareness of abnormal uptake of 99 sup(m)Tc-MDP in irradiated renal tissue prevents interpreting radiation nephritis as recurrent tumor. (orig.) [de

Renal cortex taurine content regulates renal adaptive response to altered dietary intake of sulfur amino acids.

OpenAIRE

Chesney, R W; Gusowski, N; Dabbagh, S

1985-01-01

Rats fed a reduced sulfur amino acid diet (LTD) or a high-taurine diet (HTD) demonstrate a renal adaptive response. The LTD results in hypotaurinuria and enhanced brush border membrane vesicle (BBMV) accumulation of taurine. The HTD causes hypertaurinuria and reduced BBMV uptake. This adaptation may relate to changes in plasma or renal cortex taurine concentration. Rats were fed a normal-taurine diet (NTD), LTD, or HTD for 14 d or they underwent: (a) 3% beta-alanine for the last 8 d of each d...

The value of various radiological procedures for the investigation of functional disturbances of renal transplants

International Nuclear Information System (INIS)

Burgener, F.A.; Schabel, S.I.

1978-01-01

The value of various radiological examinations was analysed with reference to 75 renal transplants which had developed complications. If the renal poles are marked with metallic clips, the size of the transplant can be estimated by abdominal x-rays. Abnormal size was found exclusively in severe rejection reactions, but only about 50% of acture rejections showed such a change. Contrast examinations were found to be valuable in the diagnosis or exclusion of anatomically localised lesions such as obstructions or anastomotic leaks. They were unsatisfactory in the diagnosis and differential diagnosis of diffuse parenchymatous abnormalities such as rejection or damage during storage. (orig.) [de

Role of quantitative and dynamic radioactive studies in renal testing

International Nuclear Information System (INIS)

Raynaud, C.

1977-01-01

Many dynamic and quantitative radioactive tests are at present used in studying renal function. Whether involving dynamic morphological tests such as sequential images, dynamic quantitative tests such as the renogram or quantitative static tests such as radioactive clearances, their effective and original contribution is rather unimportant. Only one provides original data, the Hg renal uptake test but it is generally avoided due to the radiation dose absorbed by the kidney in children. A study of the causes of this lack of effectiveness leads to the observation that such tests are not well adapted to the needs of kidneys specialists. They are for the most part based on replacing a 'cold' indicator by radioactive indicator and the advantages anticipated from using radionuclide are not evident. In fact, they are often cancelled by the shortcomings of external detection. For the future, it seems indispensable to abandon some traditional concepts which lead us to consider that the only exploitable renal function is represented by excretion. The kidney has other functions; one of the most interesting seems to be the function of uptake of heavy metals and toxic substances, a study of which is only possible using radionuclides. A new generation of radioactive tests based on a study of uptake and also on a study of other renal functions may provide dynamic or quantitative data which physician urgently need

The value of multi-slice spiral CT in the preoperative assessment of living renal donor

International Nuclear Information System (INIS)

Li Qinghai; Yan Fuhua; Xu Pengju; Zhou Meiling; Zhu Tongyu; Xu Ming; Wang Guomin

2008-01-01

Objective: The purpose of this study is to assess the value of multi-slice spiral CT (MSCT) in the preoperative evaluation of living renal donor as a all in one modality. Methods: Thirty-six potential living renal donors underwent the examination using a GE light VCT scanner. Informed consent was obtained from all participants. The plain scan, early arterial phase, late arterial phase and excretory phase scans are performed in the former 25 donors (injection rate 5 rolls, total volume 100 mi, tube tension 120 kV). While in the later 11 donors (2 ml/s 40 ml +4 ml/s 60 ml), the scanning protocol included the plain scan ( 100 kV), vascular phase and excretory phase scans (100 kV). The excretory phase data were used in the reconstruction of CT urography in both groups. All images were reviewed by one radiologist and one urologist, and the findings of MSCT were compared with intraoperative findings for 33 donors, to investigate the utilities of MSCT in assessing renal vascularity, urinary tract and lesions of renal parenchyma. When discrepancies are found between the two reviewers, consensus was obtained via discussion. Au data was statiscally processed with SPSS for Windows. Results: MSCT angiography is in accordance with intraoperative findings in demonstrating the anatomy of renal arteries and renal vein trunk, accesary arteries, early branching of renal artery. The findings from CTA are highly in accordance with the intraoperative findings, which facilitate intraoperative ligation and reduce relevant complications. CTU demonstrates the anatomy of urinary, tract in good agreement with the intraoperative findings. The image quality of 3D vascularity and CTU between the two groups, scored 4.4 ± 1.2 vs 4.2 ± 1.3 and 4.6 ± 0.8 vs 4.4 ± 0.9 respectively, no statistical between-groups difference was found (Z=-0.89, -0.47, P>0.05). Conclusion: MSCT multiphase scanning combined with CTA and CTU play a important role in the evaluation of living renal donor, which

Megalin and cubilin are endocytic receptors involved in renal clearance of hemoglobin

DEFF Research Database (Denmark)

Gburek, Jakub; Verroust, Pierre J; Willnow, Thomas E

2002-01-01

-Sepharose affinity chromatography of solubilized renal brush-border membranes. Apparent dissociation constants of 1.7 microM for megalin and 4.1 microM for cubilin were determined by surface plasmon resonance analysis. The binding was calcium dependent in both cases. Uptake of fluorescence-labeled hemoglobin by BN......The kidney is the main site of hemoglobin clearance and degradation in conditions of severe hemolysis. Herein it is reported that megalin and cubilin, two epithelial endocytic receptors, mediate the uptake of hemoglobin in renal proximal tubules. Both receptors were purified by use of hemoglobin...... not affect the uptake. By use of immunohistochemistry, it was demonstrated that uptake of hemoglobin in proximal tubules of rat, mouse, and dog kidneys occurs under physiologic conditions. Studies on normal and megalin knockout mouse kidney sections showed that megalin is responsible for physiologic...

Aspects of osseous, peritoneal and renal handling of bisphosphonate during peritoneal dialysis: a methodological study

DEFF Research Database (Denmark)

Joffe, P; Henriksen, Jens Henrik

1996-01-01

to continuous ambulatory peritoneal dialysis (CAPD). The aims were: to assess the kinetics of 99m-technetium MBP (99mTc-MBP) in CAPD, and to evaluate the correctness of the assumption that the peritoneal and renal clearances of 99mTc-MBP equal the total plasma clearance of 51-chromium ethylenediamine tetra......Tc-MBP equal the clearances of 51Cr-EDTA is correct from a clinical point of view. We found that the uptake of the tracers in soft tissue and the renal handling of 51Cr-EDTA and 99mTc-MBP are also similar. The differences between the clearance values for 51Cr-EDTA and 99mTc-MBP may be explained...

[Value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant renal neoplasms].

Science.gov (United States)

Zhang, Sheng; Wang, Xiao-qing; Xin, Xiao-jie; Xu, Yong

2013-05-01

To investigate the value of contrast enhanced ultrasound (CEUS) imaging in the differential diagnosis between benign and malignant renal neoplasms. Two hundred and forty-five cases of renal space-occupying lesions confirmed by biopsy or surgical pathology were included in this study. The CEUS features of the renal space-occupying lesions, i.e., the enhancement degree, homogeneity of enhancement, washing-in and washing-out time and enhancement pattern, were retrospectively analyzed. There were 210 cases of malignant renal tumors and 35 cases of benign lesions. The CEUS modes of the malignant renal tumors included "quick in and quick out" 82 cases, "quick in and slow out" 64 cases, "slow in and quick out" 18 cases and "slow in and slow out" 46 cases; good enhancement 150 cases (71.4%) and inhomogeneous enhancement 180 cases (85.7%).Both the contrast agent filling defect area and solid component enhancement of solid-cystic tumors were important features of malignant renal tumors. In the 35 cases of benign lesions,the CEUS modes included "quick in and quick out" 4 cases, "quick in and slow out" 8 cases, "slow in and quick out" 10 cases and "slow in and slow out" 13 cases. Most of the benign tumors showed low enhancement 51.4% (18/35) and inhomogeneous enhancement 54.3% (19/35). There were significant differences between the malignant and benign renal neoplasms in CEUS mode, degree of enhancement and homogeneity of enhancement (P benign and malignant tumors were 77.1% and 83.8%, respectively, while the two-dimensional ultrasound diagnosis of benign and malignant tumors were 68.6% and 76.7%, respectively, with a significant difference (P benign and malignant renal lesions.

A Modified method for reducing renal injury in zoledronic acid treatment of hypercalcemia and adverse skeletal events

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Jiang Liu

2013-01-01

Full Text Available Aims: In this paper, we have reported a previously undescribed risk factor of deterioration of renal function in zoledronic acid treatment of skeletal metastasis - high serum calcium level. Based on this consideration, a modified method of treatment of hypercalcemia (HCM with zoledronic acid is suggested in this paper. Material and Methods: Bone scan findings of 1090 cancer patients were analyzed, of which 26 had intense renal parenchymal uptake as a result of HCM or bone metastases. Subsequently, a total of 56 bone metastases patients with zoledronic acid treatment were divided into three groups: HCM group who were pre-treated to normal serum calcium level (13 patients, HCM group (19 patients, and normal serum calcium group (24 patients. Results: More patients with intense renal parenchymal uptake were hyperglycemic, statistically significantly (18/26 versus 19/1064, P = 2.1, E-78. No more patients with intense renal parenchymal uptake were associated with bone metastases (14/26 versus 438/1064, P = 0.20. Subsequently, more HCM patients receiving zoledronic acid treatment showed renal injury compared to patients with normal serum calcium level (5/15 versus 2/24, P < 0.05 and HCM patients with pre-treatment to normal serum calcium level (5/15 versus 1/17, P < 0.05. Conclusions: Intense renal parenchymal uptake of bisphosphonates is closely related to HCM rather than to bone metastases in cancer patients. The serum calcium should be measured and reduced to normal level before zoledronic acid is used in managements of adverse skeletal events in order to decrease the risk of renal injury.

Tc-99m DMSA renal uptake: influence of biochemical and physiologic factors

International Nuclear Information System (INIS)

Yee, C.A.; Lee, H.B.; Blaufox, M.D.

1981-01-01

Thirty-eight female Sprague-Dawley rats were studied to determine the effects of (a) tubular blockade and (b) commonly encountered changes in hydration and acid-base balance, on the urinary excretion and renal localization of Tc-99m dimercaptosuccinic acid (DMSA). Ten additional rats were studied to quantitate the in vivo protein binding of Tc-99m DMSA, and a final group of 12 animals was used to quantitate DMSA distribution in animals with diminished functional renal mass. Both osmotic diuresis and dehydration by water deprivation for 24 hr resulted in a plasma clearance of DMSA slower than in control animals. Acid-base imbalances significantly affected the renal accumulation of DMSA, and acidosis was associated with markedly increased background due to increased liver accumulation. The protein-bound portion of Tc-99m DMSA in the plasma was high, reaching 89% within the first 5 min, and rising very slightly (n.s.) with time. The unbound portion of DMSA had a plasma clearance slightly higher than the GFR. Ablation of large amounts of renal tissue, resulting in significant decreases in GFR, did not significantly affect the renal localization of DMSA in the intact portions of the kidneys. These data demonstrate that commonly encountered changes in acid-base balance and hydration will significantly alter the biologic distribution of Tc-99m DMSA. These factors should be controlled when carrying out clinical studies

Assessment of 99mTc-DMSA renoscintigraphy and uptake compared with creatinine clearance in rats with drug-induced nephrotoxicity, 1

International Nuclear Information System (INIS)

Yamada, Masafumi

1991-01-01

For evaluation of technetium-99m dimercaptosuccinic acid ( 99m Tc-DMSA) renal uptake as an absolute renal function, 99m Tc-DMSA uptake was compared with endogenous creatinine clearance (Ccr) in gentamicin-induced nephrotoxicity. Gentamicin (40 mg/kg/day) was given subcutaneously to male Wistar rats for periods of 3, 6, 9 and 12 days. On the next day, the renoscintigraphy was performed 2 hours following intravenous injection of 99m Tc-DMSA and Ccr was measured. On the 7th day, 99m Tc-DMSA uptake was significantly lower in the treated rats than that in control (32.27±0.92 vs 39.84±2.24%; p 99m Tc-DMSA uptake was measured and the histological examination was done. On the 4th day, 99m Tc-DMSA uptake was significantly lower than that on the 1st day (32.32±3.00 vs 38.91±1.95%; p 99m Tc-DMSA uptake reduces earlier than Ccr in gentamicin-induced nephrotoxicity and 99m Tc-DMSA uptake is a reliable indicator in the evaluation of a renal function in drug-induced nephrotoxicity. (author)

Renal accumulation of [{sup 111}In]DOTATOC in rats: influence of inhibitors of the organic ion transport and diuretics

Energy Technology Data Exchange (ETDEWEB)

Stahl, A.R. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich (Germany); Universitaetsklinikum Essen, Department of Radiology, Essen (Germany); Wagner, B.; Heemann, U.; Lutz, J. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nephrology, Munich (Germany); Poethko, T.; Perutka, M.; Wester, H.J.; Essler, M.; Schwaiger, M. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich (Germany)

2007-12-15

Radiation exposure to the kidney limits therapy with radiometal labelled DOTATOC. This study evaluates the organic anion and cation transport (inhibitors: probenecid and cimetidine/dexamethason) as well as diuresis (furosemide and mannitol) regarding renal uptake of [{sup 111}In]DOTATOC. One hundred eight male Fisher rats were injected with [{sup 111}In]DOTATOC via the tail vein. Prior to activity injection a total of 84 rats underwent injection with probenecid vs. sodium chloride 0.9% (48 rats), cimetidine vs. dexamethasone vs. sodium chloride 0.9% (18 rats), and furosemide vs. mannitol vs. sodium chloride 0.9% (18 rats). Rats were sacrificed at predetermined time points up to 48 h after activity injection. Kidneys, adrenal glands, pancreas, spleen, blood, liver, and muscle were harvested and injected activity per gram tissue was determined. Autoradiographic images of the kidneys were acquired in a total of 24 rats. Probenecid led to a reduction in renal uptake by up to 30% while not significantly changing the activity accumulation in the other organs investigated. This reduction was attributable to the renal cortex (ratio cortex/medulla 1.72 vs. 1.99; p = 0.006). Cimetidine and dexamethasone had no effect in any of the organs. Furosemide led to a 44% increase in renal activity accumulation attributable to enhanced renal medullary uptake (ratio cortex/medulla 1.44 versus 1.69; p = 0.006). Mannitol had no effect on renal activity uptake. Inhibition of the organic anion transport by probenecid may help reduce renal uptake regarding therapy with radiometal labelled DOTATOC. The enhancing effect of furosemide may be unfavourable for therapy. The results must be confirmed by human studies. (orig.)

Evaluation of total renal function from 99mTc-MAG3 scintigraphy in children

International Nuclear Information System (INIS)

Andersson, L.G.; Bratteby, L.E.; Takalo, R.; Svensson, L.

2002-01-01

Aim: The aim of the present study was to evaluate the usefulness of dynamic scintigraphy in the assessment of total renal function in children. The Patlak slope of 99m Tc-MAG3 renography curves were compared to the plasma clearance values of 51Cr-EDTA. Material and methods: The study sample consisted of 53 boys and 33 girls with various nephrologic disorders, referred for routine clinical reasons. The median age of the subjects was 5.1 years (range 0.3 - 14.1 years). Imaging procedure. In supine position, the patient received a bolus injection of 1 MBq/kg, (minimum 10 MBq) 99m Tc-MAG3 and a posterior dynamic gamma camera registration was performed for 21 min using 1 frame per second during the first minute and thereafter 10 seconds frames. Data analysis. Time-activity curves were generated from manually drawn heart and renal regions of interest. The MAG3 uptake was calculated from the Patlak-Rutland plot of each kidney by linear curve fitting until the beginning of the excretory phase. A sum of the slope values was used as a measure of total renal MAG3 uptake. Cr-EDTA clearance. Glomerular filtration rate (GFR) was measured from the plasma clearance of 51 Cr-EDTA using single injection, multiple-sample technique. After intravenous injection of 51 Cr-EDTA (74 kBq/kg for children up to 7 years, 37 kBq/kg for children older than 7 years), blood samples were drawn at 5, 10, 15, 45, 60, 120 and 180 min for radioactivity measurement. The GFR was calculated according to Broechner-Mortensen and expressed in ml/min. Results: The absolute 51 Cr-EDTA clearance varied from 9 to 143 ml/min. There was a close linear relationship between 51 Cr-EDTA clearance and MAG3 uptake (Fig). The correlation coefficient was 0.90 and the regression equation (y=43.5 x + 664). Conclusions: In the present study, there was a good correlation between plasma clearance of 51 Cr-EDTA and the sum of the Patlak slopes. The regression equation can be utilised to transform the 99m Tc-MAG3 uptake to an

Contribution to the study of renal load and its therapeutic modifications during acute uranium contaminations

International Nuclear Information System (INIS)

Bourguignon, M.H.N.

1977-01-01

The renal load during acute experimental contaminations in rats and the possible effects of treatment with chelators (DTPA) and bicarbonates are estinated. The following points are examined in turn: kidney uptake of uranyl nitrate and therapeutic tests; in vitro solubility of oxides UO 3 and U 3 O 8 in synthetic serum, their kidney uptake and therapeutic tests. The experimental values of the in vitro uranium oxide dissolution method were checked against in vivo observations. These experiments lead to the following conclusions: concerning the solubility of uranium compounds the strong solubility of UO 3 and much lesser solubility of U 3 O 8 in biological media are confirmed; with regard to the kidney uptake of uranium derivatives the fixation is proportional to the amount injected when the compound (uranyl nitrate) is soluble, which would correspond to the dissolved fraction in the case of more or less insoluble oxide. The right-left uptake is symmetrical. The therapeutic conclusions are as follows: the effectiveness of DTPA, in clearing the organism, especially from bone contamination is proved, but the renal uranium load is neither increased nor reduced; single injections of bicarbonates appear to reduce the kidney load in cases of U 3 O 8 contamination but are ineffective for UO 3 and UO 2 ++ . This difference may be explained by the low circulating concentration, due to weak contamination and low solubility, of U 3 O 8 as compared with the other two compounds [fr

The value of blood oxygenation level-dependent (BOLD MR imaging in differentiation of renal solid mass and grading of renal cell carcinoma (RCC: analysis based on the largest cross-sectional area versus the entire whole tumour.

Directory of Open Access Journals (Sweden)

Guang-Yu Wu

Full Text Available To study the value of assessing renal masses using different methods in parameter approaches and to determine whether BOLD MRI is helpful in differentiating RCC from benign renal masses, differentiating clear-cell RCC from renal masses other than clear-cell RCC and determining the tumour grade.Ninety-five patients with 139 renal masses (93 malignant and 46 benign who underwent abdominal BOLD MRI were enrolled. R2* values were derived from the largest cross-section (R2*largest and from the whole tumour (R2*whole. Intra-observer and inter-observer agreements were analysed based on two measurements by the same observer and the first measurement from each observer, respectively, and these agreements are reported with intra-class correlation coefficients and 95% confidence intervals. The diagnostic value of the R2* value in the evaluation was assessed with receiver-operating characteristic analysis.The intra-observer agreement was very good for R2*largest and R2*whole (all > 0.8. The inter-observer agreement of R2*whole (0.75, 95% confidence interval: 0.69~0.79 was good and was significantly improved compared with the R2*largest (0.61, 95% confidence interval: 0.52~0.68, as there was no overlap in the 95% confidence interval of the intra-class correlation coefficients. The diagnostic value in differentiating renal cell carcinoma from benign lesions with R2*whole (AUC=0.79/0.78[observer1/observer2] and R2*largest (AUC=0.75[observer1] was good and significantly higher (p=0.01 for R2*largest[observer2] vs R2*whole[observer2], p 0.7 and were not significantly different (p=0.89/0.93 for R2*largest vs R2*whole[observer1/observer2], 0.96 for R2*whole[observer1] vs R2*largest[observer2] and 0.96 for R2*whole [observer2] vs R2*largest[observer1].BOLD MRI could provide a feasible parameter for differentiating renal cell carcinoma from benign renal masses and for predicting clear-cell renal cell carcinoma grading. Compared with the largest cross

The predictive value of arterial stiffness on major adverse cardiovascular events in individuals with mildly impaired renal function

Directory of Open Access Journals (Sweden)

Han J

2016-08-01

Full Text Available Jie Han,* Xiaona Wang,* Ping Ye, Ruihua Cao, Xu Yang, Wenkai Xiao, Yun Zhang, Yongyi Bai, Hongmei Wu Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Objectives: Despite growing evidence that arterial stiffness has important predictive value for cardiovascular disease in patients with advanced stages of chronic kidney disease, the predictive significance of arterial stiffness in individuals with mildly impaired renal function has not been established. The aim of this study was to evaluate the predictive value of arterial stiffness on cardiovascular disease in this specific population. Materials and methods: We analyzed measurements of arterial stiffness (carotid–femoral pulse-wave velocity [cf-PWV] and the incidence of major adverse cardiovascular events (MACEs in 1,499 subjects from a 4.8-year longitudinal study. Results: A multivariate Cox proportional-hazard regression analysis showed that in individuals with normal renal function (estimated glomerular filtration rate [eGFR] ≥90 mL/min/1.73 m2, the baseline cf-PWV was not associated with occurrence of MACEs (hazard ratio 1.398, 95% confidence interval 0.748–2.613; P=0.293. In individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2, a higher baseline cf-PWV level was associated with a higher risk of MACEs (hazard ratio 2.334, 95% confidence interval 1.082–5.036; P=0.031. Conclusion: Arterial stiffness is a moderate and independent predictive factor for MACEs in individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2. Keywords: epidemiology, arterial stiffness, impaired renal function, predictive value, MACEs

The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

DEFF Research Database (Denmark)

Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N

2012-01-01

The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

Indium-labeled platelet uptake in rejecting renal transplants

International Nuclear Information System (INIS)

Chandler, S.T.; Buckels, J.; Hawker, R.J.; Smith, N.; Barnes, A.D.; McCollum, C.N.

1983-01-01

The uptake of 111 In autologous platelets in transplanted kidneys was measured in 16 patients shortly after operation. Each patient was then observed for two years. When transplant radioactivity had increased, despite treatment for acute rejection, the kidney was ultimately lost because of rejection

Prognostic value of the standardized uptake value for {sup 18}F-fluorodeoxyglucose in patients with stage IIIB melanoma

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Bastiaannet, E.; Hoekstra, H.J. [University of Groningen, Department of Surgical Oncology, University Medical Centre Groningen, PO Box 30.001, Groningen (Netherlands); Hoekstra, O.S. [VU Amsterdam, Nuclear Medicine and PET Research, University Medical Centre, Amsterdam (Netherlands); Jong, J.R. de; Brouwers, A.H. [University of Groningen, Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen (Netherlands); Suurmeijer, A.J.H. [University of Groningen, Department of Pathology, University Medical Centre Groningen, Groningen (Netherlands)

2012-10-15

FDG PET/CT is an excellent tool to detect melanoma metastases and also allows quantification of FDG uptake using standardized uptake value (SUV). The aim of this study was to prospectively investigate the potential prognostic value of SUV for disease-free survival (DFS) and disease-specific survival (DSS) for patients with stage IIIB melanoma. From November 2003 to March 2008, all consecutive patients were included in the present study. Inclusion criteria were: palpable, histology- or cytology-proven lymph node metastases of melanoma, and referred to the University Medical Centre Groningen for FDG PET and CT examination. Patients without distant metastases were evaluated. Multivariable survival analysis was performed to determine whether SUV was associated with DFS and DSS (Cox proportional hazard analysis). In 80 patients (without distant metastases, 65 %) SUV could be measured. Overall 5-year DFS was 41 % (95% CI 26-56 %) and 24 % (95% CI 12-38 %) in patients with a low and high SUVmean (p = 0.02), respectively. Overall 5-year DSS was 48 % (95% CI 31-62 %) and 30 % (95% CI 17-45 %) in patients with a low and high SUVmean (p = 0.04), respectively. In the multivariable analysis, SUVmean was associated with DFS (hazard ratio 1.7; p = 0.048), but was not associated with DSS (hazard ratio 1.6; p = 0.1). The number of positive nodes, extranodal growth and gender were also associated with survival. FDG uptake in clinically overt nodal melanoma metastases is inversely associated with DFS. Univariate analysis showed an association with DSS. However, after adjustment for potential confounders this association was no longer significant. If these findings are confirmed in larger studies, SUVmean could potentially be used (in addition to the number of positive nodes, tumour size and extranodal growth) as a factor in deciding on adjuvant systemic treatment. (orig.)

18F-FDG PET-CT uptake is a feature of both normal diameter and aneurysmal aortic wall and is not related to aneurysm size

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Barwick, Tara D. [Imperial College Healthcare NHS Trust, Charing Cross Hospital, Department of Radiology/Nuclear Medicine, London (United Kingdom); Hammersmith Hospital, Department of Surgery and Cancer, Imperial College London, London (United Kingdom); Lyons, O.T.A.; Waltham, M. [King' s College London, BHF Centre of Research Excellence and NIHR Biomedical Research Centre at King' s Health Partners, Academic Department of Surgery, London (United Kingdom); Mikhaeel, N.G. [Guy' s and St Thomas' Foundation NHS Trust, Department of Oncology, London (United Kingdom); O' Doherty, M.J. [King' s Health Partners, Clinical PET Centre, St Thomas' Hospital, London (United Kingdom)

2014-12-15

Aortic metabolic activity is suggested to correlate with presence and progression of aneurysmal disease, but has been inadequately studied. This study investigates the 2-[{sup 18}F] fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) uptake in a population of infra-renal abdominal aortic aneurysms (AAA), compared to a matched non-aneurysmal control group. The Positron Emission Tomography - Computed Tomography (PET/CT) database was searched for infra-renal AAA. Exclusion criteria were prior repair, vasculitis, and saccular/mycotic thoracic or thoraco-abdominal aneurysms. Matching of 159 non-aneurysmal (<3 cm diameter) controls from the same population was assessed. Infra-renal aortic wall FDG uptake was assessed using visual analysis; maximum standardized uptake value (SUV{sub max}) and target to background mediastinal blood pool ratio (TBR) were documented. Predictors of FDG uptake (age, sex, aortic diameter, hypertension, statin use, and diabetes) were assessed using univariate analysis. Follow-up questionnaires were sent to referring clinicians. Aneurysms (n = 151) and controls (n = 159) were matched (p > 0.05) for age, sex, diabetes, hypertension, smoking status, statin use, and indication for PET/CT. Median aneurysm diameter was 5.0 cm (range 3.2-10.4). On visual analysis there was no significant difference in the overall numbers with increased visual uptake 24 % (36/151) in the aneurysm group vs. 19 % (30/159) in the controls, p = ns. SUV{sub max} was slightly lower in the aneurysm group vs. controls (mean (2 SD) 1.75(0.79) vs. 1.84(0.58), p = 0.02). However there was no difference in TBR between the AAA group and controls (mean (2 SD) 1.03 (0.46) vs. 1.05(0.31), p = 0.36). During a median 18 (interquartile range 8-35) months' follow-up 20 were repaired and four were confirmed ruptured. The level of metabolic activity as assessed by {sup 18}F-FDG PET/CT in infra-renal AAA does not correlate with aortic size and does not differ between aneurysms and matched controls

Renal contrast-enhanced MR angiography: timing errors and accurate depiction of renal artery origins.

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Schmidt, Maria A; Morgan, Robert

2008-10-01

To investigate bolus timing artifacts that impair depiction of renal arteries at contrast material-enhanced magnetic resonance (MR) angiography and to determine the effect of contrast agent infusion rates on artifact generation. Renal contrast-enhanced MR angiography was simulated for a variety of infusion schemes, assuming both correct and incorrect timing between data acquisition and contrast agent injection. In addition, the ethics committee approved the retrospective evaluation of clinical breath-hold renal contrast-enhanced MR angiographic studies obtained with automated detection of contrast agent arrival. Twenty-two studies were evaluated for their ability to depict the origin of renal arteries in patent vessels and for any signs of timing errors. Simulations showed that a completely artifactual stenosis or an artifactual overestimation of an existing stenosis at the renal artery origin can be caused by timing errors of the order of 5 seconds in examinations performed with contrast agent infusion rates compatible with or higher than those of hand injections. Lower infusion rates make the studies more likely to accurately depict the origin of the renal arteries. In approximately one-third of all clinical examinations, different contrast agent uptake rates were detected on the left and right sides of the body, and thus allowed us to confirm that it is often impossible to optimize depiction of both renal arteries. In three renal arteries, a signal void was found at the origin in a patent vessel, and delayed contrast agent arrival was confirmed. Computer simulations and clinical examinations showed that timing errors impair the accurate depiction of renal artery origins. (c) RSNA, 2008.

Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT -

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Choi, Yun Young; Yang, Seoung Oh; Ryuu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [Asan Medical Center, University of Ulsan, Seoul (Korea, Republic of)

1995-09-15

Avascular necrosis(AVN) of bone can be resulted from various causes that disturb vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was determined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivocal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be performed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT -

International Nuclear Information System (INIS)

Choi, Yun Young; Yang, Seoung Oh; Ryuu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung

1995-01-01

Avascular necrosis(AVN) of bone can be resulted from various causes that disturb vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was determined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivocal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be performed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, S.; Khalid, M; Elfaki, M.; Hassan, N.; Suliman, S.M.

2007-01-01

Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

Impact of arterial occlusion during partial nephrectomy on residual renal function. An evaluation with {sup 99m}technetium-dimercaptosuccinic acid scintigraphy

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Kondo, Tsunenori; Nakazawa, Hayakazu; Ito, Fumio; Onitsuka, Shiro; Ryoji, Osamu; Yago, Rie; Hashimoto, Yasunobu; Toma, Hiroshi [Tokyo Women' s Medical Coll. (Japan)

2002-08-01

Partial nephrectomy (PNx) has been performed with temporary renal arterial occlusion and in situ renal hypothermia (conventional PNx). However, the impact of temporary renal arterial occlusion on residual renal function has not been well assessed. To address this question, we performed renal scintigraphy with {sup 99m}technetium-dimercaptosuccinic acid (DMSA) for the quantitative measurement of postoperative residual renal function after conventional PNx and partial nephrectomy without arterial occlusion (non-clamping PNx). Thirty-four patients underwent postoperative DMSA scintigraphy after PNx for renal cell carcinoma. No obvious difference in preoperative renal function between the diseased kidney and the contralateral kidney was found in any of the patients. Of these patients, 24 underwent conventional PNx, and 10 underwent non-clamping PNx. Residual renal function was evaluated using the relative DMSA uptake of the operated kidney. The relative DMSA uptake of the operated kidney was 39.9{+-}7.3% (25.1-58.8) after conventional PNx compared to 34.8{+-}8.9% (13.5-45.5) after non-clamping PNx. This difference was not statistically significant (P=0.15). Total ischemic time during conventional PNx had no adverse influence on the residual renal function. In the analysis of the other determinant factors influencing residual renal function, tumor size was the only significant factor that inversely correlated with the relative DMSA uptake. Our results showed that arterial clamping during PNx has no negative impact on the functional residual capacity as long as in situ renal hypothermia is adequately performed. (author)

Substitution of the Lys linker with the β-Ala linker dramatically decreased the renal uptake of 99mTc-labeled Arg-X-Asp-conjugated and X-Ala-Asp-conjugated α-melanocyte stimulating hormone peptides.

Science.gov (United States)

Flook, Adam M; Yang, Jianquan; Miao, Yubin

2014-11-13

The purpose of this study was to examine whether the substitution of the Lys linker with the β-Ala could reduce the renal uptake of (99m)Tc-labeled Arg-X-Asp-conjugated and X-Ala-Asp-conjugated α-melanocyte stimulating hormone (α-MSH) peptides. RSD-β-Ala-(Arg(11))CCMSH (1) {c[Arg-Ser-Asp-dTyr-Asp]-β-Ala-Cys-Cys-Glu-His-dPhe-Arg-Trp-Cys-Arg-Pro-Val-NH2}, RTD-β-Ala-(Arg(11))CCMSH (2), RVD-β-Ala-(Arg(11))CCMSH (3), RAD-β-Ala-(Arg(11))CCMSH (4), NAD-β-Ala-(Arg(11))CCMSH (5), and EAD-β-Ala-(Arg(11))CCMSH (6) peptides were synthesized and evaluated for their melanocortin 1 (MC1) receptor binding affinities in B16/F1 melanoma cells. The biodistribution of their (99m)Tc-conjugates were determined in B16/F1 melanoma-bearing C57 mice. The substitution of the Lys linker with β-Ala linker dramatically reduced the renal uptake of all six (99m)Tc-peptides. (99m)Tc-4 exhibited the highest melanoma uptake (15.66 ± 6.19% ID/g) and the lowest kidney uptake (20.18 ± 3.86% ID/g) among these (99m)Tc-peptides at 2 h postinjection. The B16/F1 melanoma lesions could be clearly visualized by single photon emission computed tomography (SPECT)/CT using (99m)Tc-4 as an imaging probe.

Relationship between renal cortex and parenchyma thickness and renal function: study with CT measurement

International Nuclear Information System (INIS)

Xu Yufeng; Tang Guangjian; Jiang Xuexiang

2006-01-01

Objective: To study the relationship between renal morphology and renal function, and to assess the value of CT as a criterion to grade renal function. Methods: Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates (GFR) were measured by renal dynamic imaging with 99 Tc m -DTPA. The 178 kidneys were divided into normal renal function, mild and severe renal impairment groups according to renal function. Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA. Using Pearson's correlation test, the correlation between the renal cortex, parenchyma thicknesses and renal GFR were examined. The value of CT in predicting renal function was assessed by using ROC analysis. Results: The renal cortex thicknesses of normal renal function, mild and severe renal impairment groups were (5.9±1.1), (4.6± 1.1), and (3.3±1.0) mm respectively, and the renal parenchyma thicknesses were (26.3±4.2), (21.3±4.6), (16.2±4.6) mm. There were significant differences of renal cortex, parenchyma thicknesses between 3 groups (cortex F=54.78, P<0.01; parenehyma F=43.90, P<0.01). The thicknesses of renal cortex (r=0.752, P<0.01), parenchyma (r=0.738, P<0.01) had positive linear correlation with renal function. ROC analysis of the renal cortex thicknesses measured by CT in predicting mild and severe renal impairment showed that the Az was 0.860 and 0.905 respectively, whereas that of parenchyma was 0.868 and 0.884. Conclusion: The thicknesses of renal cortex, parenchyma measured by CT can reflect renal function. CT was a supplementary method to assess renal function. (authors)

Mechanistic insights of intestinal absorption and renal conservation of folate in chronic alcoholism.

Science.gov (United States)

Wani, Nissar Ahmad; Thakur, Shilpa; Najar, Rauf Ahmad; Nada, Ritambhara; Khanduja, Krishan Lal; Kaur, Jyotdeep

2013-03-01

Folate mediated one-carbon metabolism is of fundamental importance for various cellular processes, including DNA synthesis and methylation of biological molecules. Due to the exogenous requirement of folate in mammals, there exists a well developed epithelial folate transport system for regulation of normal folate homeostasis. The intestinal and renal folate uptake is tightly and diversely regulated and disturbances in folate homeostasis like in alcoholism have pathological consequences. The study was sought to delineate the regulatory mechanism of folate uptake in intestine and reabsorption in renal tubular cells that could evaluate insights of malabsorption during alcoholism. The folate transporters PCFT and RFC were found to be associated with lipid rafts of membrane surfaces in intestine and kidney. Importantly, the observed lower intestinal and renal folate uptake was associated with decreased levels of folate transporter viz. PCFT and RFC in lipid rafts of intestinal and renal membrane surfaces. The decreased association of folate transporters in lipid rafts was associated with decreased protein and mRNA levels. In addition, immunohistochemical studies showed that alcoholic conditions deranged that localization of PCFT and RFC. These findings could explain the possible mechanistic insights that may result in folate malabsorption during alcoholism. Copyright © 2013 Elsevier Inc. All rights reserved.

Readiness to participate in advance care planning: A qualitative study of renal failure patients, families and healthcare providers.

Science.gov (United States)

Hutchison, Lauren A; Raffin-Bouchal, Donna S; Syme, Charlotte A; Biondo, Patricia D; Simon, Jessica E

2017-09-01

Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program. Semi-structured interviews were recorded, transcribed and then analyzed using interpretive description. Results Readiness for advance care planning was driven by individual values perceived by a collaborative encounter between clinicians and patients/families. If advance care planning is not valued, then patients/families and clinicians are not ready to initiate the process. Patients and clinicians are delaying conversations until "illness burden necessitates," so there is little "advance" care planning, only care planning in-the-moment closer to the end of life. Discussion The value of advance care planning in collaboration with clinicians, patients and their surrogates needs reframing as an ongoing process early in the patient's illness trajectory, distinguished from end-of-life decision making.

The significance of renoscintigraphy for renal transplantation

International Nuclear Information System (INIS)

Oei Hong Yoe.

1981-01-01

The aim of the study reported here was to evaluate the contribution of renoscintigraphy performed frequently and systematically, for differentiation between the various complications occurring after renal transplantation. Relevant complications of renal transplantation are described, with special attention to the diagnostic methods available at present, and the methods used for radionuclide investigations in renal transplantation are reviewed. The abnormalities seen on the sequential images in ten cases complicated by urine leakage or urinary tract obstruction are described. These are illustrated by the scintigrams and the corresponding radiograms. The results in eight patients whose transplant did not show Hippuran uptake are also described. Transplant failure in five of these eight patients was clearly demonstrated by perfusion scintigraphy. (Auth.)

Assessment of 99mTc-DMSA renoscintigraphy and uptake compared with creatinine clearance in rats with drug-induced nephrotoxicity, 2

International Nuclear Information System (INIS)

Yamada, Masafumi

1991-01-01

For evaluation of technetium-99m dimercaptosuccinic acid ( 99m Tc-DMSA) renal uptake as an absolute renal function, 99m Tc-DMSA uptake was compared with endogenous creatinine clearance (Ccr) in cisplatin-induced nephrotoxicity. At first, male Wistar rats were given intraperitoneally 1.8 mg/kg/day of cisplatin for periods of 3, 5, 7 and 9 days. On the next day, 99m Tc-DMSA uptake and Ccr were measured. Ccr of 5-day treated group was significantly lower than that of control (0.13±0.10 vs 0.34±0.05 ml/min/100 g; p 99m Tc-DMSA uptake did not change. 99m Tc-DMSA uptake of 7-day treated group was significantly lower than that of control (28.57±7.23 vs 39.84±2.23%; p 99m Tc-DMSA uptake was lower than that of control on the 8th, 11th and 15th day (32.40±3.86, 32.56±1.19, 35.21±2.97 vs 39.84±2.23%, respectively; p 99m Tc-DMSA uptake and Ccr was observed in the cisplatin-induced nephrotoxicity. 99m Tc-DMSA uptake was suggested to be a reliable indicator of a renal function in a different way from Ccr. (author)

The relation between respiratory motion artifact correction and lung standardized uptake value

International Nuclear Information System (INIS)

Yin Lijie; Liu Xiaojian; Liu Jie; Xu Rui; Yan Jue

2014-01-01

PET/CT is playing an important role in disease diagnosis and therapeutic evaluation. But the respiratory motion artifact may bring trouble in diagnosis and therapy. There are many methods to correct the respiratory motion artifact. Respiratory gated PET/CT is applied most extensively of them. Using respiratory gated PET/CT to correct respiratory motion artifact can increase the maximum standardized uptake value of lung lesion obviously, thereby improving the quality of image and accuracy of diagnosis. (authors)

Assessment of Cu-ETS as a PET radiopharmaceutical for evaluation of regional renal perfusion

International Nuclear Information System (INIS)

Green, Mark A.; Mathias, Carla J.; Willis, Lynn R.; Handa, Rajash K.; Lacy, Jeffrey L.; Miller, Michael A.; Hutchins, Gary D.

2007-01-01

The copper(II) complex of ethylglyoxal bis(thiosemicarbazone) (Cu-ETS) was evaluated as a positron emission tomography (PET) radiopharmaceutical for assessment of regional renal perfusion. Methods: The concordance of renal flow estimates obtained with 11- and 15-μm microspheres was confirmed in four immature farm pigs using co-injected 46 Sc- and 57 Co-microspheres administered into the left ventricle. With the use of both immature farm pigs (n=3) and mature Goettingen minipigs (n=6), regional renal radiocopper uptake following intravenous [ 64 Cu]Cu-ETS administration was compared to microsphere measurements of renal perfusion. The distribution and kinetics of [ 64 Cu]Cu-ETS were further studied by PET imaging of the kidneys. The rate of [ 64 Cu]Cu-ETS decomposition by blood was evaluated in vitro, employing octanol extraction to recover intact [ 64 Cu]Cu-ETS. Results: The co-injected 11- and 15-μm microspheres provided similar estimates of renal flow. A linear relationship was observed between the renal uptake of intravenous [ 64 Cu]Cu-ETS and regional renal perfusion measured using microspheres. [ 64 Cu]Cu-ETS provided high-quality PET kidney images demonstrating the expected count gradient from high-flow outer cortex to low-flow medulla. When incubated with pig blood in vitro at 37 o C, the [ 64 Cu]Cu-ETS radiopharmaceutical was observed to decompose with a half-time of 2.8 min. Conclusion: Cu-ETS appears suitable for use as a PET radiopharmaceutical for evaluation of regional renal perfusion, affording renal uptake of radiocopper that varies linearly with microsphere perfusion measurements. Quantification of renal perfusion (in ml min -1 g -1 ) with [ 60,61,62,64 Cu]Cu-ETS will require correcting the arterial input function for the fraction of blood radiocopper remaining present as the intact Cu-ETS radiopharmaceutical, since the Cu-ETS chelate has limited chemical stability in blood. Rapid octanol extraction of blood samples appears suitable as an approach

Distinguishing enhancing from nonenhancing renal masses with dual-source dual-energy CT: iodine quantification versus standard enhancement measurements.

Science.gov (United States)

Ascenti, Giorgio; Mileto, Achille; Krauss, Bernhard; Gaeta, Michele; Blandino, Alfredo; Scribano, Emanuele; Settineri, Nicola; Mazziotti, Silvio

2013-08-01

To compare the diagnostic accuracy of iodine quantification and standard enhancement measurements in distinguishing enhancing from nonenhancing renal masses. The Institutional Review Board approved this retrospective study conducted from data found in institutional patient databases and archives. Seventy-two renal masses were characterised as enhancing or nonenhancing using standard enhancement measurements (in HU) and iodine quantification (in mg/ml). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of standard enhancement measurements and iodine quantification were calculated from χ (2) tests of contingency with histopathology or imaging follow-up as the reference standard. Difference in accuracy was assessed by means of McNemar analysis. Sensitivity, specificity, PPV, NPV and diagnostic accuracy for standard enhancement measurements and iodine quantification were 77.7 %, 100 %, 100 %, 81.8 %, 89 % and 100 %, 94.4 %, 94.7, 100 % and 97 %, respectively. The McNemar analysis showed that the accuracy of iodine quantification was significantly better (P < 0.001) than that of standard enhancement measurements. Compared with standard enhancement measurements, whole-tumour iodine quantification is more accurate in distinguishing enhancing from nonenhancing renal masses. • Enhancement of renal lesions is important when differentiating benign from malignant tumours. • Dual-energy CT offers measurement of iodine uptake rather than mere enhancement values. • Whole-tumour iodine quantification seems more accurate than standard CT enhancement measurements.

Notes on the liver correction applied systematically to all renal scintigrams

International Nuclear Information System (INIS)

Artus, J.C.; Miro, L.; Durand, J.

1976-01-01

A problem still outstanding in renal scintigraphy is analyzed: how to deal with the parasitic tracer uptake by the liver. Some investigators correct systematically for the liver shadow by injecting technetium labelled colloids, for others the data supplied by 197 HgCl 2 scintigraphy alone allow to estimate the kidney uptake. Objective criteria are given as a mean to decide whether a liver scintigram is necessary in order to obtain the kidney uptake rate [fr

Evaluation of (o)-[77Br]bromohippuran as renal tubular function agent

International Nuclear Information System (INIS)

Aswegen, A. van; Roodt, J.P.; Pieters, H.; Herbst, C.P.; Otto, A.C.; Loetter, M.G.; Minnaar, P.C.; Haasbroek, F.J.

1985-01-01

(o)-[ 77 Br]bromohippuran (BHIP) was developed as renal tubular function agent due to its favourable chemical and physical properties and compared to (o)-[ 131 I]iodohippuran (IHIP). Renograms obtained from baboons were compared and absorbed radiation dose calculations performed. Although BHIP showed a delayed kidney uptake and washout pattern, good kidney clearance of the radionuclide was obtained after 30 min. Radiation dose values for BHIP were markedly lower than for IHIP indicating that larger activities of BHIP could be administered to increase counting statistics. BHIP imaging in normal volunteers did however not substantiate the favourable behaviour obtained in the primate. (author)

Integrating kidney transplantation into value-based care for people with renal failure.

Science.gov (United States)

Hippen, Benjamin E; Maddux, Franklin W

2018-01-01

Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients. The implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) offers a time-sensitive incentive for transplant centers in particular to align with extant CECs. An "expanded" CEC model proffers opportunity for robust cooperation between general nephrology practices, dialysis providers, and transplant centers to develop care coordination strategies for all patients with renal disease, realign incentives for all clinical stakeholders to increase kidney transplantation rates, and reduce total costs of care. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

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Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Hyunjong; Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

2017-01-15

To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative {sup 18}F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUV{sub max} and SUV{sub avg}), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. Preoperative IFH measured by {sup 18}F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. (orig.)

Uptake and release of glucose by the human kidney. Postabsorptive rates and responses to epinephrine.

Science.gov (United States)

Stumvoll, M; Chintalapudi, U; Perriello, G; Welle, S; Gutierrez, O; Gerich, J

1995-11-01

Despite ample evidence that the kidney can both produce and use appreciable amounts of glucose, the human kidney is generally regarded as playing a minor role in glucose homeostasis. This view is based on measurements of arteriorenal vein glucose concentrations indicating little or no net release of glucose. However, inferences from net balance measurements do not take into consideration the simultaneous release and uptake of glucose by the kidney. Therefore, to assess the contribution of release and uptake of glucose by the human kidney to overall entry and removal of plasma glucose, we used a combination of balance and isotope techniques to measure renal glucose net balance, fractional extraction, uptake and release as well as overall plasma glucose appearance and disposal in 10 normal volunteers under basal postabsorptive conditions and during a 3-h epinephrine infusion. In the basal postabsorptive state, there was small but significant net output of glucose by the kidney (66 +/- 22 mumol.min-1, P = 0.016). However, since renal glucose fractional extraction averaged 2.9 +/- 0.3%, there was considerable renal glucose uptake (2.3 +/- 0.2 mumol.kg-1.min-1) which accounted for 20.2 +/- 1.7% of systemic glucose disposal (11.4 +/- 0.5 mumol.kg-1.min-1). Renal glucose release (3.2 +/- 0.2 mumol.kg-1.min-1) accounted for 27.8 +/- 2.1% of systemic glucose appearance (11.4 +/- 0.5 mumol.kg-1.min-1). Epinephrine infusion, which increased plasma epinephrine to levels observed during hypoglycemia (3722 +/- 453 pmol/liter) increased renal glucose release nearly twofold (5.2 +/- 0.5 vs 2.8 +/- 0.1 mol.kg-1.min-1, P = 0.01) so that at the end of the infusion, renal glucose release accounted for 40.3 +/- 5.5% of systemic glucose appearance and essentially all of the increase in systemic glucose appearance. These observations suggest an important role for the human kidney in glucose homeostasis.

Commonly used reference values underestimate oxygen uptake in healthy, 50-year-old Swedish women.

Science.gov (United States)

Genberg, M; Andrén, B; Lind, L; Hedenström, H; Malinovschi, A

2018-01-01

Cardiopulmonary exercise testing (CPET) is the gold standard among clinical exercise tests. It combines a conventional stress test with measurement of oxygen uptake (V O 2 ) and CO 2 production. No validated Swedish reference values exist, and reference values in women are generally understudied. Moreover, the importance of achieved respiratory exchange ratio (RER) and the significance of breathing reserve (BR) at peak exercise in healthy individuals are poorly understood. We compared V O 2 at maximal load (peakV O 2 ) and anaerobic threshold (V O 2@ AT ) in healthy Swedish individuals with commonly used reference values, taking gender into account. Further, we analysed maximal workload and peakV O 2 with regard to peak RER and BR. In all, 181 healthy, 50-year-old individuals (91 women) performed CPET. PeakV O 2 was best predicted using Jones et al. (100·5%), while SHIP reference values underestimated peakV O 2 most: 112·5%. Furthermore, underestimation of peakV O 2 in women was found for all studied reference values (P 1·1 (2 328·7 versus 2 176·7 ml min -1 , P = 0·11). Lower BR (≤30%) related to significantly higher peakV O 2 (Pvalues underestimated oxygen uptake in women. No evidence for demanding RER > 1·1 in healthy individuals was found. A lowered BR is probably a normal response to higher workloads in healthy individuals. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Technetium-99m pyrophosphate imaging in acute renal failure associated with nontraumatic rhabdomyolysis

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Patel, R.; Mishkin, F.S.

1986-10-01

Technetium-99m pyrophosphate (Tc-PYP) imaging was performed in five patients with acute renal failure associated with nontraumatic rhabdomyolysis. Four patients had phencyclidine intoxication and one had viral pneumonia. During the acute phase, marked uptake of pyrophosphate was seen in all patients in several muscle groups, but always in the thigh adductors. The results show that phencyclidine intoxication can result in diffuse muscle uptake of Tc-PYP without overt evidence of muscle injury. Tc-PYP imaging may provide a clue to the cause of acute renal failure in patients with suspected rhabdomyolysis in whom elevations of serum creatine phosphokinase concentrations are equivocal.

Technetium-99m pyrophosphate imaging in acute renal failure associated with nontraumatic rhabdomyolysis

International Nuclear Information System (INIS)

Patel, R.; Mishkin, F.S.

1986-01-01

Technetium-99m pyrophosphate (Tc-PYP) imaging was performed in five patients with acute renal failure associated with nontraumatic rhabdomyolysis. Four patients had phencyclidine intoxication and one had viral pneumonia. During the acute phase, marked uptake of pyrophosphate was seen in all patients in several muscle groups, but always in the thigh adductors. The results show that phencyclidine intoxication can result in diffuse muscle uptake of Tc-PYP without overt evidence of muscle injury. Tc-PYP imaging may provide a clue to the cause of acute renal failure in patients with suspected rhabdomyolysis in whom elevations of serum creatine phosphokinase concentrations are equivocal

Effect of basic amino acids and aminoglycosides on 3H-gentamicin uptake in cortical slices of rat and human kindney

International Nuclear Information System (INIS)

Bennett, W.M.; Plamp, C.E.; Elliott, W.C.; Parker, R.A.; Porter, G.A.

1982-01-01

The uptake of 3 H-gentamicin was assessed in renal cortical slices of Fischer 344 male rats and four human cadaver kidneys not utilized for renal transplantation. In both species the uptake was maximal at 90 min and maintained a steady state therafter. The characteristics of the energy-dependent component of 3 H-gentamicin uptake were not altered by various basic amino acids, but competitive inhibition was induced by other aminoglycosides in a dose-dependent fashion. Thus aminoglycosides appear to share a transport process that is distinct from those of organic bases or other cationic substances. In addition, under the experimental conditions employed, the basolateral membranes of the tubular cell is capable of energy-dependent uptake of gentamicin. The role of this route of cellular uptake of aminoglycoside in clinical nephrotoxicity is speculative

Technetium-99m mercaptoacetyltriglycine clearance values in children with minimal renal disease: can a normal range be determined?

International Nuclear Information System (INIS)

Meyer, G.; Hahn, K.; Piepsz, A.; Kolinska, J.; Lepej, J.; Sixt, R.

1998-01-01

Use of technetium-99m labelled mercaptoacetyltriglycine ( 99m Tc-MAG3) simplifies and improves the quantification of renal clearance in children by virtue of its permanent availability, good imaging properties and low radiation exposure. Due to the lack of reference values for 99m Tc-MAG3 clearance in children, the Paediatric Task Group of the EANM initiated a multicentre study to evaluate 99m Tc-MAG3 clearance values in children with minimal renal disease. One hundred and twenty-five children aged between 12 months and 17 years, classified as renally healthy using defined diagnostic criteria, were included in the study. 99m Tc-MAG3 clearance was calculated using an algorithm on the basis of a single blood sample taken at any time between 30 and 40 min after tracer injection. In addition, the absolute 99m -Tc-MAG3 clearance values were normalized to body surface area. For further evaluation the children were classified into several groups according to age. There was a continuous increase in non-corrected 99m Tc-MAG3 clearance values from the age of 1 year up to the age of 17 years (mean value 8 years: 208±66 ml/min). Normal clearance values for adults were achieved by the age of 8 years. Analysis of the relationship between non-corrected clearance and age yielded a correlation coefficient of r=0.7. When these absolute clearance values were normalized to body surface area, we found nearly constant clearance values for all age groups, with a mean clearance value of 315±114 ml/min x 1.73 m 2 . The correlation coefficient for the relationship between normalized clearance and age was r=0.28. In conclusion, the clearance of 99m Tc-MAG3 increases continuously throughout childhood into adolescence due to the maturation and growth of the kidney. After normalization of the absolute clearance to body surface area, no correlation between clearance and age could be proven. (orig.)

Treatment of non-neoplastic renal hemorrhage with segmental embolization of renal artery

International Nuclear Information System (INIS)

Zhu Bing

2007-01-01

Objective: To explore the value of segmental embolization of renal artery in dealing with non- neoplastic renal hemorrhage. Methods: Four cases of non-neoplastic hemorrhage, including 2 with bleeding after renal acupuncture biopsy, 2 with bleeding after nephrolithotomy and 1 with congenital renal arteriovenous malformation, were treated with superselective segmental embolization of renal artery. 2 were embolized with coil, 1 with alcohol plus coil and 1 with PVA parcels. Results: Hematuria disappeared in 1-3 days. There was no recurrence in 7-45 months follow up and no complications induced by embolization. Conclusion: It is a safe and reliable therapy to treat non-neoplastic renal hemorrhage with segmental embolization of renal artery. (authors)

Diagnostic value of exercise thallium-201 scintigraphy for ischemic heart disease in patients with chronic renal failure

International Nuclear Information System (INIS)

Sato, Shigeaki; Ohta, Makoto; Soejima, Michimasa

1991-01-01

Recently, it has been reported that there are considerable difficulties in diagnosing ischemic heart disease by ECG alone in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). This study was designed to evaluate the diagnostic value of exercise thollium-201 myocardial scintigraphy as compared with ECG examination alone in patients with chronic renal failure. The subjects were 26 patients with chronic renal failure, including patients being treated with HD and CAPD, and 7 normal persons who served as controls. Exercise thallium-201 myocardial scintigraphy was performed according to a multistage bicycle ergometer exercise test. Exercise duration times were shorter (p<0.001) and maximum attained heart rates lower (p<0.05) in the HD group than in controls. Since exercise capacities were reduced in the dialysis patients, there were considerable difficulties in diagnosing ischemic heart disease by ECG alone. In our 26 patients, 15 cases (57.7%) had left ventricular hypertrophy, 5 cases (19.2%) had manifestations of ischemic heart disease, and 4 cases with abnormal ECGs had no abnormal findings on exercise thallium-201 myocardial scintigraphy. Thallium washout rates were higher (p<0.001) in the chronic renal failure group than in the control group, and a significant negative correlation (r=-0.70, p<0.001) was found between thallium washout rates and hematocrit values. Exercise thallium-201 myocardial scitigraphy was more accurate than ECG examination and also could be performed repeatedly without invasion. These results indicate that exercise thallium-201 myocardial scintigraphy is a valuable diagnostic method for ischemic heart disease in patients with chronic renal failure. (author)

Apparent diffusion coefficient of renal parenchyma and color Doppler ultrasound of intrarenal arteries in patients with cirrhosis related renal dysfunction

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Mohamed M Hefeda

2014-12-01

Conclusion: Liver cirrhosis, even in the presence of refractory ascites, did not affect the ADC value of renal parenchyma, however ADC value is affected in renal parenchyma of patients with hepato-renal syndrome. Duplex-Doppler ultrasound of intrarenal arteries enables the early detection of renal hemodynamic disturbances in patients with liver cirrhosis.

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, A. S; Ahmed, M.I; Elfaki, H.M; Hassan, N.; Suliman, S. M.

2006-12-01

Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

Renal Extraction and Acute Effects of Glucagon-like peptide-1 on Central and Renal Hemodynamics in Healthy Men

DEFF Research Database (Denmark)

Asmar, Ali; Simonsen, Lene; Asmar, Meena

2015-01-01

of either GLP-1 (1.5 pmol kg-1 min-1) or saline, cardiac output was estimated non-invasively, and intra-arterial blood pressure and heart rate were measured continuously. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured by Fick's Principle after...... catheterization of a renal vein. The subjects remained supine during the experiments. During GLP-1 infusion, the systolic blood pressure and arterial pulse pressure both increased by 5 ± 1 mm Hg (p=0.015 and p=0.002, respectively). Heart rate increased by 5 ± 1 bpm (p=0.005) and cardiac output increased by 18...... % (p=0.016). Renal plasma flow and glomerular filtration rate as well as clearance of sodium and lithium were not affected by GLP-1. However, plasma renin activity decreased (p=0.037), whereas plasma levels of atrial natriuretic peptide (ANP) were unaffected. Renal extraction of intact GLP-1 was 43% (p...

The effect of eating salt with iodine on the normal values of thyroid 131I uptake rate

International Nuclear Information System (INIS)

Zhang Chunyan; Wang Huawen; Li Guirong; Chen Chunmei; Zhang Lixia; Yu Yuehua

2002-01-01

131 I uptake rates of control group, which stop eating salt with iodine for over six weeks, eating salt with iodine group, the hyperthyroidism group are determined in 2 h, 6 h and 24 h respectively. The results show 131 I uptake rate of eating salt with iodine group are (7.7 +- 4.2)% in 2 h, (13.8 +- 5.3)% in 6 h and (21.9 +- 7.7)% in 24 h. There are no difference between sex. There is significance of difference (P 131 I uptake rates between the hyperthyroidism group of eating salt with iodine and control group is 5.0%, and eating salt with iodine group is 22.5%. To determine the thyroid iodine uptake rate in the patients who did not stop eating salt with iodine, the ranges of normal values must be defined. This result could be as a standard to diagnose the patients of hyperthyroidism of eating salt with iodine

The renal scan in pregnant renal transplant patients

International Nuclear Information System (INIS)

Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

1985-01-01

With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts

Difference in prognostic significance of maximum standardized uptake value on [18F]-fluoro-2-deoxyglucose positron emission tomography between adenocarcinoma and squamous cell carcinoma of the lung

International Nuclear Information System (INIS)

Tsutani, Yasuhiro; Miyata, Yoshihiro; Misumi, Keizo; Ikeda, Takuhiro; Mimura, Takeshi; Hihara, Jun; Okada, Morihito

2011-01-01

This study evaluates the prognostic significance of [18F]-fluoro-2-deoxyglucose positron emission tomography/computed tomography findings according to histological subtypes in patients with completely resected non-small cell lung cancer. We examined 176 consecutive patients who had undergone preoperative [18F]-fluoro-2-deoxyglucose-positron emission tomography/computed tomography imaging and curative surgical resection for adenocarcinoma (n=132) or squamous cell carcinoma (n=44). Maximum standardized uptake values for the primary lesions in all patients were calculated as the [18F]-fluoro-2-deoxyglucose uptake and the surgical results were analyzed. The median values of maximum standardized uptake value for the primary tumors were 2.60 in patients with adenocarcinoma and 6.95 in patients with squamous cell carcinoma (P 6.95 (P=0.83) among patients with squamous cell carcinoma, 2-year disease-free survival rates were 93.9% for maximum standardized uptake value ≤3.7 and 52.4% for maximum standardized uptake value >3.7 (P<0.0001) among those with adenocarcinoma, and notably, 100 and 57.2%, respectively, in patients with Stage I adenocarcinoma (P<0.0001). On the basis of the multivariate Cox analyses of patients with adenocarcinoma, maximum standardized uptake value (P=0.008) was a significantly independent factor for disease-free survival as well as nodal metastasis (P=0.001). Maximum standardized uptake value of the primary tumor was a powerful prognostic determinant for patients with adenocarcinoma, but not with squamous cell carcinoma of the lung. (author)

Standardized Uptake Value Ratio-Independent Evaluation of Brain Amyloidosis.

Science.gov (United States)

Chincarini, Andrea; Sensi, Francesco; Rei, Luca; Bossert, Irene; Morbelli, Silvia; Guerra, Ugo Paolo; Frisoni, Giovanni; Padovani, Alessandro; Nobili, Flavio

2016-10-18

The assessment of in vivo18F images targeting amyloid deposition is currently carried on by visual rating with an optional quantification based on standardized uptake value ratio (SUVr) measurements. We target the difficulties of image reading and possible shortcomings of the SUVr methods by validating a new semi-quantitative approach named ELBA. ELBA involves a minimal image preprocessing and does not rely on small, specific regions of interest (ROIs). It evaluates the whole brain and delivers a geometrical/intensity score to be used for ranking and dichotomic assessment. The method was applied to adniimages 18F-florbetapir images from the ADNI database. Five expert readers provided visual assessment in blind and open sessions. The longitudinal trend and the comparison to SUVr measurements were also evaluated. ELBA performed with area under the roc curve (AUC) = 0.997 versus the visual assessment. The score was significantly correlated to the SUVr values (r = 0.86, p analysis estimated a test/retest error of ≃2.3%. Cohort and longitudinal analysis suggests that the ELBA method accurately ranks the brain amyloid burden. The expert readers confirmed its relevance in aiding the visual assessment in a significant number (85) of difficult cases. Despite the good performance, poor and uneven image quality constitutes the major limitation.

Assessment of Cu-ETS as a PET radiopharmaceutical for evaluation of regional renal perfusion

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Green, Mark A. [Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47907 (United States)]. E-mail: magreen@purdue.edu; Mathias, Carla J. [Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47907 (United States); Willis, Lynn R. [Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Handa, Rajash K. [Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Lacy, Jeffrey L. [Proportional Technologies, Inc., Houston, TX 77054 (United States); Miller, Michael A. [Department of Radiology and the Indiana Center of Excellence in Biomedical Imaging, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Hutchins, Gary D. [Department of Radiology and the Indiana Center of Excellence in Biomedical Imaging, Indiana University School of Medicine, Indianapolis, IN 46202 (United States)

2007-04-15

The copper(II) complex of ethylglyoxal bis(thiosemicarbazone) (Cu-ETS) was evaluated as a positron emission tomography (PET) radiopharmaceutical for assessment of regional renal perfusion. Methods: The concordance of renal flow estimates obtained with 11- and 15-{mu}m microspheres was confirmed in four immature farm pigs using co-injected {sup 46}Sc- and {sup 57}Co-microspheres administered into the left ventricle. With the use of both immature farm pigs (n=3) and mature Goettingen minipigs (n=6), regional renal radiocopper uptake following intravenous [{sup 64}Cu]Cu-ETS administration was compared to microsphere measurements of renal perfusion. The distribution and kinetics of [{sup 64}Cu]Cu-ETS were further studied by PET imaging of the kidneys. The rate of [{sup 64}Cu]Cu-ETS decomposition by blood was evaluated in vitro, employing octanol extraction to recover intact [{sup 64}Cu]Cu-ETS. Results: The co-injected 11- and 15-{mu}m microspheres provided similar estimates of renal flow. A linear relationship was observed between the renal uptake of intravenous [{sup 64}Cu]Cu-ETS and regional renal perfusion measured using microspheres. [{sup 64}Cu]Cu-ETS provided high-quality PET kidney images demonstrating the expected count gradient from high-flow outer cortex to low-flow medulla. When incubated with pig blood in vitro at 37{sup o}C, the [{sup 64}Cu]Cu-ETS radiopharmaceutical was observed to decompose with a half-time of 2.8 min. Conclusion: Cu-ETS appears suitable for use as a PET radiopharmaceutical for evaluation of regional renal perfusion, affording renal uptake of radiocopper that varies linearly with microsphere perfusion measurements. Quantification of renal perfusion (in ml min{sup -1} g{sup -1}) with [{sup 60,61,62,64}Cu]Cu-ETS will require correcting the arterial input function for the fraction of blood radiocopper remaining present as the intact Cu-ETS radiopharmaceutical, since the Cu-ETS chelate has limited chemical stability in blood. Rapid octanol

Renal shear wave velocity by acoustic radiation force impulse did not reflect advanced renal impairment.

Science.gov (United States)

Takata, Tomoaki; Koda, Masahiko; Sugihara, Takaaki; Sugihara, Shinobu; Okamoto, Toshiaki; Miyoshi, Kenichi; Matono, Tomomitsu; Hosho, Keiko; Mae, Yukari; Iyama, Takuji; Fukui, Takeaki; Fukuda, Satoko; Munemura, Chishio; Isomoto, Hajime

2016-12-01

Acoustic radiation force impulse is a noninvasive method for evaluating tissue elasticity on ultrasound. Renal shear wave velocity measured by this technique has not been fully investigated in patients with renal disease. The aim of the present study was to compare renal shear wave velocity in end-stage renal disease patients and that in patients without chronic kidney disease and to investigate influencing factors. Renal shear wave velocities were measured in 59 healthy young subjects (control group), 31 subjects without chronic kidney disease (non-CKD group), and 39 end-stage renal disease patients (ESRD group). Each measurement was performed 10 times at both kidneys, and the mean value of eight of 10 measurements, excluding the maximum and minimum values, was compared. Renal shear wave velocity could be measured in all subjects. Renal shear wave velocity in the control group was higher than in the non-CKD group and in the ESRD group, and no difference was found between the non-CKD group and the ESRD group. Age and depth were negatively correlated to the renal shear wave velocity. In multiple regression analysis, age and depth were independent factors for renal shear wave velocity, while renal impairment was not. There was no difference between the non-CKD group and the ESRD group, even when ages were matched and depth was adjusted. Renal shear wave velocity was not associated with advanced renal impairment. However, it reflected alteration of renal aging, and this technique may be useful to detect renal impairment in the earlier stages. © 2015 Asian Pacific Society of Nephrology.

Relative Renal Blood Flow Measurements With Rb-82 and a Hybrid Gamma Camera Using a Pig Model

Science.gov (United States)

Pretorius, P. H.; Fung, L. C. T.; Schell, C. P.; King, M. A.

2005-02-01

We have successfully demonstrated with chronically implanted blood flow probes in a pig model that renal uptake of Rb-82 is indeed sensitive to acute renal blood flow changes. Two flow probes were placed around the left and right renal arteries in a surgical procedure nine weeks before the first Rb-82 measurements. Together with the flow probes, a flow restrictor was implanted around the left renal artery. Single bolus infusions of 6 mCi Rb-82 were used to study the uptake in the kidneys approximately 7 minutes apart in hybrid-image limited-angle acquisitions (stationary camera heads posterior and anterior of the pig) while changing the flow to the left kidney between acquisitions. The acquired data were reconstructed into 7.5-s frames using a maximum likelihood (ML) list-mode reconstruction algorithm exploiting timing signals inserted into the list every 0.25 s. Reconstructed data were orientated to coronal views before regions of interest (ROIs) were drawn over both kidneys with a separate background region for each. The data represented are noisy due to the reconstructed 7.5-s frames, and the total imaging time of 5 min (or 4 Rb-82 half-lives). We were able to show a steady decline in uptake of Rb-82 in the left kidney that correlates with the reduction in renal blood flow. The reduced blood flow to the left kidney affects the Rb-82 uptake to the right kidney slightly, while blood flow decreased up to 33%. Comparing the baseline renal blood flow of the left kidney obtained before and after the intervention indicates that some ischemia persists after blood flow was restored. Attenuation compensation better described the contour of the kidney but only scales the time activity curve without changing its shape.

Predictive value of ADAMTS-13 on concealed chronic renal failure in COPD patients

Science.gov (United States)

Zeng, Mian; Chen, Qingui; Liang, Wenjie; He, Wanmei; Zheng, Haichong; Huang, Chunrong

2017-01-01

Background Impaired renal function is often neglected in COPD patients. Considering that COPD patients usually have an ongoing prothrombotic state and systemic inflammation status, we investigated the association among them and explored the predictive value of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13), on concealed chronic renal failure (CRF) in COPD patients. Methods COPD patients were recruited from the First Affiliated Hospital of Sun Yat-Sen University between January 2015 and December 2016. Control was selected from contemporaneous hospitalized patients without COPD and matched by age and gender at a ratio of 1:1. Estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration formula, and all subjects were categorized as having normal renal function (eGFR ≥60 mL min−1 1.73 m−2) and having concealed CRF (normal serum creatinine while eGFR <60 mL min−1 1.73 m−2). Independent correlates of concealed CRF were investigated by logistic regression analysis, and receiver operating characteristic (ROC) curves were used to determine the predictive value of ADAMTS-13. Results In total, 106 COPD and 106 non-COPD patients were finally recruited, and the incidences of concealed CRF were 19.81% and 7.55%, respectively. ADAMTS-13 (odds ratio [OR] =0.858, 95% CI =0.795–0.926), D-dimer (OR =1.095, 95% CI =1.027–1.169), and C-reactive protein (OR =1.252, 95% CI =1.058–1.480) were significantly associated with concealed CRF. Sensitivity and specificity at an ADAMTS-13 cutoff of 318.72 ng/mL were 100% and 81.2%, respectively. The area under the ROC curve was 0.959. Conclusion Prothrombotic state and systemic inflammation status might contribute to explaining the high incidence of concealed CRF in COPD, and plasma ADAMTS-13 levels may serve as a strong predictor. PMID:29255356

Extraosseous uptake of sup(99m)technetium methylene diphosphonate: Neuroblastoma or radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Sty, J R; Kun, L; Casper, J; Babbitt, D P [Wisconsin Univ., Milwaukee (USA). Dept. of Radiology

1980-01-01

A child with a ganglioneuroblastoma and tumor uptake of sup(99m)technetium methylene diphosphonate (sup(99m)Tc-MDP) is presented. After surgical removal of an encapsulated tumor and radiation therapy, an interval bone scan demonstrated the same presurgical abnormality. Awareness of abnormal uptake of sup(99m)Tc-MDP in irradiated renal tissue prevents interpreting radiation nephritis as recurrent tumor.

99mTc DMSA scintigraphic findings in renal tuberculosis

International Nuclear Information System (INIS)

Moon, Tae Yong; Kim, Kun Il; Yoon, Chi Soon; Lee, Suck Hong; Kim, Byung Soo

1993-01-01

Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal functions are not evaluate with there methods. 99m Tc- DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluated by insuring the counts of renal radioactivity and concomitant evaluation of renal morphology could be passable with the analog images of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidneys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with non visualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and corresponding to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%,18.4%, 7.9%, 12%, 4.1%, 3.4% respectively

Evaluation of allograft perfusion by radionuclide first-pass study in renal failure following renal transplantation

International Nuclear Information System (INIS)

Baillet, G.; Ballarin, J.; Urdaneta, N.; Campos, H.; Vernejoul, P. de; Fermanian, J.; Kellershohn, C.; Kreis, H.

1986-01-01

To assess the diagnostic value of indices measured on a first-pass curve, we performed 72 radionuclide renal first-pass studies (RFP) in 21 patients during the early weeks following renal allograft transplantation. The diagnosis was based on standard clinical and biochemical data and on fine needle aspiration biopsy (FNAB) of the transplant. Aortic and renal first-pass curves were filtered using a true low-pass filter and five different indices of renal perfusion were computed, using formulae from the literature. Statistical analysis performed on the aortic and renal indices indicated excellent reproducibility of the isotopic study. Although renal indices presented a rather large scatter, they all discriminated well between normal and rejection. Three indices have a particularly good diagnostic value. In the discrimination between rejection and Acute Tubular Necrosis (ATN), only one index gave satisfying results. The indices, however, indicate that there are probably ATN with an alternation of renal perfusion and rejection episodes where perfusion is almost intact. We conclude that radionuclide first-pass study allows accurate and reproducible quantitation of renal allograft perfusion. The measured parameters are helpful to follow up the course of a post-transplantation renal failure episode and to gain more insight into renal ischemia following transplantation. (orig.)

Three-dimensional positron emission tomography image texture analysis of esophageal squamous cell carcinoma: relationship between tumor 18F-fluorodeoxyglucose uptake heterogeneity, maximum standardized uptake value, and tumor stage.

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Dong, Xinzhe; Xing, Ligang; Wu, Peipei; Fu, Zheng; Wan, Honglin; Li, Dengwang; Yin, Yong; Sun, Xiaorong; Yu, Jinming

2013-01-01

To explore the relationship of a new PET image parameter, (18)F-fluorodeoxyglucose ((18)F-FDG) uptake heterogeneity assessed by texture analysis, with maximum standardized uptake value (SUV(max)) and tumor TNM staging. Forty consecutive patients with esophageal squamous cell carcinoma were enrolled. All patients underwent whole-body preoperative (18)F-FDG PET/CT. Heterogeneity of intratumoral (18)F-FDG uptake was assessed on the basis of the textural features (entropy and energy) of the three-dimensional images using MATLAB software. The correlations between the textural parameters and SUV(max), histological grade, tumor location, and TNM stage were analyzed. Tumors with higher SUV(max) were seen to be more heterogenous on (18)F-FDG uptake. Significant correlations were observed between T stage and SUV(max) (r(s)=0.390, P=0.013), entropy (rs=0.693, Pheterogeneity and the commonly used simplistic parameter of SUV and tumor stage. Our findings suggest a complementary role of these parameters in the staging and prognosis of esophageal squamous cell carcinoma.

The value of intratumoral heterogeneity of (18)F-FDG uptake to differentiate between primary benign and malignant musculoskeletal tumours on PET/CT.

Science.gov (United States)

Nakajo, Masatoyo; Nakajo, Masayuki; Jinguji, Megumi; Fukukura, Yoshihiko; Nakabeppu, Yoshiaki; Tani, Atsushi; Yoshiura, Takashi

2015-01-01

The cumulative standardized uptake value (SUV)-volume histogram (CSH) was reported to be a novel way to characterize heterogeneity in intratumoral tracer uptake. This study investigated the value of fluorine-18 fludeoxyglucose ((18)F-FDG) intratumoral heterogeneity in comparison with SUV to discriminate between primary benign and malignant musculoskeletal (MS) tumours. The subjects comprised 85 pathologically proven MS tumours. The area under the curve of CSH (AUC-CSH) was used as a heterogeneity index, with lower values corresponding with increased heterogeneity. As 22 tumours were indiscernible on (18)F-FDG positron emission tomography, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) and AUC-CSH were obtained in 63 positive tumours. The Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for analyses. The difference between benign (n = 35) and malignant tumours (n = 28) was significant in AUC-CSH (p = 0.004), but not in SUVmax (p = 0.168) and SUVmean (p = 0.879). The sensitivity, specificity and accuracy for diagnosing malignancy were 61%, 66% and 64% for SUVmax (optical threshold value, >6.9), 54%, 60% and 57% for SUVmean (optical threshold value, >3) and 61%, 86% and 75% for AUC-CSH (optical threshold value, ≤0.42), respectively. The area under the ROC curve was significantly higher in AUC-CSH (0.71) than SUVmax (0.60) (p = 0.018) and SUVmean (0.51) (p = 0.005). The heterogeneity index, AUC-CSH, has a higher diagnostic accuracy than SUV analysis in differentiating between primary benign and malignant MS tumours, although it is not sufficiently high enough to obviate histological analysis. AUC-CSH can assess the heterogeneity of (18)F-FDG uptake in primary benign and malignant MS tumours, with significantly greater heterogeneity associated with malignant MS tumours. AUC-CSH is more diagnostically accurate than SUV analysis in differentiating between benign and

Value of adding the renal pathological score to the kidney failure risk equation in advanced diabetic nephropathy.

Directory of Open Access Journals (Sweden)

Masayuki Yamanouchi

Full Text Available There have been a limited number of biopsy-based studies on diabetic nephropathy, and therefore the clinical importance of renal biopsy in patients with diabetes in late-stage chronic kidney disease (CKD is still debated. We aimed to clarify the renal prognostic value of pathological information to clinical information in patients with diabetes and advanced CKD.We retrospectively assessed 493 type 2 diabetics with biopsy-proven diabetic nephropathy in four centers in Japan. 296 patients with stage 3-5 CKD at the time of biopsy were identified and assigned two risk prediction scores for end-stage renal disease (ESRD: the Kidney Failure Risk Equation (KFRE, a score composed of clinical parameters and the Diabetic Nephropathy Score (D-score, a score integrated pathological parameters of the Diabetic Nephropathy Classification by the Renal Pathology Society (RPS DN Classification. They were randomized 2:1 to development and validation cohort. Hazard Ratios (HR of incident ESRD were reported with 95% confidence interval (CI of the KFRE, D-score and KFRE+D-score in Cox regression model. Improvement of risk prediction with the addition of D-score to the KFRE was assessed using c-statistics, continuous net reclassification improvement (NRI, and integrated discrimination improvement (IDI.During median follow-up of 1.9 years, 194 patients developed ESRD. The cox regression analysis showed that the KFRE,D-score and KFRE+D-score were significant predictors of ESRD both in the development cohort and in the validation cohort. The c-statistics of the D-score was 0.67. The c-statistics of the KFRE was good, but its predictive value was weaker than that in the miscellaneous CKD cohort originally reported (c-statistics, 0.78 vs. 0.90 and was not significantly improved by adding the D-score (0.78 vs. 0.79, p = 0.83. Only continuous NRI was positive after adding the D-score to the KFRE (0.4%; CI: 0.0-0.8%.We found that the predict values of the KFRE and the D

Value of adding the renal pathological score to the kidney failure risk equation in advanced diabetic nephropathy.

Science.gov (United States)

Yamanouchi, Masayuki; Hoshino, Junichi; Ubara, Yoshifumi; Takaichi, Kenmei; Kinowaki, Keiichi; Fujii, Takeshi; Ohashi, Kenichi; Mise, Koki; Toyama, Tadashi; Hara, Akinori; Kitagawa, Kiyoki; Shimizu, Miho; Furuichi, Kengo; Wada, Takashi

2018-01-01

There have been a limited number of biopsy-based studies on diabetic nephropathy, and therefore the clinical importance of renal biopsy in patients with diabetes in late-stage chronic kidney disease (CKD) is still debated. We aimed to clarify the renal prognostic value of pathological information to clinical information in patients with diabetes and advanced CKD. We retrospectively assessed 493 type 2 diabetics with biopsy-proven diabetic nephropathy in four centers in Japan. 296 patients with stage 3-5 CKD at the time of biopsy were identified and assigned two risk prediction scores for end-stage renal disease (ESRD): the Kidney Failure Risk Equation (KFRE, a score composed of clinical parameters) and the Diabetic Nephropathy Score (D-score, a score integrated pathological parameters of the Diabetic Nephropathy Classification by the Renal Pathology Society (RPS DN Classification)). They were randomized 2:1 to development and validation cohort. Hazard Ratios (HR) of incident ESRD were reported with 95% confidence interval (CI) of the KFRE, D-score and KFRE+D-score in Cox regression model. Improvement of risk prediction with the addition of D-score to the KFRE was assessed using c-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). During median follow-up of 1.9 years, 194 patients developed ESRD. The cox regression analysis showed that the KFRE,D-score and KFRE+D-score were significant predictors of ESRD both in the development cohort and in the validation cohort. The c-statistics of the D-score was 0.67. The c-statistics of the KFRE was good, but its predictive value was weaker than that in the miscellaneous CKD cohort originally reported (c-statistics, 0.78 vs. 0.90) and was not significantly improved by adding the D-score (0.78 vs. 0.79, p = 0.83). Only continuous NRI was positive after adding the D-score to the KFRE (0.4%; CI: 0.0-0.8%). We found that the predict values of the KFRE and the D-score were

The origin of extrarenal arterial blood supply of renal malignancy and its clinical value

International Nuclear Information System (INIS)

Du Duanming; Tong Xiaoqiang; Song Li; Zou Yinghua

2007-01-01

Objective: To study the mechanisms of extrarenal arterial blood supply of renal malignancy for its interventional therapy. Methods: Routine abdominal aortography and selective questionable feeding arteriography were performed in 141 patients with renal malignancy. The characteristics and formation mechanisms of extrarenal arterial blood supply for renal malignancy were analyzed. Results: Of the 141 patients, extrarenal arterial blood supply of renal malignancy were found in 51 patients and there were 87 branchs. The breakthrough of renal capsule with malignancy were found in those 51 patients. No extrarenal arterial blood supply of renal malignancy was found in 90 patients, including 50 patients with and 40 patients without the renal capsule breakthrough with malignancy. The emerge of extrarenal arterial blood supply of renal malignancy were significantly different (χ 2 =31.64, P<0.01) between the patients with and without the breakthrough of renal capsule with malignancy. The origin of extrarenal arterial blood supply were correlated with the location of the tumor. Conclusions: It is important to determine the origin of the extrarenal arterial blood supply in renal malignancy for its interventional therapy. (authors)

Study of radioactive fibrinogen metabolism in renal allotransplantation

International Nuclear Information System (INIS)

Akiyama, Takahiro; Nagai, Nobuo; Kaneko, Shigeo; Matsuura, Takeshi; Iguchi, Masanori

1979-01-01

Turn over administrated radioactive fibrinogen and uptake to renal allograft were studied in 9 cases of renal allotransplanted patients. In patients with acute rejection crisis biological half-time (T 1/2) of 131 I-fibrinogen were shortened and allograft/heart counts ratio of 125 I-fibrinogen were elevated up to 125 - 140 percent at 24 - 48 hours after administration; these parameters seemed to be useful in aid of diagnosis of acute rejection. It is suggested that deposition of fibrinogen into allograft and increased turn over of plasma fibrinogen occurred in acute rejection. (author)

A role for the organic anion transporter OAT3 in renal creatinine secretion in mice

Science.gov (United States)

Eraly, Satish A.; Rao, Satish Ramachandra; Gerasimova, Maria; Rose, Michael; Nagle, Megha; Anzai, Naohiko; Smith, Travis; Sharma, Kumar; Nigam, Sanjay K.; Rieg, Timo

2012-01-01

Tubular secretion of the organic cation, creatinine, limits its value as a marker of glomerular filtration rate (GFR) but the molecular determinants of this pathway are unclear. The organic anion transporters, OAT1 and OAT3, are expressed on the basolateral membrane of the proximal tubule and transport organic anions but also neutral compounds and cations. Here, we demonstrate specific uptake of creatinine into mouse mOat1- and mOat3-microinjected Xenopus laevis oocytes at a concentration of 10 μM (i.e., similar to physiological plasma levels), which was inhibited by both probenecid and cimetidine, prototypical competitive inhibitors of organic anion and cation transporters, respectively. Renal creatinine clearance was consistently greater than inulin clearance (as a measure of GFR) in wild-type (WT) mice but not in mice lacking OAT1 (Oat1−/−) and OAT3 (Oat3−/−). WT mice presented renal creatinine net secretion (0.23 ± 0.03 μg/min) which represented 45 ± 6% of total renal creatinine excretion. Mean values for renal creatinine net secretion and renal creatinine secretion fraction were not different from zero in Oat1−/− (−0.03 ± 0.10 μg/min; −3 ± 18%) and Oat3−/− (0.01 ± 0.06 μg/min; −6 ± 19%), with greater variability in Oat1−/−. Expression of OAT3 protein in the renal membranes of Oat1−/− mice was reduced to ∼6% of WT levels, and that of OAT1 in Oat3−/− mice to ∼60%, possibly as a consequence of the genes for Oat1 and Oat3 having adjacent chromosomal locations. Plasma creatinine concentrations of Oat3−/− were elevated in clearance studies under anesthesia but not following brief isoflurane anesthesia, indicating that the former condition enhanced the quantitative contribution of OAT3 for renal creatinine secretion. The results are consistent with a contribution of OAT3 and possibly OAT1 to renal creatinine secretion in mice. PMID:22338083

PET imaging and biodistribution analysis of the effects of succinylated gelatin combined with L-lysine on renal uptake and retention of ⁶⁴Cu-cyclam-RAFT-c(-RGDfK-)₄ in vivo.

Science.gov (United States)

Jin, Zhao-Hui; Furukawa, Takako; Sogawa, Chizuru; Claron, Michael; Aung, Winn; Tsuji, Atsushi B; Wakizaka, Hidekatsu; Zhang, Ming-Rong; Boturyn, Didier; Dumy, Pascal; Fujibayashi, Yasuhisa; Saga, Tsuneo

2014-04-01

(64)Cu-cyclam-RAFT-c(-RGDfK-)4, an αVβ3 integrin-targeting tetrameric cyclic RGD peptide probe, is a potential theranostic compound for positron emission tomography (PET) of tumor angiogenesis and for internal radiotherapy owing to the multiple decay modes of (64)Cu. Since kidneys are dose-limiting organs in internal radiotherapy, we aimed to reduce the renal accumulation of (64)Cu-cyclam-RAFT-c(-RGDfK-)4 by co-injection with Gelofusine (GF), a succinylated gelatin solution, and/or L-lysine (Lys), and to explore, for the first time, the related mechanisms using the noninvasive and quantitative PET imaging technology. Biodistribution assays, dynamic and static PET scans, and metabolism studies with radio-thin-layer chromatography (radio-TLC) were performed in healthy or αVβ3-positive tumor-bearing mice. In the results, co-injection with GF markedly reduced the renal uptake and slightly increased the tumor uptake of (64)Cu-cyclam-RAFT-c(-RGDfK-)4. L-Lysine alone had no effect on the probe biodistribution, but the combined use of Lys and GF tended to enhance the effect of GF. Dynamic PET and metabolite analysis by radio-TLC highly revealed that GF blocks the renal reabsorption of (64)Cu-cyclam-RAFT-c(-RGDfK-)4, but does not interfere with its metabolism and excretion. In conclusion, administration of GF and Lys is a useful strategy for kidney protection in (64)Cu-cyclam-RAFT-c(-RGDfK-)4-based internal radiotherapy. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Usefulness of parametric renal clearance images in the assessment of basic risk factors for renalnal clearance images in the assessment of basic risk factors for renal scarring in children with recurrent urinary tract infections.

Science.gov (United States)

Pietrzak-Stelasiak, Ewa; Bieńkiewicz, Małgorzata; Woźnicki, Wojciech; Bubińska, Krystyna; Kowalewska-Pietrzak, Magdalena; Płachcińska, Anna; Kuśmierek, Jacek

2017-01-01

Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study. To establish a clinical value of parametric renal clearance images in detection of renal scarring. A prospective study was performed in a group of 91 children at the age of 4 to 18 years with recurrent UTI. Clinically documented incidents of APN were noted in 32 children: in 8 cases - one and in the remaining 24 - 2 to 5 (mean 3) incidents. In the remaining 59 patients only infections of the lower part of urinary tract were diagnosed. Static renal 99mTc-DMSA SPECT study and after 2-4 days dynamic renal studies (99mTc-EC) were performed in every patient not earlier than 6 months after the last documented incident of UTI. PAR images generated from a dynamic study by in-house developed software and SUM images were compared with a gold standard SPECT study. Percentages of children with detected renal scar(s) with SPECT and PAR methods amounted to 55% and 54%, respectively and were statistically significantly higher (p children with history of APN detected with SPECT and PAR methods were significantly more frequent than with infections of only lower part of urinary tract (72% vs. 46%; p = 0.017 and 69% vs. 46%; p = 0.036, respectively). A SUM method did not reveal statistically significant differences between frequencies of detection of scars in groups specified above - 38% vs. 27% (p = 0.31). Both SPECT and PAR methods showed also that frequencies of occurrence of renal scars in children with higher grades of VUR were higher than

Diagnostic value of computed tomographic findings of nutcracker syndrome: Correlation with renal venography and renocaval pressure gradients

International Nuclear Information System (INIS)

Kim, Kyung Won; Cho, Jeong Yeon; Kim, Seung Hyup; Yoon, Jeong-Hee; Kim, Dae Sik; Chung, Jin Wook; Park, Jae Hyung

2011-01-01

Purpose: To evaluate the diagnostic values of CT findings of nutcracker syndrome (NCS). Methods and materials: Twenty seven subjects that underwent CT and renal venography, were divided into three groups based on the venographic renocaval pressure gradient (PG) and collateral veins of the left renal vein (LRV): non-compensated NCS patients with PG ≥ 3 mm Hg (group 1, n = 12), partially compensated NCS patients with borderline PG (1 2 test). Mean values of all quantitative CT parameters differed significantly only between groups 1 and 3 (P < .05, one-way ANOVA test). For differentiating the non-compensated NCS from the control group, the beak sign showed 91.7% sensitivity and 88.9% specificity. Of the various CT parameters, the beak sign and LRV diameter ratio of ≥4.9 showed the greatest diagnostic accuracy (AUC 0.903, ROC analysis). Conclusion: Beak sign of the LRV and CT findings can be useful in diagnosing the non-compensated NCS.

Renal tract abnormalities missed in a historical cohort of young children with UTI if the NICE and AAP imaging guidelines were applied.

Science.gov (United States)

Narchi, Hassib; Marah, Muhaned; Khan, Asad Aziz; Al-Amri, Abdulla; Al-Shibli, Amar

2015-10-01

In a historical cohort of children with a urinary tract infection (UTI) who had already undergone all the imaging procedures, the aim was to determine renal tract abnormalities which would have been missed had we implemented the new guidelines from the National Institute for Health and Care Excellence in the United Kingdom (NICE) or the American Academy of Pediatrics (AAP). After a UTI episode, forty-three children (28 females, 65%) aged between 2 months and 2 years presenting at two general hospitals with a febrile UTI before 2008 underwent all the recommended imaging studies predating the new guidelines. Hydronephrosis was defined and graded according to the Society for Fetal Urology (SFU) classification. Hydronephrosis grade II (mild pelvicalyceal dilatation), grade III (moderate dilatation), and grade IV (gross dilatation with thinning of the renal cortex), duplication, vesicoureteral reflux (VUR) grade II and above, renal scarring and reduced renal uptake (<45%) on technetium-99m-labeled dimercaptosuccinic acid (DMSA) scintigraphy were considered significant abnormalities. We calculated the proportion of abnormalities which would have been missed had the new guidelines been used instead. The median of age was 7.6 months (mean 8.7, range 2-24 months), with the majority (n = 37, 86%) being under 1 year of age. Ultrasound (US) showed hydronephrosis in 14 (32%), all grade II. A voiding cystourethrogram (VCUG) was performed in all and showed VUR ≥ grade II in 16 (37%), including eight children (19%) where it was bilateral. DMSA scan showed scarring in 25 children (58%) of whom 11 (26%) had bilateral scars. Reduced differential renal uptake was present in 10 children (23%). Of the 29 children with normal US, 18 (62%) had renal scarring and nine (31%) had VUR ≥ grade II. The NICE guidelines would have missed 63% of the children with VUR ≥ grade II, including a high proportion of grades IV and V VUR, 44% of the children with renal scarring, and 20% of the

Role of RENAL nephrometry scoring system in planning surgical intervention in patients with localized renal mas

OpenAIRE

Mohamed Samir Shaaban; Tamer Mohammed Abou Youssif; Ahmed Mostafa; Hossam Eldin Hegazy; Mohammed Adel Atta

2015-01-01

Purpose: The study was designed to validate the value of preoperative planning using RENAL nephrometry scoring system in patients having organ confined renal tumors and undergoing surgical intervention and to assess its correlation with the surgical technique. Patient and methods: Forty patients with organ-confined renal masses underwent RENAL nephrometry scoring which was correlated with the surgical technique either radical or nephron-sparing surgery. Result: RENAL nephrometry scoring...

Renal Cu and Na excretion and hepatic Cu metabolism in both Cu acclimated and non acclimated rainbow trout (Oncorhynchus mykiss)

DEFF Research Database (Denmark)

Grosell, M.; Hogstrand, C.; Wood, C.M.

1998-01-01

protein depending on whether the Cu is derived from recent branchial uptake or is already present in the plasma prior to Cu-64 exposure. The plasma Cu pool derived from recent branchial uptake and the Cu pool present in the plasma prior to Cu-64 exposure is accessible to renal excretion to different...... Na+ efflux decreased by 40%, which was largely due to increased tubular Na+ reabsorption. Renal compensation for the impaired branchial Na+ uptake, seen during Cu exposure, thus seems to be involved in Cu acclimation in rainbow trout. (C) 1998 Elsevier Science B.V....

Prognostic implication of the metastatic lesion-to-ovarian cancer standardised uptake value ratio in advanced serous epithelial ovarian cancer

International Nuclear Information System (INIS)

Chung, Hyun Hoon; Lee, Maria; Kim, Hee-Seung; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang; Cheon, Gi Jeong

2017-01-01

To evaluate the prognostic value of metabolic activity of metastatic lesions measured by 18 F-flurodeoxyglucose ( 18 F-FDG) uptake on preoperative positron emission tomography/computed tomography (PET/CT) in patients with advanced serous epithelial ovarian cancer (EOC). Clinico-pathological variables and PET/CT parameters such as the maximum standardised uptake value of the ovarian cancer (SUV ovary ), metastatic lesions (SUV meta ), and the metastatic lesion-to-ovarian cancer standardised uptake value ratio (SUV meta /SUV ovary ) were assessed in International Federation of Gynaecology and Obstetrics (FIGO) stage III, IV patients. Clinico-pathological data were retrospectively reviewed for 94 eligible patients. The median progression-free survival (PFS) was 18.5 months (range, 6-90 months), and 57 (60.6%) patients experienced recurrence. Older age [P = 0.017, hazard ratio (HR) 1.036, 95% CI 1.006-1.066], residual disease after surgery (P = 0.024, HR 1.907, 95% CI 1.087-3.346), and high SUV meta /SUV ovary (P = 0.019, HR 2.321, 95% CI 1.148-4.692) were independent risk factors of recurrence. Patients with high SUV meta /SUV ovary showed a significantly worse PFS than those with low SUV meta /SUV ovary (P = 0.007, log-rank test). Preoperative SUV meta /SUV ovary was significantly associated with recurrence and has an incremental prognostic value for PFS in patients with advanced serous EOC. (orig.)

Standardized uptake value and quantification of metabolism for breast cancer imaging with FDG and L-[1-C-11]tyrosine PET

NARCIS (Netherlands)

Kole, AC; Nieweg, OE; Pruim, J; Paans, AMJ; Plukker, JTM; Hoekstra, HJ; Vaalburg, W; Schraffordt Koops, H.

The aims of the study were to compare the value of L-[1-C-11]tyrosine (TYR) and [F-18]fluoro-2-deoxy-D-glucose (FDG) as tumor tracers in patients with breast cancer, to investigate the correlation between quantitative values and standardized uptake values (SUVs) and to estimate the value of SUVs for

Evaluation of renal allograft dysfunction employing dynamic SPECT with 99mTc-MAG3 and graph plot analysis

International Nuclear Information System (INIS)

Akahira, Hideaki

1996-01-01

To estimate renal blood flow and tubular function in transplanted kidneys, we applied the 4 compartments model and the graphic analysis method to 99m Tc-MAG3 dynamic SPECT and calculated some parameters, i.e. K1 (renal influx rate constant), K3 (tubular transporting rate constant), Vd12 (intrarenal distribution volume), and others. Twenty-three renal transplant recipients were examined and divided into following 3 groups according to their serum creatinine levels (SCr); Group I: less than 13 mg/dl (1.1±0.3, n=7), Group II: 1.4-2.5 mg/dl (1.8±0.3, n=11), and Group III more than 2.6 mg/dl (3.9±0.9, n=5). The K3 value became lower in the order of Group I>II>III, and well correlated with blood urea nitrogen (BUN, r=-0.95, p 99m Tc-MAG3 uptake function, respectively. (author)

Advanced glycation end products overload might explain intracellular cobalamin deficiency in renal dysfunction, diabetes and aging.

Science.gov (United States)

Obeid, Rima; Shannan, Batool; Herrmann, Wolfgang

2011-11-01

Advanced glycation end products (AGEs) contribute to aging. Cobalamin (Cbl) is required for cell growth and functions, and its deficiency causes serious complications. Diabetics and renal patients show high concentrations of Cbl, but metabolic evidence of Cbl deficiency that is reversible after Cbl treatment. Cbl might be sequestered in blood and cannot be delivered to the cell. Megalin mediates the uptake of transcobalamin-Cbl complex into the proximal tubule cells. Megalin is involved in the uptake and degradation of AGEs. In aging, diabetes or renal dysfunction, AGEs might overload megalin thus lowering Cbl uptake. Transcobalamin-Cbl might retain in blood. Shedding of megalin and transcobalamin receptor under glycation conditions is also a possible mechanism of this phenomenon. Copyright © 2011 Elsevier Ltd. All rights reserved.

Extraosseous uptake of sup(99m)technetium methylene diphosphonate: Neuroblastoma or radiation therapy

International Nuclear Information System (INIS)

Sty, J.R.; Kun, L.; Casper, J.; Babbitt, D.P.

1980-01-01

A child with a ganglioneuroblastoma and tumor uptake of sup(99m)technetium methylene diphosphonate (sup(99m)Tc-MDP) is presented. After surgical removal of an encapsulated tumor and radiation therapy, an interval bone scan demonstrated the same presurgical abnormality. Awareness of abnormal uptake of sup(99m)Tc-MDP in irradiated renal tissue prevents interpreting radiation nephritis as recurrent tumor. (orig.) [de

Ultrasonography assessment of renal size and its correlation with body mass index in adults without known renal disease

International Nuclear Information System (INIS)

Raza, M.; Hameed, A.; Khan, M.I.

2012-01-01

Many conditions affect renal size. To evaluate abnormalities in renal size, knowledge of standardised values for normal renal dimensions is essential as it shows variability in the values of normal renal size depending on body size, age and ethnicity. Ultrasound, being an easily available, non-invasive, safe and less expensive modality, is widely used for evaluation of renal dimensions and repeated follow-ups. The objectives of this study were to determine renal size by ultrasound in adults without any known renal disease, and to determine the relationship of renal size with body mass index. Methods: Study was conducted in the Department of Diagnostic Radiology, Shifa International Hospital and PIMS Islamabad. Renal size was assessed by ultrasound in 4,035 adult subjects with normal serum creatinine and without any known renal disease, between November 2002 and December 2010. Renal length, width, thickness and volume were obtained and mean renal length and volume were correlated with body mass index and other factors like age, side, gender, weight and height of the subjects. Results: Mean renal length on right side was 101.6+-8.9 mm, renal width 42.7+-7.1 mm, and parenchymal thickness 14.4+-2.9 mm. On left side, mean renal length was 102.7+-9.2 mm, width 47.6+-7.0 mm, and parenchymal thickness 15.1+-3.1 mm. Mean renal volume on right was 99.8+-37.2 cm/sup 3/ and on left was 124.4+-41.3 cm/sup 3/. Left renal size was significantly larger than right in both genders. Relationship of mean renal length was significant when correlated with age, side, gender, height and weight, and body mass index. Renal volumes also showed a similar relationship with side, gender, height and weight, and body mass index; but with age such a relationship was seen only for left kidney. Conclusion: Pakistani population has mean renal size smaller than reference values available in international literature. Renal length and volume have a direct relationship with body mass index. Mean renal

Assessment of split renal function with sup(99m)Tc-aprotinin

Energy Technology Data Exchange (ETDEWEB)

Aprile, C.; Saponaro, R.; Villa, G.; Carena, M.; Lunghi, F.; Salvadeo, A.; Solerte, S.B.

1986-05-01

The aim of this work is to correlate the net kidney uptake of sup(99m)Tc-aprotinin (TcA) in 103 subjects with separate effective renal plasma flow (ERPF) and some blood chemistry parameters at 90, 180, and 360 min postinjection both in the normal and diseased kidney. Correlations found with separate ERPFs are highly significant at any time. However, although the slope of the regression line is steeper at 180 min, r tends to deteriorate slightly with time postinjection and a higher intercept of the y axis; this pattern is more pronounced if diseased kidneys are considered separately. The following are probably related to the renal handling of TcA: (1) Early scans better reflect blood flow to the kidney, while later scans are more related to the metabolism/-excretion tubular mechanisms; (2) correlations found with urea, creatinine, urea clearance, and creatinine clearance are highly significant at any time; (3) in 20 additional patients with diseased kidneys, renal uptake measurements done 360 min postinjection first with TcA and then with MSA showed better correlations with ERPF employing TcA. Our results indicate that TcA is a feasible indicator of split renal function even at 90 min postinjections when a scan is easily carried out on an outpatient basis.

Studies of the skeletal pathophysiology of renal osteodystrophy using nucleomedical procedures

Energy Technology Data Exchange (ETDEWEB)

Otsuka, Nobuaki (Kawasaki Medical School, Kurashiki, Okayama (Japan))

1988-12-01

Bone scintigraphy with Tc-99m labeled phosphorous compounds has been performed in a series of 160 long-term hemodialysis patients with chronic renal failure. Renal osteodystrophy (ROD) was classified by five features of RI uptake in the entire skeleton: type A (low turn-over type) - a relatively decreased RI uptake in the bone tissue and an increased uptake in the soft tissue; type C (normal type) - normal findings; type D (osteomalacia type) - a strong RI uptake in the costochondral joints; type F (hyperparathyroid type) - strong RI uptake in the skull and submandible; and type G (calcification type) - an ectopic calcification. The group of type F had elevated levels of both alkaline phosphatase (ALP) and parathyroid hormones (PTH); on the contrary, both ALP and PTH were decreased in the group of type A. This suggested an increased and decreased bone metabolism in type F and A, respectively. The group of type D was characterized by having hypophosphatemia. Pathophysiologic types of ROD varied from day to day. Bone mineral density (BMD) tended to decrease in the radius. For the spine, however, BMD increased in some cases and decreased in the other cases with prolonging the duration of hemodialysis. Bone scintigraphy and BMD determination in both the cortical and cavernous bone tissue may provide integrated information about ROD presenting with heterogeneity of the entire skeleton. (Namekawa, K).

Preoperative examination of potential renal transplant donors: value of gadolinium-enhanced 3D-MR-angiography in comparison with DSA and urography

International Nuclear Information System (INIS)

Winterer, J.T.; Paul, G.; Einert, A.; Altehoefer, C.; Uhrmeister, P.; Laubenberger, J.

2000-01-01

Purpose: To assess a contrast-enhanced standardized MRA protocol for the presurgical evaluation of potential renal transplant donors. Methods: Twenty-three potential donors for renal transplantations were examined with gadolinium-enhanced, two-phase MR angiograms (1.5 T) and DSA/urography for the number of renal arteries, the presence of aberrant arterial and venous branches, renal artery stenoses and anatomy of the renal collecting system and ureters. The diagnostic value was assessed by evaluating different image processing modalities and interobserver variability. Results: Using maximum intensity projections (MIP) together with multiplanar reformatting (MPR), accessory arteries were detected with a sensitivity/specificity of 100%/98%. Depending on diagnostic experience, exclusive evaluation of MIP yielded a sensitivitiy/specificity of 67-100%/95-100%. Using MIP/MPR, venous depiction was good in 80%, with MIP solely in 30-40%. At least the proximal third of the ureter was visible in 67%. Conclusion: MPR/MIP evaluation of two-phase, contrast-enhanced MRA provides an excellent depiction of renal vessel anatomy for presurgical evaluation of renal transplant donors. Exclusive MIP assessment is less reliable and depends strongly on the examiner's experience. For sufficient visualization of the ureters, either additional measurements or low-dose diuretic injection have to be performed. (orig.) [de

In-111-labeled leukocytes in the diagnosis of rejection and cytomegalovirus infection in renal transplant patients

International Nuclear Information System (INIS)

Forstrom, L.A.; Loken, M.K.; Cook, A.; Chandler, R.; McCullough, J.

1981-01-01

Indium-111-labeled (In-111) leukocytes have been shown to be useful in the localization of inflammatory processes, including renal transplant rejection. Using previously reported labeling methods, 63 studies with this agent have been performed in 53 renal transplant patients. Indications for study included suspected rejection or cytomegalovirus (CMV) infection. Studies were performed in 33 men and 20 women, with ages ranging from 6 to 68 years. Autologous cells were normally used for labeling, although leukocytes obtained from ABO-compatible donors were used in three subjects. Rectilinear scanner and/or scintillation camera images were obtained at 24 hours after intravenous administration of 0.1 to 0.6 mCi of In-111-leukocytes. There was abnormal uptake of In-111-leukocytes in the transplanted kidney in 11 of 15 cases of rejection. In three additional cases of increased transplant uptake, CMV infection was present in two. Abnormal lung uptake was present in 13 of 14 patients with CMV infection. In four additional cases, increased lung uptake was associated with other pulmonary inflammatory disease. Increased lung activity was not seen in patients with uncomplicated transplant rejection. These results suggest that In-111-leukocyte imaging may be useful in the differential diagnosis of rejection versus CMV infection in renal transplant patients

In-111-labeled leukocytes in the diagnosis of rejection and cytomegalovirus infection in renal transplant patients

International Nuclear Information System (INIS)

Forstrom, L.A.; Loken, M.K.; Cook, A.; Chandler, R.; McCullough, J.

1981-01-01

Indium-111-labelled (In-111) leukocytes have been shown to be useful in the localization of inflammatory processes, including renal transplant rejection. Using previously reported labelling methods, 63 studies with this agent have been performed in 53 renal transplant patients. Indications for study included suspected rejection or cytomegalovirus (CMV) infection. Studies were performed in 33 men and 20 women, with ages ranging from 6 to 68 years. Autologous cells were normally used for labeling, although leukocytes obtained from ABO-compatible donors were used in three subjects. Rectilinear scanner and/or scintillation camera images were obtained at 24 hours after intravenous administration of 0.1 to 0.6 mCi of In-111 leukocytes. There was abnormal uptake of In-111-leukocytes in the transplanted kidney in 11 of 15 cases of rejection. In three additional cases of increased transplant uptake, CMV infection was present in two. Abnormal lung uptake was present in 13 of 14 patients with CMV infection. In four additional cases, increased lung uptake was associated with other pulmonary inflammatory disease. Increased lung activity was not seen in patients with uncomplicated transplant rejection. These results suggest that In-111-leukocyte imaging may be useful in the differential diagnosis of rejection versus CMV infection in renal transplant patients

The diagnostic value of contrast-enhanced CT in Acute bilateral renal cortical necrosis: a case report

International Nuclear Information System (INIS)

Choi, Pil Youb; Lee, Su Han; Lee, Woo Dong

1996-01-01

Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renal medulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal cortical necrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is a useful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following an operation for abdominal trauma

Thyroid uptake test

International Nuclear Information System (INIS)

Ganatra, R.D.

1992-01-01

The uptake of radioiodine by the thyroid gland is altered by the iodine content of diet or drugs. American diet has a high iodine content because each slice of the white bread contains nearly 150μg of iodine due to the bleaching process employed in the production of the bread. This carrier content of iodine reduces the uptake so much, that the normal American uptakes are usually three to four times lower than the uptakes in the developing countries. The other drawback of the thyroid uptake test is that it is affected by the iodine containing drugs. Anti-diarrhoea medications are quire common in the developing countries and many of them contain iodine moiety. Without a reliable drug history, a low thyroid uptake value may lead to a misleading conclusion

Uptake of indium-111 labelled platelets by normal, nephrotic and transplanted kidneys

International Nuclear Information System (INIS)

Desir, G.; Lange, R.; Smith, E.; Bia, M.; Flye, M.; Kashgarian, M.; Canganelli, A.; Ezekowitz

1984-01-01

To determine the role of platelets in the genesis of renal transplant (T) rejection, the authors studied 3 groups of adult patients. Group I, n=8, had normal renal function (Cr=1 +- 0.1 mg%, Mean +- SD). Group II, n=9, had nephrotic syndrome (Cr=2.4 +- 1). Group III, n=7, consisted of 5 cadaveric (C) and 2 living related donor (LRD) T. In Group II, 1 patient had received a T 4 years prior to study. Group I and II received 448 +- 101 μCi and Group III 236 +- 51 μCi of Indium-111. In Groups I and II the first image was obtained 18 +- 6 hrs after injection. In Group II the first was obtained 6 +- 2 hr after injection and 1-3 times/day thereafter for a maximum of 7 days. Renal biopsies were obtained in all patients in Group III during imaging (n=5) or within 2 - 5 days of the last image. One patient was studied twice. In Group III, 5 patients received prednisone and azothiaprine and 2 prednisone and cyclosporine. Platelet uptake index (PUI) was calculated as the ratio of uptake over the T against a reference area. Rejection was diagnosed by biopsy. In groups I and II platelet uptake was seen only in the T patient. In Group III the PUI was 1.54 +- .13 in the rejecting T (n=5), 1.42 +- .2 in the non-rejecting T (n=3), 1.62 in a LRD non-rejecting T and 1.31 (n=2) in C non-rejecting T. In the four patients studied within 5 days of T the PUI was elevated at 1.47 +- .1. The authors conclude that: 1) platelets do not accumulate in normal or nephrotic native kidneys, 2) significant uptake occurs in the first week after C and LRD whether or not rejection is present, and 3) uptake in non-rejecting kidneys cannot be ascribed to perfusion induced endothelial injury since it was present in LRD transplants

Prognostic implication of the metastatic lesion-to-ovarian cancer standardised uptake value ratio in advanced serous epithelial ovarian cancer

Energy Technology Data Exchange (ETDEWEB)

Chung, Hyun Hoon; Lee, Maria; Kim, Hee-Seung; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynaecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

2017-11-15

To evaluate the prognostic value of metabolic activity of metastatic lesions measured by {sup 18}F-flurodeoxyglucose ({sup 18}F-FDG) uptake on preoperative positron emission tomography/computed tomography (PET/CT) in patients with advanced serous epithelial ovarian cancer (EOC). Clinico-pathological variables and PET/CT parameters such as the maximum standardised uptake value of the ovarian cancer (SUV{sub ovary}), metastatic lesions (SUV{sub meta}), and the metastatic lesion-to-ovarian cancer standardised uptake value ratio (SUV{sub meta}/SUV{sub ovary}) were assessed in International Federation of Gynaecology and Obstetrics (FIGO) stage III, IV patients. Clinico-pathological data were retrospectively reviewed for 94 eligible patients. The median progression-free survival (PFS) was 18.5 months (range, 6-90 months), and 57 (60.6%) patients experienced recurrence. Older age [P = 0.017, hazard ratio (HR) 1.036, 95% CI 1.006-1.066], residual disease after surgery (P = 0.024, HR 1.907, 95% CI 1.087-3.346), and high SUV{sub meta}/SUV{sub ovary} (P = 0.019, HR 2.321, 95% CI 1.148-4.692) were independent risk factors of recurrence. Patients with high SUV{sub meta}/SUV{sub ovary} showed a significantly worse PFS than those with low SUV{sub meta}/SUV{sub ovary} (P = 0.007, log-rank test). Preoperative SUV{sub meta}/SUV{sub ovary} was significantly associated with recurrence and has an incremental prognostic value for PFS in patients with advanced serous EOC. (orig.)

Extraosseous uptake of /sup 99/sup(m)technetium methylene diphosphonate. Neuroblastoma or radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Sty, J R; Kun, L; Casper, J; Babbitt, D P

1980-01-01

A child with a ganglioneuroblastoma and tumor uptake of /sup 99/sup(m)technetium methylene diphosphate (/sup 99/sup(m)Tc-MDP) is presented. After surgical removal of an encapsulated tumor and radiation therapy, an interval bone scan demonstrated the same presurgical abnormality. Awareness of abnormal uptake of /sup 99/sup(m)Tc-MDP in irradiated renal tissue prevents interpreting radiation nephritis as recurrent tumor.

Impact on creatinine renal clearance by the interplay of multiple renal transporters: a case study with INCB039110.

Science.gov (United States)

Zhang, Yan; Warren, Mark S; Zhang, Xuexiang; Diamond, Sharon; Williams, Bill; Punwani, Naresh; Huang, Jane; Huang, Yong; Yeleswaram, Swamy

2015-04-01

Serum creatinine is commonly used as a marker of renal function, but increases in serum creatinine might not represent changes in glomerular filtration rate (GFR). INCB039110 (2-(3-(4-(7H-pyrrolo[2,3-day]pyrimidin-4-yl)-1H-pyrazol-1-yl)-1-(1-(3-fluoro-2-(trifluoromethyl)isonicotinoyl)piperidin-4-yl)azetidin-3-yl)acetonitrile) is an inhibitor of the Janus kinases (JAKs) with selectivity for JAK1. In a phase 1 study, a modest and reversible increase in serum creatinine was observed after treatment with INCB039110. However, a dedicated renal function study with INCB039110, assessed by iohexol plasma clearance, conducted in healthy volunteers indicated no change in GFR. In vitro studies were therefore conducted to investigate the interaction of INCB039110 with five transporters that are likely involved in the renal clearance of creatinine. Cell systems expressing individual or multiple transporters were used, including a novel quintuple-transporter model OAT2/OCT2/OCT3/MATE1/MATE2-K. INCB039110 potently inhibited OCT2-mediated uptake of creatinine as well as MATE1-/MATE2-K-mediated efflux of creatinine. Given the interactions of INCB039110 with multiple transporters affecting creatinine uptake and efflux, an integrated system expressing all five transporters was sought; in that system, INCB039110 caused a dose-dependent decrease in transcellular transport of creatinine with weaker net inhibition compared with the effects on individual transporters. In summary, a molecular mechanism for the increase in serum creatinine by INCB039110 has been established. These studies also underline the limitations of using serum creatinine as a marker of renal function. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

DEFF Research Database (Denmark)

Petersen, L J; Petersen, J R; Ladefoged, S D

1995-01-01

The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

Rotational digital subtraction angiography of the renal arteries: technique and evaluation in the study of native and transplant renal arteries.

Science.gov (United States)

Seymour, H R; Matson, M B; Belli, A M; Morgan, R; Kyriou, J; Patel, U

2001-02-01

Rotational digital subtraction angiography (RDSA) allows multidirectional angiographic acquisitions with a single injection of contrast medium. The role of RDSA was evaluated in 60 patients referred over a 7-month period for diagnostic renal angiography and 12 patients referred for renal transplant studies. All angiograms were assessed for their diagnostic value, the presence of anomalies and the quantity of contrast medium used. The effective dose for native renal RDSA was determined. 41 (68.3%) native renal RDSA images and 8 (66.7%) transplant renal RDSA images were of diagnostic quality. Multiple renal arteries were identified in 9/41 (22%) native renal RDSA diagnostic images. The mean volume of contrast medium in the RDSA runs was 51.2 ml and 50 ml for native and transplant renal studies, respectively. The mean effective dose for 120 degrees native renal RDSA was 2.36 mSv, equivalent to 1 year's mean background radiation. Those RDSA images that were non-diagnostic allowed accurate prediction of the optimal angle for further static angiographic series, which is of great value in transplant renal vessels.

Assessment of split renal function with sup(99m)Tc-aprotinin

International Nuclear Information System (INIS)

Aprile, C.; Saponaro, R.; Villa, G.; Solerte, S.B.

1986-01-01

The aim of this work is to correlate the net kidney uptake of sup(99m)Tc-aprotinin (TcA) in 103 subjects with separate effective renal plasma flow (ERPF) and some blood chemistry parameters at 90, 180, and 360 min postinjection both in the normal and diseased kidney. Correlations found with separate ERPFs are highly significant at any time (P<0.001). However, although the slope of the regression line is steeper at 180 min, r tends to deteriorate slightly with time postinjection and a higher intercept of the y axis; this pattern is more pronounced if diseased kidneys are considered separately. The following are probably related to the renal handling of TcA: (1) Early scans better reflect blood flow to the kidney, while later scans are more related to the metabolism/-excretion tubular mechanisms; (2) correlations found with urea, creatinine, urea clearance, and creatinine clearance are highly significant at any time; (3) in 20 additional patients with diseased kidneys, renal uptake measurements done 360 min postinjection first with TcA and then with MSA showed better correlations with ERPF employing TcA. Our results indicate that TcA is a feasible indicator of split renal function even at 90 min postinjections when a scan is easily carried out on an outpatient basis. (orig.)

Does the intensity of diffuse thyroid gland uptake on F-18 fluorodeoxyglucose positron emission tomography/computed tomography scan predict the severity of hypothyroidism? Correlation between maximal standardized uptake value and serum thyroid stimulating hormone levels

International Nuclear Information System (INIS)

Pruthi, Ankur; Choudhury, Partha Sarathi; Gupta, Manoj; Taywade, Sameer

2015-01-01

F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) scan and hypothyroidism. The aim was to determine whether the intensity of diffuse thyroid gland uptake on F-18 FDG PET/CT scans predicts the severity of hypothyroidism. A retrospective analysis of 3868 patients who underwent F-18 FDG PET/CT scans, between October 2012 and June 2013 in our institution for various oncological indications was done. Out of them, 106 (2.7%) patients (79 females, 27 males) presented with bilateral diffuse thyroid gland uptake as an incidental finding. These patients were investigated retrospectively and various parameters such as age, sex, primary cancer site, maximal standardized uptake value (SUVmax), results of thyroid function tests (TFTs) and fine-needle aspiration cytology results were noted. The SUVmax values were correlated with serum thyroid stimulating hormone (S. TSH) levels using Pearson's correlation analysis. Pearson's correlation analysis. Clinical information and TFT (serum FT3, FT4 and TSH levels) results were available for 31 of the 106 patients (27 females, 4 males; mean age 51.5 years). Twenty-six out of 31 patients (84%) were having abnormal TFTs with abnormal TSH levels in 24/31 patients (mean S. TSH: 22.35 μIU/ml, median: 7.37 μIU/ml, range: 0.074-211 μIU/ml). Among 7 patients with normal TSH levels, 2 patients demonstrated low FT3 and FT4 levels. No significant correlation was found between maximum standardized uptake value and TSH levels (r = 0.115, P > 0.05). Incidentally detected diffuse thyroid gland uptake on F-18 FDG PET/CT scan was usually associated with hypothyroidism probably caused by autoimmune thyroiditis. Patients should be investigated promptly irrespective of the intensity of FDG uptake with TFTs to initiate replacement therapy and a USG examination to look for any suspicious nodules

Diagnostic value of 18F-FDG uptake by spleen in acute radiation disease

Directory of Open Access Journals (Sweden)

Shao-jie WU

2015-07-01

Full Text Available Objective　To investigate whether 18F-FDG uptake can be applied in dosimetry to facilitate a rapid and accurate evaluation of individual radiation dosage after a nuclear accident. Methods　Forty-eight Tibetan minipigs were randomly assigned into 6 groups, i.e., 0, 1, 2, 5, 8 and 11Gy groups. Animals in all except 0Gy group received total body irradiation (TBI with a 8MV X centrifugal linear accelerator, and 18F-FDG combined positron-emission tomography and computed tomography (PET/CT were carried out before TBI, and also at 6, 24 and 72h after receiving TBI in different doses ranging from 1 to 11Gy. Spleen tissues and blood samples were collected for histological examination, apoptosis, and routine blood analysis. Results　Mean standardized uptake values (SUVs of the spleen showed significant differences between experimental groups and control group. The spleen SUVs at 6h post-irradiation showed significant correlation with radiation dose; Spearman's correlation coefficient was 0.95(P<0.01. Histopathological observations showed that the degree of splenic damage was proportional to the radiation dose. Moreover, flow cytometry revealed that apoptosis was one of the major forms of splenic lymphocyte death. Conclusion　In the Tibetan minipig model, it was shown that radiation doses bear a close relationship with the 18F-FDG uptake of spleen. This finding suggests that 18F-FDG PET/CT may be useful for the rapid detection of individual radiation dosage after acute radiation disease (ARD. DOI: 10.11855/j.issn.0577-7402.2015.07.08

Correction of differential renal function for asymmetric renal area ratio in unilateral hydronephrosis.

Science.gov (United States)

Aktaş, Gul Ege; Sarıkaya, Ali

2015-11-01

Children with unilateral hydronephrosis are followed up with anteroposterior pelvic diameter (APD), hydronephrosis grade, mercaptoacetyltriglycine (MAG-3) drainage pattern and differential renal function (DRF). Indeterminate drainage preserved DRF in higher grades of hydronephrosis, in some situations, complicating the decision-making process. Due to an asymmetric renal area ratio, falsely negative DRF estimations can result in missed optimal surgery times. This study was designed to assess whether correcting the DRF estimation according to kidney area could reflect the clinical situation of a hydronephrotic kidney better than a classical DRF calculation, concurrently with the hydronephrosis grade, APD and MAG-3 drainage pattern. We reviewed the MAG-3, dimercaptosuccinic acid (DMSA) scans and ultrasonography (US) of 23 children (6 girls, 17 boys, mean age: 29 ± 50 months) with unilateral hydronephrosis. MAG-3 and DMSA scans were performed within 3 months (mean 25.4 ± 30.7 days). The closest US findings (mean 41.5 ± 28.2 days) were used. DMSA DRF estimations were obtained using the geometric mean method. Secondary calculations were performed to correct the counts (the total counts divided by the number of pixels in ROI) according to kidney area. The renogram patterns of patients were evaluated and separated into subgroups. The visual assessment of DMSA scans was noted and the hydronephrotic kidney was classified in comparison to the normal contralateral kidney's uptake. The correlations of the DRF values of classical and area-corrected methods with MAG-3 renogram patterns, the visual classification of DMSA scan, the hydronephrosis grade and the APD were assessed. DRF estimations of two methods were statistically different (p: 0.001). The categories of 12 hydronephrotic kidneys were changed. There were no correlations between classical DRF estimations and the hydronephrosis grade, APD, visual classification of the DMSA scan and uptake evaluation. The DRF

The changes in renal function after a single dose of intravenous furosemide in patients with compensated liver cirrhosis

Directory of Open Access Journals (Sweden)

Mejirisky Yoram

2006-11-01

Full Text Available Abstract Background Patients with compensated Child-A cirrhosis have sub clinical hypovolemia and diuretic treatment could result in renal impairment. Aim To evaluate the changes in renal functional mass as reflected by DMSA uptake after single injection of intravenous furosemide in patients with compensated liver cirrhosis. Methods Eighteen cirrhotic patients were divided in two groups; eight patients (group 1, age 56 ± 9.6 yrs, Gender 5M/3F, 3 alcoholic and 5 non alcoholic were given low intravenous 40 mg furosemide and ten other patients (group 2, age 54 ± 9.9, Gender 6M/4F, 4 alcoholic and 6 non alcoholic were given high 120 mg furosemide respectively. Renoscintigraphy with 100MBq Of Tc 99 DMSA was given intravenously before and 90 minutes after furosemide administration and SPECT imaging was determined 3 hours later. All patients were kept under low sodium diet (80mEq/d and all diuretics were withdrawn for 3 days. 8-hours UNa exertion, Calculated and measured Creatinine clearance (CCT were performed for all patients. Results Intravenous furosemide increased the mean renal DMSA uptake in 55% of patients with compensated cirrhosis and these changes persist up to three hours after injection. This increase was at the same extent in either low or high doses of furosemide. (From 12.8% ± 3.8 to 15.2% ± 2.2, p 40%, as compared to normal calculated creatinine clearance (CCT 101 ± 26, and measured CCT of 87 ± 30 cc/min (P Conclusion A single furosemide injection increases renal functional mass as reflected by DMSA in 55% of patients with compensated cirrhosis and identify 45% of patients with reduced uptake and who could develop renal impairment under diuretics. Whether or not albumin infusion exerts beneficial effect in those patients with reduced DMSA uptake remains to be determined.

Role of magnetic resonance urography in pediatric renal fusion anomalies

International Nuclear Information System (INIS)

Chan, Sherwin S.; Ntoulia, Aikaterini; Khrichenko, Dmitry; Back, Susan J.; Darge, Kassa; Tasian, Gregory E.; Dillman, Jonathan R.

2017-01-01

Renal fusion is on a spectrum of congenital abnormalities that occur due to disruption of the migration process of the embryonic kidneys from the pelvis to the retroperitoneal renal fossae. Clinically, renal fusion anomalies are often found incidentally and associated with increased risk for complications, such as urinary tract obstruction, infection and urolithiasis. These anomalies are most commonly imaged using ultrasound for anatomical definition and less frequently using renal scintigraphy to quantify differential renal function and assess urinary tract drainage. Functional magnetic resonance urography (fMRU) is an advanced imaging technique that combines the excellent soft-tissue contrast of conventional magnetic resonance (MR) images with the quantitative assessment based on contrast medium uptake and excretion kinetics to provide information on renal function and drainage. fMRU has been shown to be clinically useful in evaluating a number of urological conditions. A highly sensitive and radiation-free imaging modality, fMRU can provide detailed morphological and functional information that can facilitate conservative and/or surgical management of children with renal fusion anomalies. This paper reviews the embryological basis of the different types of renal fusion anomalies, their imaging appearances at fMRU, complications associated with fusion anomalies, and the important role of fMRU in diagnosing and managing children with these anomalies. (orig.)

Role of magnetic resonance urography in pediatric renal fusion anomalies

Energy Technology Data Exchange (ETDEWEB)

Chan, Sherwin S. [Children' s Mercy Hospital, Department of Radiology, Kansas City, MO (United States); Ntoulia, Aikaterini; Khrichenko, Dmitry [The Children' s Hospital of Philadelphia, Division of Body Imaging, Department of Radiology, Philadelphia, PA (United States); Back, Susan J.; Darge, Kassa [The Children' s Hospital of Philadelphia, Division of Body Imaging, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Tasian, Gregory E. [University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); The Children' s Hospital of Philadelphia, Division of Urology, Department of Surgery, Philadelphia, PA (United States); Dillman, Jonathan R. [Cincinnati Children' s Hospital Medical Center, Division of Thoracoabdominal Imaging, Department of Radiology, Cincinnati, OH (United States)

2017-12-15

Renal fusion is on a spectrum of congenital abnormalities that occur due to disruption of the migration process of the embryonic kidneys from the pelvis to the retroperitoneal renal fossae. Clinically, renal fusion anomalies are often found incidentally and associated with increased risk for complications, such as urinary tract obstruction, infection and urolithiasis. These anomalies are most commonly imaged using ultrasound for anatomical definition and less frequently using renal scintigraphy to quantify differential renal function and assess urinary tract drainage. Functional magnetic resonance urography (fMRU) is an advanced imaging technique that combines the excellent soft-tissue contrast of conventional magnetic resonance (MR) images with the quantitative assessment based on contrast medium uptake and excretion kinetics to provide information on renal function and drainage. fMRU has been shown to be clinically useful in evaluating a number of urological conditions. A highly sensitive and radiation-free imaging modality, fMRU can provide detailed morphological and functional information that can facilitate conservative and/or surgical management of children with renal fusion anomalies. This paper reviews the embryological basis of the different types of renal fusion anomalies, their imaging appearances at fMRU, complications associated with fusion anomalies, and the important role of fMRU in diagnosing and managing children with these anomalies. (orig.)

Reduction of renal uptake of 111In-DOTA-labeled and A700-labeled RAFT-RGD during integrin αvβ3 targeting using single photon emission computed tomography and optical imaging.

Science.gov (United States)

Briat, Arnaud; Wenk, Christiane H F; Ahmadi, Mitra; Claron, Michael; Boturyn, Didier; Josserand, Véronique; Dumy, Pascal; Fagret, Daniel; Coll, Jean-Luc; Ghezzi, Catherine; Sancey, Lucie; Vuillez, Jean-Philippe

2012-06-01

Integrin α(v)β(3) expression is upregulated during tumor growth and invasion in newly formed endothelial cells in tumor neovasculature and in some tumor cells. A tetrameric RGD-based peptide, regioselectively addressable functionalized template-(cyclo-[RGDfK])4 (RAFT-RGD), specifically targets integrin α(v)β(3) in vitro and in vivo. When labeled with indium-111, the RAFT-RGD is partially reabsorbed and trapped in the kidneys, limiting its use for further internal targeted radiotherapy and imaging investigations. We studied the effect of Gelofusine on RAFT-RGD renal retention in tumor-bearing mice. Mice were imaged using single photon emission computed tomography and optical imaging 1 and 24 h following tracer injection. Distribution of RAFT-RGD was further investigated by tissue removal and direct counting of the tracer. Kidney sections were analyzed by confocal microscopy. Gelofusine significantly induced a >50% reduction of the renal reabsorption of (111)In-DOTA-RAFT-RGD and A700-RAFT-RGD, without affecting tumor uptake. Injection of Gelofusine significantly reduced the renal retention of labeled RAFT-RGD, while increasing the tumor over healthy tissue ratio. These results will lead to the development of future therapeutic approaches. © 2012 Japanese Cancer Association.

Qualitative and quantitative evaluation of renal parenchymal damage by 99mTc-DMSA planar and SPECT scintigraphy

International Nuclear Information System (INIS)

Itoh, Kazuo; Yamashita, Tetsufumi; Tsukamoto, Eriko; Nonomura, Katsuya; Furudate, Masayori; Koyanagi, Tomohiko

1995-01-01

The initial 99m Tc-DMSA studies carried out over a four year period in 229 patients with various heterogenic causes of lower urinary tract abnormalities were reviewed. Anatomical damage to the renal parenchyma was graded by means of planar and SPECT studies into a six group classification proposed by Monsour et al.: grade 0 (normal), I (equivocal), II (single defect), III (more than 2 defects), IV (contracted or small) and V (no visualization). Parenchymal uptake of 99m Tc-DMSA was quantitated from planar images at 2 hours postinjection by a computer assisted gamma camera method. SPECT studies could enhance the pick-up rate for parenchymal uptake defects by a factor of 1.5 in comparison with planar imaging. The incidence of anatomical damage to the renal parenchyma increased with a high radiological grade for VUR, and renal uptake per injection dose of 99m Tc-DMSA by the individual kidney significantly decreased in grades III and IV of the anatomical classification. These data revealed that 99m Tc-DMSA planar is still useful for evaluating gross structural damage and for quantitative evaluation of the kidney with computer assistance. SPECT scintigraphy is more effective in disclosing anatomical damage to the renal parenchyma than planar, although it needs further discussion as to whether SPECT may increase sensitivity with minimal or no adverse affect on specificity. (author)

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

International Nuclear Information System (INIS)

Gupta, Nakul; Patel, Anish; Ensor, Joe; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael; Matin, Surena; Gupta, Sanjay

2017-01-01

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nakul [Houston Methodist Hospital (United States); Patel, Anish [The University of Texas Southwestern Medical Center (United States); Ensor, Joe [Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States); Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States); Matin, Surena [The University of Texas MD Anderson Cancer Center, Department of Urology (United States); Gupta, Sanjay, E-mail: sgupta@mdanderson.org [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

2017-02-15

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy.

Science.gov (United States)

Kinahan, Paul E; Fletcher, James W

2010-12-01

The use of standardized uptake values (SUVs) is now common place in clinical 2-deoxy-2-[(18)F] fluoro-D-glucose (FDG) position emission tomography-computed tomography oncology imaging and has a specific role in assessing patient response to cancer therapy. Ideally, the use of SUVs removes variability introduced by differences in patient size and the amount of injected FDG. However, in practice there are several sources of bias and variance that are introduced in the measurement of FDG uptake in tumors and also in the conversion of the image count data to SUVs. In this article the overall imaging process is reviewed and estimates of the magnitude of errors, where known, are given. Recommendations are provided for best practices in improving SUV accuracy. Copyright © 2010 Elsevier Inc. All rights reserved.

Arterial spin labelling MRI for detecting pseudocapsule defects and predicting renal capsule invasion in renal cell carcinoma.

Science.gov (United States)

Zhang, H; Wu, Y; Xue, W; Zuo, P; Oesingmann, N; Gan, Q; Huang, Z; Wu, M; Hu, F; Kuang, M; Song, B

2017-11-01

To evaluate prospectively the performance of combining morphological and arterial spin labelling (ASL) magnetic resonance imaging (MRI) for detecting pseudocapsule defects in renal cell carcinoma (RCC), and to predict renal capsule invasion confirmed histopathologically. Twenty consecutive patients with suspicious renal tumours underwent MRI. Renal ASL imaging was performed and renal blood flow was measured quantitatively. The diagnostic performance of T2-weighted images alone, and a combination of T2-weighted and ASL images for predicting renal capsule invasion were assessed. Twenty renal lesions were evaluated in 20 patients. All lesions were clear cell RCCs (ccRCCs) confirmed at post-surgical histopathology. Fifteen ccRCCs showed pseudocapsule defects on T2-weighted images, of which 12 cases showed existing blood flow in defect areas on perfusion images. To predict renal capsule invasion, the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 71.4%, 86.7%, 100%, respectively, for T2-weighted images alone, and 92.3%, 100%, 100%, 87.5%, respectively, for the combination of T2-weighted and ASL images. ASL images can reflect the perfusion of pseudocapsule defects and as such, the combination of T2-weighted and ASL images produces promising diagnostic accuracy for predicting renal capsule invasion. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Renal autotransplantation--a possibility in the treatment of complex renal vascular diseases and ureteric injuries.

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Hau, Hans Michael; Bartels, Michael; Tautenhahn, Hans-Michael; Morgul, Mehmet Haluk; Fellmer, Peter; Ho-Thi, Phuc; Benckert, Christoph; Uhlmann, Dirk; Moche, Michael; Thelen, Armin; Schmelzle, Moritz; Jonas, Sven

2012-12-31

We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure. Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period. Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu's arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6-13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period. The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.

Renal albumin absorption in physiology and pathology.

Science.gov (United States)

Birn, H; Christensen, E I

2006-02-01

Albumin is the most abundant plasmaprotein serving multiple functions as a carrier of metabolites, hormones, vitamins, and drugs, as an acid/base buffer, as antioxidant and by supporting the oncotic pressure and volume of the blood. The presence of albumin in urine is considered to be the result of the balance between glomerular filtration and tubular reabsorption. Albuminuria has been accepted as an independent risk factor and a marker for renal as well as cardiovascular disease, and during the past decade, evidence has suggested that albumin itself may cause progression of renal disease. Thus, the reduction of proteinuria and, in particular, albuminuria has become a target in itself to prevent deterioration of renal function. Studies have shown albumin and its ligands to induce expression of inflammatory and fibrogenic mediators, and it has been hypothesized that increased filtration of albumin causes excessive tubular reabsorption, resulting in inflammation and fibrosis, resulting in the loss of renal function. In addition, it is known that tubular dysfunction in itself may cause albuminuria owing to decreased reabsorption of filtered albumin, and, recently, it has been suggested that significant amounts of albumin fragments are excreted in the urine as a result of tubular degradation. Thus, although both tubular and glomerular dysfunction influences renal handling of albumin, it appears that tubular reabsorption plays a central role in mediating the effects of albumin on renal function. The present paper will review the mechanisms for tubular albumin uptake and the possible implications for the development of renal disease.

Dose-dependent effects of (anti)folate preinjection on 99mTc-radiofolate uptake in tumors and kidneys

International Nuclear Information System (INIS)

Mueller, Cristina; Schibli, Roger; Forrer, Flavio; Krenning, Eric P.; Jong, Marion de

2007-01-01

Introduction: The folate receptor (FR) is frequently overexpressed in tumors and can be targeted with folate-based (radio)pharmaceuticals. However, significant accumulation of radiofolates in FR-positive kidneys represents a drawback. We have shown that preadministration of the antifolate pemetrexed (PMX) significantly improved the tumor-to-kidney ratio of radiofolates in mice. The aim of this study was to investigate the dose dependence of these effects and whether the same results could be achieved with folic acid (FA) or 5-methyl-tetrahydrofolate (5-Me-THF). Methods: Biodistribution was assessed 4 h postinjection of the organometallic 99m Tc-picolylamine monoacetic acid folate in nude mice bearing FR-positive KB tumor xenografts. PMX (50-400 μg/mouse) was injected 1 h previous to radioactivity. The effects of FA and 5-Me-THF (0.5-50 μg/mouse) were investigated likewise. Tissues and organs were collected and counted for radioactivity and the values tabulated as percentage of injected dose per gram tissue (% ID/g). Results: PMX administration reduced renal retention ( 10% ID/g), while the tumor uptake (average 1.35%±0.40% ID/g vs. control: 1.79%±0.49% ID/g) was only slightly affected independent of the PMX dose. Replacement of PMX by FA or 5-Me-THF (50 μg/mouse) resulted in a significant renal blockade (<0.1% ID/g) but at the same time in an undesired reduction of tumor uptake (<0.2% ID/g). Conclusions: Selective reduction of radiofolate uptake in kidneys under retention of high tumor accumulation could be achieved in combination with PMX over a broad dose range but not with FA or 5-Me-THF

Value of Renal Biopsy in Diagnosing Infantile Nephropathic Cystinosis Associated With Secondary Nephrogenic Diabetes Insipidus.

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Joyce, Emily; Ho, Jacqueline; El-Gharbawy, Areeg; Salgado, Cláudia M; Ranganathan, Sarangarajan; Reyes-Múgica, Miguel

2017-01-01

Cystinosis is the most common cause of inherited renal Fanconi syndrome in young children, and typically presents with laboratory findings of a proximal tubulopathy and corneal crystals by one year of age. We describe here renal biopsy findings in a 20-month-old patient with an atypical presentation of distal renal tubular acidosis, diabetes insipidus, and the absence of corneal crystals. Although renal biopsy is usually not necessary to establish the diagnosis of cystinosis, when the patient presents with atypical signs and symptoms, a renal biopsy may be extremely valuable. A 20-month-old boy presented with failure to thrive, polyuria, polydipsia, and rickets. He initially showed evidence of a renal tubular acidosis, mild renal insufficiency, and nephrogenic diabetes insipidus. His initial ophthalmologic examination did not demonstrate corneal crystals. His subsequent workup revealed phosphaturia, suggesting a partial proximal tubulopathy. Concomitantly, a renal biopsy revealed prominent podocytes with an immature glomerular appearance, and electron microscopy analysis showed numerous intracellular crystals within tubular epithelial cells. Subsequent laboratory and genetic testing confirmed a diagnosis of infantile nephropathic cystinosis. This case highlights the variability in the clinical presentation of cystinosis, resulting in an uncommon clinical picture of a rare disease. Given that treatment is available to prolong renal function and minimize the extra-renal manifestations of this disorder, early diagnosis is essential. It is important to raise the index of suspicion of cystinosis by recognizing its subtle morphological changes in young patients, and that nephrogenic diabetes insipidus can be secondary to this disorder.

Prognostic and predictive value of VHL gene alteration in renal cell carcinoma: a meta-analysis and review.

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Kim, Bum Jun; Kim, Jung Han; Kim, Hyeong Su; Zang, Dae Young

2017-02-21

The von Hippel-Lindau (VHL) gene is often inactivated in sporadic renal cell carcinoma (RCC) by mutation or promoter hypermethylation. The prognostic or predictive value of VHL gene alteration is not well established. We conducted this meta-analysis to evaluate the association between the VHL alteration and clinical outcomes in patients with RCC. We searched PUBMED, MEDLINE and EMBASE for articles including following terms in their titles, abstracts, or keywords: 'kidney or renal', 'carcinoma or cancer or neoplasm or malignancy', 'von Hippel-Lindau or VHL', 'alteration or mutation or methylation', and 'prognostic or predictive'. There were six studies fulfilling inclusion criteria and a total of 633 patients with clear cell RCC were included in the study: 244 patients who received anti-vascular endothelial growth factor (VEGF) therapy in the predictive value analysis and 419 in the prognostic value analysis. Out of 663 patients, 410 (61.8%) had VHL alteration. The meta-analysis showed no association between the VHL gene alteration and overall response rate (relative risk = 1.47 [95% CI, 0.81-2.67], P = 0.20) or progression free survival (hazard ratio = 1.02 [95% CI, 0.72-1.44], P = 0.91) in patients with RCC who received VEGF-targeted therapy. There was also no correlation between the VHL alteration and overall survival (HR = 0.80 [95% CI, 0.56-1.14], P = 0.21). In conclusion, this meta-analysis indicates that VHL gene alteration has no prognostic or predictive value in patients with clear cell RCC.

The effect of L-cysteine on the portion-selective uptake of cadmium in the renal proximal tubule

International Nuclear Information System (INIS)

Murakami, Masataka; Sano, Kenichi; Webb, M.

1987-01-01

Cadmium (Cd), co-administered with an excess of L-cysteine, accumulates rapidly in the kidneys of the rat. After subcutaneous (s.c.) injection of 3 μmol CdCl 2 /kg body wt the concentrations of Cd in the blood and kidneys increase with the dose of cysteine over the range 0.06-5.0 mmol/kg body wt. At cysteine doses of less than 1.5 mmol/kg body wt the ratio of the concentrations of Cd in the outer medulla and cortex of the kidney remains the same as that after the injection of Cd alone. This ratio, however, is more than doubled at dose levels of 5-10 mmol cysteine/kg body wt. Hepatic uptake of Cd is unaffected by doses of cysteine below 1.5 mmol/kg body wt but decreases markedly at higher doses. In animals that are dosed simultaneously with 5 mmol cysteine/kg body wt, renal uptake of 109 Cd is known to occur in the straight segments of the proximal tubules. At a dose level of less than 1.5 mmol cysteine/kg body wt the present autoradiographical studies show that 109 Cd is taken up predominantly by the proximal convoluted tubules of the kidney cortex. At the critical dose level (1.5 mmol/kg body wt), cysteine decreases the retention of Cd at the s.c. injection site, but probably has little effect on the distribution of Cd between protein and other carrier molecules in the blood. This distribution, however, is altered at higher cysteine dose levels. It is suggested that, under the latter conditions, stable Cd-cysteine complexes are formed in the blood and are filtered readily through the glomeruli. These complexes are taken up in the kidney at the sites of cysteine reabsorption which, by studies with L-[ 35 S]-cysteine, are identified as the straight segments of the proximal tubules. (orig.)

The diagnosis value of color doppler ultrasound in evaluating small renal carcinoma

International Nuclear Information System (INIS)

Chen Gaiyi

2009-01-01

Objective: To characterize the ultrasound and color doppler imaging of small renal carcinoma. Methods: Ultrasound and color doppler images by convex-probe and high frequency-probe of 24 patients with renal carcinoma confirmed by surgery and histology were analyzed retrospectively. Tumor echo, halo, internal blood flow and peripheral tumor blood flow were observed. Results: Tumor echo in 9 lesions was hyper-echo, in 4 was iso-echoic, in 10 was hypo-echo, and in 1 was echoless. Halo was detected in 9 tumors, and small cyst was detected in 5 tumors. By using the convex-probe, peripheral and internal blood flow signal in 24 tumors were observed. Spot blood follow was detected in 6 tumors, half-circularity blood follow in 18 tumors and no circularity blood follow. Detection rate of internal blood flow was 20.83%. By using the high frequency-probe in 21 tumors, spot blood was detected in 1 tumor, half-circularity blood follow in 14 tumors, circularity blood follow in 6 tumors. Detection rate of internal blood flow was 90.48%. It was not satisfied for high frequency-probe in 3 patients because of obesity. Accordance of the diagnosis by high frequency-probe ultrasound was 90.48% and 91.67% by CT (P > 0.05). Conclusion: Detection of renal carcinoma is sensitive by ultrasound. The high frequency-probe is significant sensitive to detect blood follow in renal carcinoma and is helpful to correct diagnosis of renal carcinoma. (authors)

An experimental study on recovery of renal function using 99mTc DMSA scintigram after percutaneous nephrostomy in unilateral hydronephrosis

International Nuclear Information System (INIS)

Moon, Tae Yong; Nam, Sang Hwa; Park, Jong Yeon; Kim, Byung Soo

1992-01-01

Obstruction on the urinary tract eventually results in damage to the kidneys and lose of function. The questions that concern the clinician are the degree of nephron loss in that kidney and potential for recovery following the relief of obstruction. 99m Tc DMSA accumulates in tubule cells and has been proposed as a marker of the tubular mass. The authors estimated the renal uptake ratio of 99m Tc DMSA for the degree of nephron loss corresponding to duration of hydronephrosis following left ureteral ligation in 5 New Zealand white rabbits and the potential for recovery following percutaneous nephrostomy of hydronephrosis in 24 rabbits. While the renal uptake ratio of 99m Tc DMSA of the kidney with unilateral hydronephrosis following ureteral ligation reduced dramatically within 24 hour, that of the opposite healthy kidney increased, and the total renal uptake ratio was same as normal functioning kidneys before ureteral ligation. Upon ureteral release, there was no evidence of definite recovery or impairment in the experimental kidneys for 5 days. The authors conclude that a combination of ureteral release and administration of some drugs such as renal vasodilator or diuretics is an appropriate treatment for the recovery of function in unilateral hydronephrosis

WE-D-204-07: Development of An ImageJ Plugin for Renal Function Quantification: RenalQuant

Energy Technology Data Exchange (ETDEWEB)

Marques da Silva, A; Narciso, L [PUCRS, Porto Alegre, RS (Brazil)

2015-06-15

Purpose: Commercial workstations usually have their own software to calculate dynamic renal functions. However, usually they have low flexibility and subjectivity on delimiting kidney and background areas. The aim of this paper is to present a public domain software, called RenalQuant, capable to semi-automatically draw regions of interest on dynamic renal scintigraphies, extracting data and generating renal function quantification parameters. Methods: The software was developed in Java and written as an ImageJ-based plugin. The preprocessing and segmentation steps include the user’s selection of one time frame with higher activity in kidney’s region, compared with background, and low activity in the liver. Next, the chosen time frame is smoothed using a Gaussian low pass spatial filter (σ = 3) for noise reduction and better delimitation of kidneys. The maximum entropy thresholding method is used for segmentation. A background area is automatically placed below each kidney, and the user confirms if these regions are correctly segmented and positioned. Quantitative data are extracted and each renogram and relative renal function (RRF) value is calculated and displayed. Results: RenalQuant plugin was validated using retrospective 20 patients’ 99mTc-DTPA exams, and compared with results produced by commercial workstation software, referred as reference. The renograms intraclass correlation coefficients (ICC) were calculated and false-negative and false-positive RRF values were analyzed. The results showed that ICC values between RenalQuant plugin and reference software for both kidneys’ renograms were higher than 0.75, showing excellent reliability. Conclusion: Our results indicated RenalQuant plugin can be trustingly used to generate renograms, using DICOM dynamic renal scintigraphy exams as input. It is user friendly and user’s interaction occurs at a minimum level. Further studies have to investigate how to increase RRF accuracy and explore how to solve

Relationship Between Adult Renal Dimensions and Biometric ...

African Journals Online (AJOL)

We measured renal dimensions sonographically and correlated the values obtained with some anthropometric parameters in order to identify the best estimate of renal size in a clinical setting. The renal dimensions of 200 adult subjects referred for abdomino-pelvic scan at University of Nigeria Teaching Hospital, Enugu ...

[Non-metastatic clear cell renal cancer: dependence of the tumour stage on clinico-anatomic and morphologic factors; prognostic value of macro- and karyometric characteristics].

Science.gov (United States)

Iurin, A G

2010-01-01

Non-metastatic clear-cell renal cancer: dependence of the tumour stage on clinico-anatomic and morphologic factors; prognostic value of macro- and karyometric characteristics Sankt Peterburg Pathology Bureau, Sankt Peterburg It was shown based on multivariate regression analysis that pT1a3bN0MO stages of non-metastatic clear-cell renal cancer significantly correlate not only with the tumor size and invasion into the fatty tissue and/or renal vein but also with the invasion into the renal capsule and with the mean maximum diameter and mean nucleus area of tumor cells. There was no correlation of clear-cell renal cancer stages with tumor proliferative activity, gene p53 mutation, oncosuppressor gene PTEN expression, fraction of tumour clear-cell component, and such clinical characteristics as patients' sex, age, and body mass index. Taking into account statistically significant differences between the patients' survival rates, the regression equations developed in this work may be used for the prediction of disease outcome.

Clinical values for abnormal 18F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

International Nuclear Information System (INIS)

Lee, Hwan Seo; Kim, Jae Seung; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

2014-01-01

Highlights: • Abnormal 18 F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • 18 F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of 18 F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in 18 F-FDG uptake. However, both physiologic and abnormal lesions increase 18 F-FDG uptake. Therefore, we evaluated 18 F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including 18 F-FDG PET/CT and biopsies. All lesions with abnormal HN 18 F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal 18 F-FDG uptake were calculated. Results: Abnormal 18 F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal 18 F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine tonsil (n = 2), and epiglottis (n = 1). The sensitivity and

Dynamic renal scintigraphy at hydronephrosis

International Nuclear Information System (INIS)

Petrov, T.; Chukov, I.; Svrakova, E.

1998-01-01

The aim of the study was to estimate the clinical relevance and accuracy of dynamic renal scintigraphy (DRS) in case of obstructed kidneys as hydronephrosis is among the complications at different renal diseases, like nephrolithiasis and urolithiasis. Twenty-one patients mainly with unilateral hydronephrosis were studied. DRS with 99m Tc-MAG3 or 99m Tc-EC was done and quantitative parameters of the morphological and functional status of every kidney were assessed. At 24 % of the patients accumulation curves typical for obstructed by hydronephrosis kidneys were obtained. At 38 % the type of renograms of the affected kidneys was intermediate one, closer to that at the cases with nephrosclerosis, with lower uptake and severe parenchymal changes. The rest 38 % of the cases showed normal renograms or slightly delayed downslope. DRS is a very precise and sensitive method for evaluation of the degree of kidney damage in cases with hydronephrosis

Attenuation values of renal parenchyma in virtual noncontrast images acquired from multiphase renal dual-energy CT: Comparison with standard noncontrast CT.

Science.gov (United States)

Lin, Yuan-Mao; Chiou, Yi-You; Wu, Mei-Han; Huang, Shan-Su; Shen, Shu-Huei

2018-04-01

To compare the renal parenchyma attenuation of virtual noncontrast (VNC) images derived from multiphase renal dual-energy computed tomography (DECT) with standard noncontrast (SNC) images, and to determine the optimum phase for VNC images. Twenty-nine men and 16 women (mean age, 61 ± 13 years; range, 37-89 years) underwent dynamic renal DECT (100/Sn140 kVp) were included in this institutional review board-approved retrospective study. There were four phases of the scan, which included noncontrast, corticomedullary (CMP), nephrographic (NP), and excretory phases (EP). The VNC images was generated from CMP, NP and EP. CT numbers of SNC images and VNC images of each phases were measured in the renal cortex and medulla. Mean standard deviation of subcutaneous fat was measured as image noise on SNC and VNC images. Radiation dose was recorded and potential radiation dose reduction was estimated. Results were tested for statistical significance using the unpaired t-test and agreement using Bland-Altman plot analysis. The difference in mean attenuation between SNC and each phase of VNC images were ≤4 HU. The mean attenuation of renal cortex and medulla was 33.2 ± 4.4 HU, and 34.2 ± 4.8 HU in SNC, 33.6 ± 7.6 HU and 31.1 ± 8.3 HU in VNC of CMP, 34.8 ± 8.6 HU and 35.6 ± 8.5 HU in VNC of NP, 31.5 ± 7.6 HU and 32.4 ± 7.5 HU in VNC of EP. In VNC of CMP, the attenuation of the cortex was higher than the medulla (p VNC of NP, the attenuation of renal cortex was higher than SNC (p VNC of EP, the attenuation of cortex and medulla were lower than SNC (p VNC images from multiphase renal DECT were similar to SNC images. Using the nephrographic phase can gives more comparable VNC images to SNC images in renal parenchyma than other phases. Copyright © 2018 Elsevier B.V. All rights reserved.

Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge.

Science.gov (United States)

Bonnassieux, Martin; Duclos, Antoine; Schneider, Antoine G; Schmidt, Aurélie; Bénard, Stève; Cancalon, Charlotte; Joannes-Boyau, Olivier; Ichai, Carole; Constantin, Jean-Michel; Lefrant, Jean-Yves; Kellum, John A; Rimmelé, Thomas

2018-02-01

Acute kidney injury requiring renal replacement therapy is a major concern in ICUs. Initial renal replacement therapy modality, continuous renal replacement therapy or intermittent hemodialysis, may impact renal recovery. The aim of this study was to assess the influence of initial renal replacement therapy modality on renal recovery at hospital discharge. Retrospective cohort study of all ICU stays from January 1, 2010, to December 31, 2013, with a "renal replacement therapy for acute kidney injury" code using the French hospital discharge database. Two hundred ninety-one ICUs in France. A total of 1,031,120 stays: 58,635 with renal replacement therapy for acute kidney injury and 25,750 included in the main analysis. None. PPatients alive at hospital discharge were grouped according to initial modality (continuous renal replacement therapy or intermittent hemodialysis) and included in the main analysis to identify predictors of renal recovery. Renal recovery was defined as greater than 3 days without renal replacement therapy before hospital discharge. The main analysis was a hierarchical logistic regression analysis including patient demographics, comorbidities, and severity variables, as well as center characteristics. Three sensitivity analyses were performed. Overall mortality was 56.1%, and overall renal recovery was 86.2%. Intermittent hemodialysis was associated with a lower likelihood of recovery at hospital discharge; odds ratio, 0.910 (95% CI, 0.834-0.992) p value equals to 0.0327. Results were consistent across all sensitivity analyses with odds/hazards ratios ranging from 0.883 to 0.958. In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat clinically limited.

Assessment of renal fibrosis in chronic kidney disease using diffusion-weighted MRI

International Nuclear Information System (INIS)

Zhao, J.; Wang, Z.J.; Liu, M.; Zhu, J.; Zhang, X.; Zhang, T.; Li, S.; Li, Y.

2014-01-01

Aim: To assess the performance of diffusion-weighted magnetic resonance imaging (MRI) for the assessment of renal fibrosis in chronic kidney disease (CKD), with histopathology as a reference standard. Materials and methods: Forty patients with CKD and 30 healthy volunteers were recruited for the study. All participants underwent diffusion-weighted MRI. Renal biopsy was performed in 25 patients with CKD. Mean renal medullary and cortical apparent diffusion coefficient (ADC) values were compared between CKD patients and the healthy volunteers. Pearson's correlation coefficient was calculated to investigate the relationship between ADC values, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), 24 h urinary protein (24h-UPRO), and renal histopathological scores. Results: Cortical and medullary ADC values in the CKD group were significantly lower compared to those in the healthy controls. In the CKD group, a significant negative correlation was found between cortical ADC values and SCr/24h-UPRO, and significant positive correlation was found between cortical ADC and eGFR. There was also a significant negative correlation between medullary ADC values and SCr. Both cortical and medullary ADC values were significantly correlated with histopathological fibrosis score. Conclusion: Renal ADC values strongly correlate with histological measures of fibrosis, and have the potential to enhance the non-invasive monitoring of chronic kidney disease. - Highlights: • Renal ADC values in the CKD patients were lower than those in controls. • Renal ADC values were strongly correlated with histological fibrosis score. • Renal ADC values have the potential to enhance the noninvasive monitoring of CKD

An experimental study on recovery of renal function using {sup 99m}Tc DMSA scintigram after percutaneous nephrostomy in unilateral hydronephrosis

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Moon, Tae Yong; Nam, Sang Hwa; Park, Jong Yeon; Kim, Byung Soo [College of Medicine, Pusan National University, Pusan (Korea, Republic of)

1992-07-15

Obstruction on the urinary tract eventually results in damage to the kidneys and lose of function. The questions that concern the clinician are the degree of nephron loss in that kidney and potential for recovery following the relief of obstruction. {sup 99m}Tc DMSA accumulates in tubule cells and has been proposed as a marker of the tubular mass. The authors estimated the renal uptake ratio of {sup 99m}Tc DMSA for the degree of nephron loss corresponding to duration of hydronephrosis following left ureteral ligation in 5 New Zealand white rabbits and the potential for recovery following percutaneous nephrostomy of hydronephrosis in 24 rabbits. While the renal uptake ratio of {sup 99m}Tc DMSA of the kidney with unilateral hydronephrosis following ureteral ligation reduced dramatically within 24 hour, that of the opposite healthy kidney increased, and the total renal uptake ratio was same as normal functioning kidneys before ureteral ligation. Upon ureteral release, there was no evidence of definite recovery or impairment in the experimental kidneys for 5 days. The authors conclude that a combination of ureteral release and administration of some drugs such as renal vasodilator or diuretics is an appropriate treatment for the recovery of function in unilateral hydronephrosis.

What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

NARCIS (Netherlands)

Barwari, K.; Kümmerlin, I.P.E.D.; Ten Kate, F.J.; Algaba, F.; Trias, I.; Wijkstra, H.; Rosette, de la J.J.M.C.H.; Laguna, M.P.

2013-01-01

Purpose Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by

What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

NARCIS (Netherlands)

Barwari, K.; Kummerlin, I. P.; ten Kate, F. J.; Algaba, F.; Trias, I.; Wijkstra, H.; de la Rosette, J. J.; Laguna, P.

2013-01-01

Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by five

MAG3 diuresis renography and output efficiency measurement in renal transplant patients

International Nuclear Information System (INIS)

Spicer, T.; Gruenewald, S.; Chi, K.K.; Larcos, G.; Farlow, D.; Choong, K.; Chapman, J.

1997-01-01

Full text: Urinary tract obstruction following renal transplantation often presents a diagnostic dilemma, as some patients with equivocal investigations subsequently show improvement following stenting. The purposes of this study were to (1) establish a normal range of renal output efficiency (ROE) in transplants, and (2) assess the usefulness of MAG3 diuresis renography and ROE in suspected allograft obstruction. Twenty-two renal transplant patients with stable function and no evidence of hydronephrosis on serial ultrasound had a diuretic MAG3 scan with calculation of ROE. Three patients with proven graft obstruction underwent the same scanning procedure. Methodology was as follows: (1) 60 MBq of 99m Tc-DTPA GFR was performed (single injection-dual blood sample method); (2) patients were then prehydrated with either oral or IV fluid; (3) 10 min prior to scanning, intravenous Frusemide 20-80 mg (dose depending on renal function) was injected, and then (4) 200 MBq of MAG3 for a 20 min scan. The studies were then qualitatively and quantitatively reviewed to assess uptake and excretion, and the ROE was calculated. The mean ROE for the twenty-two normal renal transplant patients was 85.7% ± 4.1% (range 78 - 90%). Technetium-99m-DTPA GFR was 55.5 mL/min/1.73m 2 (range 27 to 83). The MAG3 scans in the three obstructed patients were equivocal for obstruction but the ROE values of 59%, 68% and 75% were more than 2.5 standard deviations below our calculated normal mean. The 99m Tc-DTPA GFRs were 61,17 and 57 mL/min/1.73m 2 , respectively. Thus, in normal grafts the ROE should exceed 78 per cent. Our data suggest that ROE may be a useful addition to standard scintigraphic parameters in diagnosis of graft obstruction

Aortic {sup 18}F-FDG uptake in patients suffering from granulomatosis with polyangiitis

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Kemna, Michael J. [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Bucerius, Jan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); University Hospital RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Drent, Marjolein [Maastricht University, Department of Pharmacology and Toxicology, Maastricht (Netherlands); Voeoe, Stefan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Veenman, Martine [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Paassen, Pieter van [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Tervaert, Jan Willem Cohen [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Sint Franciscus Gasthuis, Noordoever Academy, Rotterdam (Netherlands); Kroonenburgh, Marinus J.P.G. van [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

2015-08-15

The objective of the study was to systematically assess aortic inflammation in patients with granulomatosis with polyangiitis (GPA) using {sup 18}F-2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. Aortic inflammation was studied in PET/CT scans obtained from 21 patients with GPA; 14 patients with sarcoidosis were included as disease controls, 7 patients with stage I or II head and neck carcinoma ascertained during routine clinical practice were used as healthy controls (HC) and 5 patients with large vessel vasculitis (LVV) were used as positive controls. Aortic {sup 18}F-FDG uptake was expressed as the blood-normalized maximum standardized uptake value (SUV{sub max}), known as the target to background ratio (mean TBR{sub max}). The mean TBR{sub max} (interquartile range) of the aorta in patients with GPA, sarcoidosis, HC and LVV were 1.75 (1.32-2.05), 1.62 (1.54-1.74), 1.29 (1.22-1.52) and 2.03 (1.67-2.45), respectively. The mean TBR{sub max} was significantly higher in patients suffering from GPA or LVV compared to HC (p < 0.05 and p < 0.005, respectively) and tended to be higher in patients suffering from sarcoidosis, but this did not reach statistical significance (p = 0.098). The mean TBR{sub max} of the most diseased segment was significantly higher compared to HC [1.57 (1.39-1.81)] in LVV patients [2.55 (2.22-2.82), p < 0.005], GPA patients [2.17 (1.89-2.83), p < 0.005] and patients suffering from sarcoidosis [2.04 (1.88-2.20), p < 0.05]. In GPA patients, the mean TBR{sub max} of the aorta was significantly higher in patients with previous renal involvement [2.01 (1.69-2.53)] compared to patients without renal involvement in the past [1.60 (1.51-1.80), p < 0.05]. Interrater reproducibility with a second reader was high (all intraclass correlation coefficients >0.9). Patients suffering from GPA show marked aortic FDG uptake. (orig.)

Diagnostic value of renal clearance techniques using iodo-hippuran /sup 131/I and /sup 99m/-DTPA

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Heidenreich, P; Hoer, G [Technische Univ. Muenchen (Germany, F.R.). Nuklearmedizinische Klinik und Poliklinik

1976-01-01

Methods and clinical indications of divided renal clearance determination using /sup 131/I-hippuran are presented and their value as a diagnostic tool in urology is shown by two case reports. For quantitative assessment of renal function we prefer the whole body clearance (with partial shielding of kidneys and bladder) which obviates the necessity of the theoretical assumption of compartmental distribution of radiopharmaceuticals. Using simplified clearance techniques only based on analysis of plasma disappearance curves (slope clearance one- and two-compartment model), clinically useful results are also obtainable, especially in follow up studies. The evaluation of tubular and glomerular kidney function by simultaneous application of /sup 131/I-hippuran and sup(99m)Tc-DTPA is suitable for estimation of filtration fraction in patients with urological and nephrological diseases. Even with regard to therapy and follow up studies of urinary tract tuberculosis, remarkable dignostic informations may be achieved.

Camera functional scintiscanning of the kidneys - its significance and value for nuclear-medical renal diagnostics especially in comparison with isotope nephrography

International Nuclear Information System (INIS)

Wibmer, A.

1982-01-01

The thesis aimed at demonstrating the significance of functional scintiscanning in comparison with radioisotope nephrography and its informative value in individual kidney disease cases. To this end, 248 functional scintigrams of patients taken from various disease groups and 96 functional scintigrams of non-kidney-diseased persons were evaluated. As against nephrography, functional scintigraphic imaging has the advantage of displaying simultaneously both functional graphs and sequential scintigrams. This allows to asses the morphology, location and function of the non-functioning renal parenchyma and to localize and differentiate dysfunctions which are globally detectable in RIN, at a low patient exposure and within one single examination. ''Region-of-Interest'' selection in functional scintiscanning allows an exact demonstration of the kidneys which results in new normal values for the functional parameters. Owing to its case in handling and very low level of patient exposure, functional scintiscanning lends itself to an orientational examination of large patient groups, to an examination of severely ill patients without putting too much strain of them and to follow-up of all nephropathies. It even provides some information in renal insufficiency where other methods fail. However, functional scintiscanning appears to be inappropriate as a diagnostic method in inflammatory processes, hypertension and renal artery stenoses. (orig./MG) [de

Technique and value of three dimensional reconstruction of stones in the renal pelvis using spiral CT

International Nuclear Information System (INIS)

Fink, B.K.; Fink, U.; Pentenrieder, M.; Kohz, P.; Englmeier, H.K.; Schmeller, N.

1994-01-01

5 patients with staghorn calculi in the renal pelvis were examined by spiral CT. From the raw data three dimensional reconstructions of the stones were obtained. In all patients it was possible to compare the three dimensional model with the stone following performance of percutaneous lithopaxy and endoscopic removal of the fragments. In all cases the three dimensional reconstruction provided a realistic image of the stones and was of practical value for the urologist for preoperative diagnosis and intraoperative control. (orig.) [de

Sepsis patients' renal manifestation on contrast-enhanced CT

International Nuclear Information System (INIS)

Sasaguri, K.; Yamaguchi, K.; Nakazono, T.; Mizuguchi, M.; Irie, H.

2016-01-01

Aim: To evaluate renal volume and attenuation changes in patients with sepsis on contrast-enhanced computed tomography (CT) with respect to the severity of sepsis. Materials and methods: Forty-four patients with sepsis who underwent CT before and after the onset of sepsis were retrospectively analysed. Renal volume and CT attenuation value of the renal cortex on contrast-enhanced CT were measured for each patient and changes in renal volume and CT attenuation value from before to after the onset of sepsis were calculated. The changes were correlated with the severity of sepsis (Sepsis-related Organ Failure Assessment [SOFA] score). The time course of the renal volume and CT attenuation changes were also evaluated. Results: Renal volume increased by 17.6% and CT attenuation value decreased by 19% after the onset of sepsis with statistically significant differences (p<0.001 for both renal volume and CT attenuation changes). The renal volume and CT attenuation changes had significant correlations with the SOFA score (r=0.36, p=0.018 and −0.43, p=0.005, respectively). The time course of the renal volume and CT attenuation changes seemed to be gradual compared to that of the SOFA score and to lag behind the peak of the SOFA score. Conclusion: In patients with sepsis, the renal volume increases and the CT attenuation value decreases in proportion to the severity of sepsis. The changes may lag behind the peak of severity of sepsis and can be observed for a relatively long time after a patient's recovery from sepsis. - Highlights: • The renal volume increases and the renal enhancement on contrast-enhanced CT decreases in patients with sepsis. • The degrees of these changes are correlated with severity of sepsis. • These changes may lag behind the peak of severity of sepsis and last for a long time after a patient's recovery from sepsis.

Update on Mechanisms of Renal Tubule Injury Caused by Advanced Glycation End Products

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Hong Sun

2016-01-01

Full Text Available Diabetic nephropathy (DN caused by advanced glycation end products (AGEs may be associated with lipid accumulation in the kidneys. This study was designed to investigate whether Nε-(carboxymethyl lysine (CML, a member of the AGEs family increases lipid accumulation in a human renal tubular epithelial cell line (HK-2 via increasing cholesterol synthesis and uptake and reducing cholesterol efflux through endoplasmic reticulum stress (ERS. Our results showed that CML disrupts cholesterol metabolism in HK-2 cells by activating sterol regulatory element-binding protein 2 (SREBP-2 and liver X receptor (LXR, followed by an increase in 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoAR mediated cholesterol synthesis and low density lipoprotein receptor (LDLr mediated cholesterol uptake and a reduction in ATP-binding cassette transporter A1 (ABCA1 mediated cholesterol efflux, ultimately causing lipid accumulation in HK-2 cells. All of these responses could be suppressed by an ERS inhibitor, which suggests that CML causes lipid accumulation in renal tubule cells through ERS and that the inhibition of ERS is a potential novel approach to treating CML-induced renal tubular foam cell formation.

Acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis in the dog.

Science.gov (United States)

Anderson, W P; Johnston, C I; Korner, P I

1979-01-01

1. The acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis were studied in chronically instrumented, unanaesthetized dogs. 2. Stenosis was induced over 30 sec by inflation of a cuff around the renal artery to lower distal pressure to 60, 40 or 20 mmHg, with stenosis maintained for 1 hr. This resulted in an immediate fall in renal vascular resistance, but over the next 5--30 min both resistance and renal artery pressure were restored back towards prestenosis values. Only transient increases in systemic arterial blood pressure and plasma renin and angiotensin levels were seen with the two milder stenoses. Despite restoration of renal artery pressure, renal blood flow remained reduced at all grades of stenosis. 3. Pre-treatment with angiotensin I converting enzyme inhibitor or sarosine1, isoleucone8 angiotensin II greatly attenuated or abolished the restoration of renal artery pressure and renal vascular resistance after stenosis, and plasma renin and angiotensin II levels remained high. Renal dilatation was indefinitely maintained, but the normal restoration of resistance and pressure could be simulated by infusing angiotensin II into the renal artery. 4. The effective resistance to blood flow by the stenosis did not remain constant but varied with changes in the renal vascular resistance. PMID:219182

The value of quantitative methods for assessment of renal transplant and comparison with physician expertness

International Nuclear Information System (INIS)

Firouzi, F.; Fazeli, M.

2002-01-01

Radionuclide renal diagnostic studies play an important role in assessing renal allograft. Various quantitative parameters have been derived from the Radionuclide renogram to facilitate and confirm the changes in perfusion and/or function of kidney allograft. These quantitative methods were divided into parameters used for assessing renal graft perfusion and parameters used for evaluating parenchymal function. The blood flow in renal transplants can be quantified by measuring the rate of activity appearance in the kidney graft and the ratio of the integral activity under the transplanted kidney and arterial curves e.g. Hilton's perfusion index and Karachi's kidney/aortic ratio. Quantitative evaluation of graft extraction and excretion was assessed by parameters derived from 123 I/ 131 I-OH, 99 mTc-DTPA or 99 mTc-Mag renogram. In this study we review retrospectively renal transplanted patients scintigraphies that all of them under gone to renal allograft needle biopsy nearly to date of allograft scan. We performed quantitative methods for all patients. We observed perfusion parameters affected by quality of bolus injection and numerical aviations related to changes in the site and size of region of interest. Quantitative methods for renal parenchymal functions were nonspecific and far from defining a specific cause of graft dysfunction. In conclusion, neither perfusion nor parenchymal parameters have not enough diagnostic power for specific diagnosis of graft dysfunction. Physician expertness by using scintigraphic images and renogram curves is more sensitive and specific for diagnosis of renal allograft dysfunction

Radio-active iodine uptake in vitiligo

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Kumar, V.; Shankar, V.; Chaudhary, S.; Bhatia, K.K.; Mehta, L.K.; Arora, D.R. (Medical College and Hospital, Rohtak-124001 (India))

1990-01-01

Vitiligo and thyroid disease are commonly associated disorders. Twenty-two clinically euthyroid vitiligo patients were studied for functional assessment of thyroid by radioactive iodine uptake assay. Half of them showed abnormal uptake values at 24 hours. Of these patients, 90% had lower values indicating a tendency towards developing hypothyroid state. Subclinical thyroid dysfunction in vitiligo appears to be an adaptive change. (author).

Radio-active iodine uptake in vitiligo

International Nuclear Information System (INIS)

Kumar, V.; Shankar, V.; Chaudhary, S.; Bhatia, K.K.; Mehta, L.K.; Arora, D.R.

1990-01-01

Vitiligo and thyroid disease are commonly associated disorders. Twenty-two clinically euthyroid vitiligo patients were studied for functional assessment of thyroid by radioactive iodine uptake assay. Half of them showed abnormal uptake values at 24 hours. Of these patients, 90% had lower values indicating a tendency towards developing hypothyroid state. Subclinical thyroid dysfunction in vitiligo appears to be an adaptive change. (author)

Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

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Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

2014-08-15

Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

Non-invasive differentiation of pancreatic lesions: is analysis of FDG kinetics superior to semiquantitative uptake value analysis?

International Nuclear Information System (INIS)

Nitzsche, E.U.; Hoegerle, S.; Mix, M.; Brink, I.; Otte, A.; Moser, E.

2002-01-01

The diagnostic utility of fluorine-18 2-deoxy-D-glucose positron emission tomography (FDG PET) for the non-invasive differentiation of focal pancreatic lesions originating from cancer or chronic pancreatitis by combined visual image interpretation and semiquantitative uptake value analysis has been documented. However, in clinical routine some misdiagnosis is still observed. This is because there is potential overlap between the semiquantitative uptake values obtained for active inflammatory lesions and cancer. Therefore, this prospective study was undertaken to test the hypothesis that analysis of dynamic kinetics of focal pancreatic lesions based on FDG PET may more accurately determine the benign or malignant nature of such lesions. Thirty patients (56±17 years) were studied dynamically with FDG PET for a period of 60-90 min. Patients were assigned to one of four groups: control, acute pancreatitis, chronic pancreatitis or pancreatic cancer. Two observers, blinded to the clinical data, analysed the time-activity curves of FDG kinetics based on region of interest analysis. The diagnosis predicted by FDG PET was compared with the result of histological examination of the surgical specimen. Analysis of FDG kinetics revealed significant differences in the shape of the time-activity curve for controls, pancreatic cancer and inflammatory disease. Surprisingly, there was no significant difference in the time-activity curve shape for chronic pancreatitis and acute pancreatitis; this is, however, not a clinical issue. Furthermore, acquisition time (60 min vs 90 min) did not affect interpretation of the time-activity curve, so that scanning time may be regularly shortened to 60 min. Interobserver agreement was 1. Based on these findings, non-invasive differentiation between pancreatic cancer and chronic pancreatitis was correctly predicted in all cases, as confirmed by histology. In addition, the specificity was increased compared with that obtained from standardised

Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas

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Zhong, Yan; Wang, Haiyi; Shen, Yanguang; Ma, Lu; Pan, Jingjing; Ye, Huiyi [Chinese PLA General Hospital, Department of Radiology, Beijing (China); Guo, Aitao [Chinese PLA General Hospital, Department of Pathology, Beijing (China); Wang, Jia [Handan Central Hosptical, Department of Radiology, Hebei (China); Kang, Suhai [264 Hospital of PLA, X-ray Department, Taiyuan (China)

2017-12-15

To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs). We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated. Mean ADC values for renal oncocytomas were significantly higher than those for chromophobe RCCs (1.59±0.21 vs. 1.09±0.29 x 10{sup -3} mm{sup 2}/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930). Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours. (orig.)

Renal glucose metabolism in normal physiological conditions and in diabetes.

Science.gov (United States)

Alsahli, Mazen; Gerich, John E

2017-11-01

The kidney plays an important role in glucose homeostasis via gluconeogenesis, glucose utilization, and glucose reabsorption from the renal glomerular filtrate. After an overnight fast, 20-25% of glucose released into the circulation originates from the kidneys through gluconeogenesis. In this post-absorptive state, the kidneys utilize about 10% of all glucose utilized by the body. After glucose ingestion, renal gluconeogenesis increases and accounts for approximately 60% of endogenous glucose release in the postprandial period. Each day, the kidneys filter approximately 180g of glucose and virtually all of this is reabsorbed into the circulation. Hormones (most importantly insulin and catecholamines), substrates, enzymes, and glucose transporters are some of the various factors influencing the kidney's role. Patients with type 2 diabetes have an increased renal glucose uptake and release in the fasting and the post-prandial states. Additionally, glucosuria in these patients does not occur at plasma glucose levels that would normally produce glucosuria in healthy individuals. The major abnormality of renal glucose metabolism in type 1 diabetes appears to be impaired renal glucose release during hypoglycemia. Copyright © 2017 Elsevier B.V. All rights reserved.

Renal artery stenosis: comparative assessment by unenhanced renal artery mra versus contrast-enhanced MRA

International Nuclear Information System (INIS)

Khoo, Michael M.Y.; Deeab, Dhafer; Gedroyc, Wladyslaw M.W.; Dick, Elizabeth A.; Duncan, Neil; Taube, David

2011-01-01

To evaluate steady-state free precession (SSFP) non-contrast-enhanced MR angiography (Unenhanced-MRA) versus conventional contrast-enhanced MR angiography (CE-MRA) in the detection of renal artery stenosis (RAS). Retrospective analysis of 70 consecutive patients referred for suspected RAS, examined by SSFP Unenhanced-MRA and CE-MRA. Image quality, quality of visible renal arterial segments, presence and grade of RAS were evaluated. The Unenhanced-MRA were compared against reference standard CE-MRA results. 149 renal arteries were assessed with 21 haemodynamically significant stenoses (≥50% stenosis) demonstrated by CE-MRA. Combined sensitivity and specificity for RAS detection by Unenhanced-MRA was 72.8% and 97.8% respectively. There is substantial correlation for RAS detection between Unenhanced-MRA and CE-MRA with kappa values of between 0.64 and 0.74. There was excellent inter-observer correlation for RAS on Unenhanced-MRA (kappa values 0.82-1.0). Our study has shown Unenhanced-MRA to be a viable alternative to CE-MRA, yielding images equal in quality without the requirement for gadolinium contrast agents. The sensitivity and specificity for the detection of haemodynamically significant stenoses are comparable to CE-MRA. Potentially, Unenhanced-MRA could be used as an initial investigation to avoid performing CE-MRA in patients with normal renal arteries, however we suggest that its real value will lie in being complementary to CE-MRA. (orig.)

Determinants of renal potassium excretion in critically ill patients : The role of insulin therapy

NARCIS (Netherlands)

Hoekstra, Miriam; Yeh, Lu; Oude Lansink, Annemieke; Vogelzang, Mathijs; Stegeman, Coen A.; Rodgers, Michael G. G.; van der Horst, Iwan C. C.; Wietasch, Gotz; Zijlstra, Felix; Nijsten, Maarten W. N.

Objectives: Insulin administration lowers plasma potassium concentration by augmenting intracellular uptake of potassium. The effect of insulin administration on renal potassium excretion is unclear. Some studies suggest that insulin has an antikaliuretic effect although plasma potassium levels were

Functional characteristics of a renal H+/lipophilic cation antiport system in porcine LLC-PK1 cells and rats.

Science.gov (United States)

Matsui, Ryutaro; Hattori, Ryutaro; Usami, Youhei; Koyama, Masumi; Hirayama, Yuki; Matsuba, Emi; Hashimoto, Yukiya

2018-02-01

We have recently found an H + /quinidine (a lipophilic cation, QND) antiport system in Madin-Darby canine kidney (MDCK) cells. The primary aim of the present study was to evaluate whether the H + /lipophilic cation antiport system is expressed in porcine LLC-PK 1 cells. That is, we investigated uptake and/or efflux of QND and another cation, bisoprolol, in LLC-PK 1 cells. In addition, we studied the renal clearance of bisoprolol in rats. Uptake of QND into LLC-PK 1 cells was decreased by acidification of the extracellular pH or alkalization of the intracellular pH. Cellular uptake of QND from the apical side was much greater than from the basolateral side. In addition, apical efflux of QND from LLC-PK 1 cells was increased by acidification of the extracellular pH. Furthermore, lipophilic cationic drugs significantly reduced uptake of bisoprolol in LLC-PK 1 cells. Renal clearance of bisoprolol in rats was approximately 7-fold higher than that of creatinine, and was markedly decreased by alkalization of the urine pH. The present study suggests that the H + /lipophilic cation antiport system is expressed in the apical membrane of LLC-PK 1 cells. Moreover, the H + /lipophilic cation antiport system may be responsible for renal tubular secretion of bisoprolol in rats. Copyright © 2017 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.

Normal values of iodine - 131 uptake in 24 hours, in Rio Grande do Norte, Brazil

International Nuclear Information System (INIS)

Oliveira Filho, T.F. de; Oliveira, C.F.F. de

Thorough clinical exams on all patients come to the radioisotope Laboratory at UFRN, where carried out attempting to select those patients with thyroids considered to be clinically normal. After wayne tests for hypo and hyperthyroidism were carried out, 100 patients were considered to be fit for the research. All of them had an impalpable and asympitomatic thyroid. Waynes clinical indices were precisely revealed in 93% of cases. It was concluded that the normal values of uptake of 131 I during the 24 hours in RGN varied between 14% and 44% [pt

Prediction of renovascualar hypertension by captopril-stimulated renal vein renin ratios

International Nuclear Information System (INIS)

Roubidoux, M.A.; Dunnick, N.R.; Svetkey, L.; Newmann, G.E.; Cohan, R.H.; Kadir, S.; Klotman, P.

1989-01-01

The authors have prospectively studied 114 patients with suspected renovascular hypertension to determine whether captopril-stimulated, selective, renal vein renin ratios could be used to predict renovascular hypertension. As judged by the response to correction of renal artery lesions, 14 patients had renovascular hypertension, and renal vein renin ratios were significant in eight (sensitivity 57%). Overall, the positive predictive value of renal vein renin ratios was 33%, and the negative predictive value was 89%. The authors concluded that, in patients with renal artery stenosis, renal vein renin ratios predict neither the need for conventional arteriography nor potential benefit from the correction of vascular insufficiency

Standardized uptake value of FDG corrected by lean body mass measured by DEXA

International Nuclear Information System (INIS)

Guirao, M.A.; Sanchez, A.M.; Saravi, F.D.; Mosconi, S.; Frias, L.

2002-01-01

Evaluating the metabolic activity of tumor lesion sometimes becomes important to evaluate grading of malignancy, prognosis, or response to therapy. The most used measure of the metabolic activity of [18F]-Fluorodeoxiglucose (FDG) in clinical PET is the Standardized Uptake Value (SUV). It relates the activity measured by the PET scan to the injected dose of FDG divided by the body mass. This approach overestimates SUV in 'heavy' patients, as the proportion of the 'low avid of FDG' fat mass increases. For this reason, different approaches are being evaluated to obtain a more accurate SUV measure. Aims: to compare the measured lean body mass by Dual X-Ray Absorptiometry with the previous methods of correction, to assess the more independent to the body constitution. Material and Methods: FDG metabolism was studied to 15 patients of both sexes, age between 28 and 72 y.o., body weight 55 to 92 Kg. One hour after the IV injection of 0.0045mCi/Kg of FDG, a whole body emission and transmission scan was performed to each subject in a positron emission tomograph (QUEST 250, GE-UGM, USA) for over 1 hour. Body lean mass composition was measured the same or next day by DEXA (Lunar DPX-L, USA.) ROIs were drawn on brain, liver and muscle. SUVbw =[(corrected mCi/g of tissue) / (mCi injected / body weight in grams)] was calculated for each tissue, and then recalculated replacing body weight with the measured lean body mass (SUVlm), calculated lean mass (SUVlc), body mass index (SUVmi) and body surface area (SUVsa). Corrected SUVs were normalized to each SUVbw average for a comparable visualization of results. Results: obtained data was analyzed by linear regression and curve estimation for each case in all tissues with the SPSS statistical software. A positive correlation between SUVbw and subject weight was confirmed for the 3 tissues. In Muscle and liver there was no significant correlation. The liver scanning time was variable ( 90 to 123 minutes after injection). Relating liver

Reevaluation of the 131I thyroid uptake in Rio de Janeiro

International Nuclear Information System (INIS)

Rosenthal, D.; Frankenfeld, T.G.P.; Assis Paiva, H.J. de; Fridman, J.

1982-01-01

The values of the 3 and 24 hour thyroid radioiodine uptake were analysed in 919 of the patients examined during 1977-1980. Reference values determined for 95% of the normal population are 2.5 - 17.5% for the 3 hour thyroid uptake values, and 10.5 - 41.2% for the 24 hour values. The non-toxic diffuse goiter group has significantly higher mean values than normals or patients with non-toxic nodular goiters and cold nodules, their upper values reaching 24.7% and 52.9% for 3 and 24 hour uptake. The discriminatory power of the test for non-toxic diffuse goiters may be increased if higher limits than those determined for normals are used in day to day routine. Values of 20% for 3 hour uptake and 45% for the 24 hour uptake improve diagnosis in these patients without seriously reducing the capacity for identification of thyrotoxicosis. A value greater than 0.6 for the ratio between the 3 hour and 24 hour uptake can serve as a coadjuvant factor in the diagnosis of diffuse toxic goiters; values higher than 0.8 were found in less than 0.5% of the non-toxic patients. (Author) [pt

MAG3 in a renal transplant with complications

International Nuclear Information System (INIS)

Rynderman, J.

2002-01-01

Full text: A 42 year-old female presenting with glomerulonephritis induced end stage renal failure was found suitable for a renal transplant (Tx). A cadaveric renal Tx was performed after a prolonged cold ischaemic time of 12 hours (optimal<4 hours). The surgery was uncomplicated and doppler ultrasound (u/s) post surgery demonstrated good perfusion to the transplant. Sequential MAG3 renal scanning, at days 1, 3 and 5 post transplant demonstrated reduced but clearly identifiable perfusion and an accumulation renogram ('hot kidney') consistent with acute tubular necrosis (ATN). These results lead to a biopsy being performed at day 5. The biopsy demonstrated rejection and tubular dilatation m keeping with ATN Intense anti-rejection therapy commenced. The day 7, MAG3 study demonstrated some improvement in perfusion, uptake, and clearance, however, overall function remained impaired Dialysis was resumed. At day 10, the patient developed pain with a distended, firm, and tender abdomen. An urgent MAG3 study demonstrated acute vascular insult with near complete absence of perfusion or function ('cold kidney') and the decrease on accumulation renogram. Renal u/s demonstrated a peri-nephric haematoma and markedly abnormal intra-renal blood flow in keeping with acute rejection. This lead to an emergency renal Tx nephrectomy Macroscopically, the kidney was swollen with extensive necrosis and surrounded by fresh blood, with microscopy showing extensive rejection and venous thrombosis. Post nephrectomy the patient returned to haemodialysis While limited by ATN in the early post Tx period, MAG3 imaging provided timely, accurate and non invasive diagnostic information as to the viability of the renal Tx and to the ultimate decision to remove the kidney. This case also demonstrates the importance of frequent serial scanning in early post Tx monitoring. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

[Value of fractional flow reserve measurement in endovascular therapy for patients with Stanford B type aortic dissection complicated with renal blood flow injury].

Science.gov (United States)

Guo, Xi; Li, Peng; Liu, Guangrui; Huang, Xiaoyong; Yong, Qiang; Wang, Guoqin; Huang, Lianjun

2015-10-01

To analyze the value of fractional flow reserve (FFR) measurement on endovascular therapy for patients with renal artery stenosis. Clinical data of 12 patients with Stanford B type aortic dissection complicated with renal blood flow injury in Anzhen hospital hospitalized from May 2013 to February 2014 were retrospectively analyzed. Renal artery angiography was performed and fractional flow reserve (FFR) was measured before Thoracic endovascular aortic repair. After operation, renal artery FFR was measured again, and renal artery stenting was performed in patients with FFR ≤ 0.90 or average pressure difference between proximal and distal of renal artery > 20 mmHg (1 mmHg = 0.133 kPa) and not applied for patients with FFR > 0.90.The patients were then subsequently followed up clinically. Kidney function were measured after 1 month, and contrast-enhanced ultrasonography data were obtained at 1 and 3 months later, respectively. The FFR of 1 patient was 0.90, while the FFR of other patients were less than 0.90 before thoracic endovascular aortic repair. After the procedure,the angiography showed that the blood flow of renal artery in 8 patients were fluency, and the FFR index was over 0.90. There were 4 patients with FFR less than 0.90. After renal artery stenting, the FFR of these 4 patients were all above 0.90. Compared with pre-procedure, blood urea nitrogen ((8.84 ± 3.99) mmol/L vs. (5.18 ± 1.69) mmol/L, P = 0.011) and uric acid ((359.3 ± 77.3) µmol/L vs. (276.9 ± 108.3) µmol/L, P = 0.008) decreased significantly after 1 month, and there was no significant difference in serum creatinine (P = 0.760). Contrast-enhanced ultrasonography results showed that blood flow of renal artery were fluency after 1 month and 3 months. In patients with aortic dissection complicating renal blood flow injury, the FFR measurement is meaningful in evaluating the blood flow status of target organs and guide the endovascular revascularization.

Effect of PTA on blood pressure, renal plasma flow and renal venous renin activity in renovascular hypertension

International Nuclear Information System (INIS)

Arlart, I.P.; Dewitz, H. von; Rosenthal, J.

1983-01-01

Percutaneous transluminal angioplasty (PTA) is more and more accepted for interventional management of renal artery stenosis in hypertensive patients. This study was carried out to assess the behaviour of arterial blood-pressure, renal plasma flow and renal venous rening activity in renovascular hypertension following catheter dilatation. Using the data the possibility is calculated to predict the effect of PTA on blood pressure preinterventionally. The results demonstrate that a successful employment of PTA depends on a normal contralateral renal plasma flow and a normalization of plasma flow of the poststenotic kidney. Determination of plasma renin activity is only of restricted value. (orig.)

Prognostic value of lymph node-to-primary tumor standardized uptake value ratio in endometrioid endometrial carcinoma

Energy Technology Data Exchange (ETDEWEB)

Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

2018-01-15

To determine whether the relative metabolic activity of pelvic or para-aortic LN compared with that of primary tumor measured by preoperative [{sup 18}F]FDG PET/CT scan has prognostic value in patients with endometrioid endometrial carcinoma. We retrospectively reviewed patients with endometrioid endometrial carcinoma who underwent preoperative [{sup 18}F]FDG PET/CT scans. Prognostic values of PET/CT-derived metabolic variables such as maximum standardized uptake value (SUV) of the primary endometrial carcinoma (SUV{sub Tumor}) and LN (SUV{sub LN}), and the LN-to-endometrial carcinoma SUV ratio (SUV{sub LN} / SUV{sub Tumor}) were assessed. Clinico-pathological data, imaging data, and treatment results were reviewed for 107 eligible patients. Median post-surgical follow-up was 23 months (range, 6-60), and 7 (6.5%) patients experienced recurrence. Regression analysis showed that SUV{sub LN} / SUV{sub Tumor} (P < 0.001), SUV{sub LN} (P = 0.003), International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.006), and tumor grade (P = 0.011) were risk factors of recurrence. Multivariate regression analysis revealed that FIGO stage (P = 0.034) was the independent risk factor of recurrence. SUV{sub LN} / SUV{sub Tumor} showed significant correlation with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), recurrence (P = 0.001), tumor grade (P < 0.001), and deep myometrial invasion of tumor (P = 0.022). Patient groups categorized by SUV{sub LN} / SUV{sub Tumor} showed significant difference in progression-free survival (Log-rank test, P = 0.001). Preoperative SUV{sub LN} / SUV{sub Tumor} measured by [{sup 18}F]FDG PET/CT was significantly associated with recurrence, and may become a novel prognostic factor in patients with endometrioid endometrial carcinoma. (orig.)

Renal hemodynamic effects of activation of specific renal sympathetic nerve fiber groups.

Science.gov (United States)

DiBona, G F; Sawin, L L

1999-02-01

To examine the effect of activation of a unique population of renal sympathetic nerve fibers on renal blood flow (RBF) dynamics, anesthetized rats were instrumented with a renal sympathetic nerve activity (RSNA) recording electrode and an electromagnetic flow probe on the ipsilateral renal artery. Peripheral thermal receptor stimulation (external heat) was used to activate a unique population of renal sympathetic nerve fibers and to increase total RSNA. Total RSNA was reflexly increased to the same degree with somatic receptor stimulation (tail compression). Arterial pressure and heart rate were increased by both stimuli. Total RSNA was increased to the same degree by both stimuli but external heat produced a greater renal vasoconstrictor response than tail compression. Whereas both stimuli increased spectral density power of RSNA at both cardiac and respiratory frequencies, modulation of RBF variability by fluctuations of RSNA was small at these frequencies, with values for the normalized transfer gain being approximately 0.1 at >0.5 Hz. During tail compression coherent oscillations of RSNA and RBF were found at 0.3-0.4 Hz with normalized transfer gain of 0.33 +/- 0.02. During external heat coherent oscillations of RSNA and RBF were found at both 0.2 and 0.3-0.4 Hz with normalized transfer gains of 0. 63 +/- 0.05 at 0.2 Hz and 0.53 +/- 0.04 to 0.36 +/- 0.02 at 0.3-0.4 Hz. Renal denervation eliminated the oscillations in RBF at both 0.2 and 0.3-0.4 Hz. These findings indicate that despite similar increases in total RSNA, external heat results in a greater renal vasoconstrictor response than tail compression due to the activation of a unique population of renal sympathetic nerve fibers with different frequency-response characteristics of the renal vasculature.

Dynamic Contrast-Enhanced MR Imaging of Renal Ischemia-Reperfusion Injury

Energy Technology Data Exchange (ETDEWEB)

Baik, Jun Hyun; Ahn, Myeong Im; Park, Young Ha; Chung, Soo Kyo [Catholic University, Seoul (Korea, Republic of)

2010-02-15

To evaluate the usefulness of magnetic resonance imaging (MRI) in a renal ischemia-reperfusion injury. Twenty-four rabbits were randomly divided into four groups, including a sham operated group (n=3). Renal ischemia was induced for 30 minutes (group 1), 60 minutes (group 2) and 120 minutes (group 3). MR imaging was performed before ischemia as well as one hour, 24 hours, and 72 hours after reperfusion. A 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy was performed before ischemia, as well as 24 hours and 72 hours after reperfusion. The signal-to-noise ratio (SNR) on the T2WI, time-relative signal intensity (%RSI) curve on dynamic enhanced images, and relative left renal uptake (%) on DMSA scan were obtained and compared to the histologic findings. The SNR of the cortex on the T2WI changed significantly over the course of the reperfusion time (p<0.001), but was not significantly different among the ischemia groups. The area under the time-%RSI curve gradually decreased from cortex to inner medulla before ischemia, which was reversed and gradually increased after reperfusion. The areas under the time-%RSI curve of outer and inner medulla were significantly different among the ischemia groups (p=0.04, p=0.008). The relative renal uptake (%) of left kidney decreased significantly over the reperfusion time (p=0.03), and was also significantly different among the ischemia groups (p=0.005). Tubular cell necrosis was observed in 16 rabbits (76.2%). The histologic grades of group 3 were higher than those of group 1 and group 2 (p=0.002). Even in rabbits without tubular cell necrosis, the areas under the time-%RSI curves of the cortex, outer, and inner medulla after a 72 hour reperfusion time were significantly lower than those before ischemia (p=0.007, p=0.005, p=0.004). The results of this study suggest that dynamic enhanced MR imaging could be a useful tool for the evaluation of renal ischemia and reperfusion injury.

Determination of renal clearance of 131I-hippuran

International Nuclear Information System (INIS)

Ridzon, S.

1982-01-01

The author presents his own method for the determination of total renal clearance of 131 I-hippuran under conditions of its diminishing plasma concentration following single intravenous administration. Total renal clearance is determined as the ratio of the amount of activity excreted into the urine over a certain time interval and of the area limited by the curve of activity decrease in plasma and by the time axis in the corresponding interval. The results are demonstrated in five investigated healthy subjects, and very good agreement of the calculated values of total renal clearance for different time intervals in the same subject is pointed out. When isotope nephrography is simultaneously performed, the method allows to determine also the values of isolated renal clearance for each kidney separately. (author)

Dependence of renal blood flow on renal artery stenosis measured using CT angiography

Energy Technology Data Exchange (ETDEWEB)

Luedemann, Lutz [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiotherapy; Nafz, B.; Persson, P. [Charite - Universitaetsmedizin Berlin (Germany). Inst. for Vegetative Physiology; Elsner, F. [Krankenhaus am Urban, Berlin (Germany). Dept. of Anesthesiology; Grosse-Siestrup, C.; Meissler, M. [Charite - Universitaetsmedizin Berlin (Germany). Experimental Animal Unit; Gutberlet, M. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Univ. Leipzig/ Leipzig Heart Center (Germany). Dept. of Diagnostic and Interventional Radiology; Lengsfeld, P.; Voth, M. [Bayer-Schering Pharma AG, Berlin (Germany). Global Medical Affairs Diagnostic Imaging

2011-03-15

The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney. Materials and Methods: We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images. Results: A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %. Conclusion: The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction. (orig.)

Dependence of renal blood flow on renal artery stenosis measured using CT angiography

International Nuclear Information System (INIS)

Luedemann, Lutz; Nafz, B.; Persson, P.; Elsner, F.; Grosse-Siestrup, C.; Meissler, M.; Gutberlet, M.; Univ. Leipzig/ Leipzig Heart Center; Lengsfeld, P.; Voth, M.

2011-01-01

The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney. Materials and Methods: We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images. Results: A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %. Conclusion: The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction. (orig.)

Evaluation of renal quantitative T2* changes on MRI following administration of ferumoxytol as a T2* contrast agent.

Science.gov (United States)

Hedgire, Sandeep S; McDermott, Shaunagh; Wojtkiewicz, Gregory R; Abtahi, Seyed Mahdi; Harisinghani, Mukesh; Gaglia, Jason L

2014-01-01

To evaluate the time-dependent changes in regional quantitative T2* maps of the kidney following intravenous administration of ferumoxytol. Twenty-four individuals with normal kidney function underwent T2*-weighted MRI of the kidney before, immediately after, and 48 hours after intravenous administration of ferumoxytol at a dose of 4 mg/kg (group A, n=12) or 6 mg/kg (group B, n=12). T2* values were statistically analyzed using two-tailed paired t-tests. In group A, the percentage changes from baseline to immediate post and baseline to 48 hours were 85.3% and 64.2% for the cortex and 90.8% and 64.6% for the medulla, respectively. In group B, the percentage changes from baseline to immediate post and baseline to 48 hours were 85.2% and 73.4% for the cortex and 94.5% and 74% for the medulla, respectively. This difference was significant for both groups (P<0.0001). There is significant and differential uptake of ferumoxytol in the cortex and medulla of physiologically normal kidneys. This differential uptake may offer the ability to interrogate renal cortex and medulla with possible clinical applications in medical renal disease and transplant organ assessment. We propose an organ of interest based dose titration of ferumoxytol to better differentiate circulating from intracellular ferumoxytol particles.

Nuclear medicine in acute and chronic renal failure

Energy Technology Data Exchange (ETDEWEB)

Sherman, R.A.; Byun, K.J.

1982-07-01

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. /sup 131/I OIH, /sup 67/gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease.

Nuclear medicine in acute and chronic renal failure

International Nuclear Information System (INIS)

Sherman, R.A.; Byun, K.J.

1982-01-01

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131 I OIH, 67 gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

Doppler Flow Wire Evaluation of Renal Blood Flow Reserve in Hypertensive Patients with Normal Renal Arteries

International Nuclear Information System (INIS)

Beregi, Jean-Paul; Mounier-Vehier, Claire; Devos, Patrick; Gautier, Corinne; Libersa, Christian; McFadden, Eugene P.; Carre, Alain

2000-01-01

Purpose: To study the vasomotor responses of the renal microcirculation in patients with essential hypertension.Methods: We studied the reactivity of the renal microcirculation to papaverine, with intraarterial Doppler and quantitative arteriography, in 34 renal arteries of 19 hypertensive patients without significant renal artery stenosis. Isosorbide dinitrate was given to maximally dilate proximal renal arteries. APV (average peak blood flow velocity) was used as an index of renal blood flow.Results: Kidneys could be divided into two distinct subgroups based on their response to papaverine. An increase in APV of up to 55% occurred in 21 kidneys, an increase > 55% in 13 kidneys. Within each group the values were normally distributed. Both baseline APV and the effect of papaverine on mean velocity differed significantly between groups.Conclusion: There seems to be a subgroup of patients with essential hypertension that has an impaired reactivity to papaverine, consistent with a functional impairment of the renal microcirculation. Further studies are required to determine whether this abnormality contributes to or results from elevated blood pressure

Effects of a MATE protein inhibitor, pyrimethamine, on the renal elimination of metformin at oral microdose and at therapeutic dose in healthy subjects.

Science.gov (United States)

Kusuhara, H; Ito, S; Kumagai, Y; Jiang, M; Shiroshita, T; Moriyama, Y; Inoue, K; Yuasa, H; Sugiyama, Y

2011-06-01

A microdose study of metformin was conducted to investigate the predictability of drug-drug interactions at the therapeutic dose (ThD). Healthy subjects received a microdose (100 µg) or ThD (250 mg) of metformin orally, with or without a potent and competitive multidrug and toxin extrusion (MATE) inhibitor, pyrimethamine (50 mg, p.o.), in a crossover fashion. Pyrimethamine significantly reduced the renal clearance of metformin by 23 and 35% at the microdose and ThD, respectively. At ThD, but not at microdose, it caused significant increases in the maximum concentration (C(max)) and area under the plasma concentration-time curve (AUC) of metformin (142 and 139% of control values, respectively). Human canalicular membrane vesicles showed pyrimethamine-inhibitable metformin uptake. Pyrimethamine did not affect plasma lactate/pyruvate after ThD of metformin but significantly reduced the renal clearance of creatinine, thereby causing elevation of plasma creatinine level. This microdose study quantitatively predicted a drug-drug interaction involving the renal clearance of metformin at ThD by pyrimethamine. Pyrimethamine is a useful in vivo inhibitor of MATE proteins.

Luminal uptake and intracellular transport of insulin in renal proximal tubules

International Nuclear Information System (INIS)

Hellfritzsch, M.; Christensen, E.I.; Sonne, O.

1986-01-01

It is generally accepted that proteins taken up from the renal tubular fluid are transported into lysosomes in proximal tubule cells. Recently, however, it has been postulated that insulin in isolated perfused rat kidneys did not accumulate in lysosomes but to a certain degree in the Golgi region. The present study was undertaken to investigate the intracellular handling of biologically unaltered insulin in rat renal proximal tubule cells. Rats were prepared for in vivo micropuncture and either a colloidal gold insulin complex or insulin monoiodinated in the A-14 position ( 125 I-insulin) was microinfused into proximal tubules. After 5, 10, 25 or 60 min the tubules were fixed by microinfusion of glutaraldehyde and processed for electron microscopy or electron microscope autoradiography. A qualitative analysis of tubules infused with colloidal gold insulin or 125 I-insulin showed that insulin was taken up by endocytosis and transported to lysosomes, and a quantitative autoradiographic analysis of the 125 I-insulin microinfused tubules showed that the grain density after five min was significantly increased for endocytic vacuoles and for lysosomes. After 60 min the grain density was still significant over lysosomes. The accumulation of grains was non-significant over all other areas analyzed at any time. This study shows that insulin is taken up from the luminal side of the proximal tubule by endocytosis and transported to the lysosomes. There was no significant transport to the Golgi region

Duplex ultrasound for identifying renal artery stenosis

DEFF Research Database (Denmark)

Zachrisson, Karin; Herlitz, Hans; Lönn, Lars

2017-01-01

Background Renal artery duplex ultrasound (RADUS) is an established method for diagnosis of renal artery stenosis (RAS), but there is no consensus regarding optimal RADUS criteria. Purpose To define optimal cutoff values for RADUS parameters when screening for RAS using intra-arterial trans...

Evaluation of recovery in hydronephrosis using renal functional CT studies

International Nuclear Information System (INIS)

Watanabe, Kiyotaka

1985-01-01

Using renal functional CT studies, we studied 22 patients who underwent surgical treatment for unilateral hydronephrosis. The tissue-plasma ratio of contrast enhancement (TPR), which is an indicator of renal function per unit of parenchymal volume, improved after the operation. On the other hand, the renal parenchymal volume (PV) decreased in proportion to the shrinkage of the kidney. The pre and postoperative values of renal functional index (RFI), the product of the TPR and PV, showed a good correlation (r=0.928, p<0.01). Therefore, RFI values were found to be useful for assessing the recovery of hydronephrosis. (author)

Serum carcinoembryonic antigen (CEA) in chronic renal failure

International Nuclear Information System (INIS)

Pyo, H.J.; Kim, S.G.; Shin, Y.T.; Kwon, I.S.; Chung, S.I.; Lee, J.S.; Koh, C.S.

1980-01-01

The serum CEA levels were measured by radioimmunoassay technique in 15 patients with chronic renal failure, who were not treated with hemodialysis, in 39 patients under hemodialysis and in 23 patients who received renal transplantation. The results were compared with those in 65 normal adults and the following results were obtained. 1) Serum CEA concentrations in 65 normal adults were in the range of 1.0 to 4.3 ng/ml with a mean value of 1.6+-0.66 ng/ml. 2) Serum CEA concentrations in 15 chronic renal failure patients who were not treated with hemodialysis, were in the range of 0.3 to 8.3 ng/ml with a mean value of 3.6+-2.10 ng/ml which was significantly higher than those of normal controls (P 0.05). 4) In 23 patients who received renal transplantation, serum CEA levels were significantly higher than normal controls (P<0.001), but not significantly different from those of chronic renal failure patients. (author)

The role of DMSA renal scintigraphy in the first episode of urinary tract infection in childhood

International Nuclear Information System (INIS)

Supavekin, S.; Pravisithikul, N.; Kutanavanishapong, S.; Chiewvit, S.; Surapaitoolkorn, W.

2013-01-01

The role of dimercaptosuccinic acid (DMSA) renal scintigraphy in the first episode of urinary tract infection (UTI) has been the subject of debate for many years. The aim of this study was to evaluate the relationship of voiding cystourethrography (VCUG), renal ultrasonography and DMSA renal scintigraphy and to detect renal parenchymal changes by performing DMSA renal scintigraphy at 6 months after the first episode of UTI. A prospective study was conducted in 67 hospitalized children (46 boys, 21 girls). Mean age of the patients was 0.97±1.57 years (0.02-7.26 years). All children received VCUG, renal ultrasonography and DMSA renal scintigraphy. DMSA renal scintigraphy was performed at 1 and 6 months after UTI. Of 67 children, 17 (25.4%), 23 (34.3%) and 20 (29.9%) had vesicoureteral reflux (VUR), abnormal renal ultrasonography and abnormal DMSA renal scintigraphy, respectively. Unilateral hydronephrosis had a significant correlation with VUR at p value 0.024. In renal units, abnormal renal ultrasonography and hydronephrosis had significant correlations with VUR at p values 0.039 and 0.021, respectively. In patients and renal units, hydronephrosis had no significant correlation with abnormal DMSA renal scintigraphy at 1 month after UTI. However, abnormal renal ultrasonography and VUR had significant correlations with abnormal DMSA renal scintigraphy at p values 0.022 and <0.001 in patients and at p values 0.024 and <0.001 in renal units, respectively. Both in patients and renal units, VUR (Grade I-III) had no significant correlation with abnormal DMSA renal scintigraphy. However, severe VUR (Grade IV-V) had significant correlations with abnormal DMSA renal scintigraphy at p values <0.001 and <0.001, respectively. Seventeen patients underwent DMSA renal scintigraphy at 6 months after UTI. In addition, 15 (88.2%) developed persistent renal scarring. Abnormal renal ultrasonography and severe VUR identify renal parenchymal changes. DMSA renal scintigraphy in the first

Preoperative evaluation of living renal donors: value of contrast-enhanced 3D magnetic resonance angiography and comparison of three rendering algorithms

Energy Technology Data Exchange (ETDEWEB)

Fink, C. [Abteilung Radiologische Diagnostik, Radiologische Universitaetsklinik Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Abteilung Onkologische Diagnostik und Therapie, Forschungsschwerpunkt Radiologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Hallscheidt, P.J.; Hosch, W.P.; Kauffmann, G.W.; Duex, M. [Abteilung Radiologische Diagnostik, Radiologische Universitaetsklinik Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Ott, R.C.; Wiesel, M. [Abteilung Urologie und Poliklinik, Chirurgische Universitaetsklinik Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)

2003-04-01

The aim of this study was to assess the value of contrast-enhanced three-dimensional MR angiography (CE 3D MRA) in the preoperative assessment of potential living renal donors, and to compare the accuracy for the depiction of the vascular anatomy using three different rendering algorithms. Twenty-three potential living renal donors were examined with CE 3D MRA (TE/TR=1.3 ms/3.7 ms, field of view 260-320 x 350 mm, 384-448 x 512 matrix, slab thickness 9.4 cm, 72 partitions, section thickness 1.3 mm, scan time 24 s, 0.1 mmol/kg body weight gadobenate dimeglumine). Magnetic resonance angiography data sets were processed with maximum intensity projection (MIP), volume rendering (VR), and shaded-surface display (SSD) algorithms. The image analysis was performed independently by three MR-experienced radiologists recording the number of renal arteries, the presence of early branching or vascular pathology. The combination of digital subtraction angiography (DSA) and intraoperative findings served as the gold standard for the image analysis. In total, 52 renal arteries were correspondingly observed in 23 patients at DSA and surgery. Other findings were 3 cases of early branching of the renal arteries, 4 cases of arterial stenosis and 1 case of bilateral fibromuscular dysplasia. With MRA source data all 52 renal arteries were correctly identified by all readers, compared with 51 (98.1%), 51-52 (98.1-100%) and 49-50 renal arteries (94.2-96.2%) with the MIP, VR and SSD projections, respectively. Similarly, the sensitivity, specificity and accuracy was highest with the MRA source data followed by MIP, VR and SSD. Time requirements were lowest for the MIP reconstructions and highest for the VR reconstructions. Contrast-enhanced 3D MRA is a reliable, non-invasive tool for the preoperative evaluation of potential living renal donors. Maximum intensity projection is favourable for the processing of 3D MRA data, as it has minimal time and computational requirements, while having

Preoperative evaluation of living renal donors: value of contrast-enhanced 3D magnetic resonance angiography and comparison of three rendering algorithms

International Nuclear Information System (INIS)

Fink, C.; Hallscheidt, P.J.; Hosch, W.P.; Kauffmann, G.W.; Duex, M.; Ott, R.C.; Wiesel, M.

2003-01-01

The aim of this study was to assess the value of contrast-enhanced three-dimensional MR angiography (CE 3D MRA) in the preoperative assessment of potential living renal donors, and to compare the accuracy for the depiction of the vascular anatomy using three different rendering algorithms. Twenty-three potential living renal donors were examined with CE 3D MRA (TE/TR=1.3 ms/3.7 ms, field of view 260-320 x 350 mm, 384-448 x 512 matrix, slab thickness 9.4 cm, 72 partitions, section thickness 1.3 mm, scan time 24 s, 0.1 mmol/kg body weight gadobenate dimeglumine). Magnetic resonance angiography data sets were processed with maximum intensity projection (MIP), volume rendering (VR), and shaded-surface display (SSD) algorithms. The image analysis was performed independently by three MR-experienced radiologists recording the number of renal arteries, the presence of early branching or vascular pathology. The combination of digital subtraction angiography (DSA) and intraoperative findings served as the gold standard for the image analysis. In total, 52 renal arteries were correspondingly observed in 23 patients at DSA and surgery. Other findings were 3 cases of early branching of the renal arteries, 4 cases of arterial stenosis and 1 case of bilateral fibromuscular dysplasia. With MRA source data all 52 renal arteries were correctly identified by all readers, compared with 51 (98.1%), 51-52 (98.1-100%) and 49-50 renal arteries (94.2-96.2%) with the MIP, VR and SSD projections, respectively. Similarly, the sensitivity, specificity and accuracy was highest with the MRA source data followed by MIP, VR and SSD. Time requirements were lowest for the MIP reconstructions and highest for the VR reconstructions. Contrast-enhanced 3D MRA is a reliable, non-invasive tool for the preoperative evaluation of potential living renal donors. Maximum intensity projection is favourable for the processing of 3D MRA data, as it has minimal time and computational requirements, while having

The rebirth of interest in renal tubular function.

Science.gov (United States)

Lowenstein, Jerome; Grantham, Jared J

2016-06-01

The measurement of glomerular filtration rate by the clearance of inulin or creatinine has evolved over the past 50 years into an estimated value based solely on plasma creatinine concentration. We have examined some of the misconceptions and misunderstandings of the classification of renal disease and its course, which have followed this evolution. Furthermore, renal plasma flow and tubular function, which in the past were estimated by the clearance of the exogenous aryl amine, para-aminohippurate, are no longer measured. Over the past decade, studies in experimental animals with reduced nephron mass and in patients with reduced renal function have identified small gut-derived, protein-bound uremic retention solutes ("uremic toxins") that are poorly filtered but are secreted into the lumen by organic anion transporters (OATs) in the proximal renal tubule. These are not effectively removed by conventional hemodialysis or peritoneal dialysis. Residual renal function, urine produced in patients with advanced renal failure or undergoing dialysis treatment, may represent, at least in part, secretion of fluid and uremic toxins, such as indoxyl sulfate, mediated by proximal tubule OATs and might serve as a useful survival function. In light of this new evidence of the physiological role of proximal tubule OATs, we suggest that measurement of renal tubular function and renal plasma flow may be of considerable value in understanding and managing chronic kidney disease. Data obtained in normal subjects indicate that renal plasma flow and renal tubular function might be measured by the clearance of the endogenous aryl amine, hippurate. Copyright © 2016 the American Physiological Society.

Hg uptake in ureteral obstructions

International Nuclear Information System (INIS)

Desgrez, J.P.; Bourguignon, M.; Raynaud, C.; CEA, 91 - Orsay

1976-01-01

In the presence of a total obstruction the results obtained with the Hg uptake test, as indeed with other functional tests, inform on the value of the kidney function at the time but have no prognostic value where repair possibilities are concerned. Some preliminary results seem to show however that very soon after the obstacle is removed, by the 10th or 15th day perhaps, quantitative functional tests may once more be used to evaluate the functional prognosis. This would mean that by waiting about two weeks after the disappearance of a total obstruction the Hg uptake test may again be used in all confidence. In order to check this deduction, which is based on slender evidence but which nevertheless has important practical implications, the measurement of the Hg uptake rate during the days following removal of the obstacle appears essential. In long-standing partial obstructions the Hg uptake rate gives an accurate assessment of the functional balance and helps considerably in the choice of therapy [fr

Atrial Natriuretic Peptide Stimulates Dopamine Tubular Transport by Organic Cation Transporters: A Novel Mechanism to Enhance Renal Sodium Excretion

Science.gov (United States)

Kouyoumdzian, Nicolás M.; Rukavina Mikusic, Natalia L.; Kravetz, María C.; Lee, Brenda M.; Carranza, Andrea; Del Mauro, Julieta S.; Pandolfo, Marcela; Gironacci, Mariela M.; Gorzalczany, Susana; Toblli, Jorge E.; Fernández, Belisario E.

2016-01-01

The aim of this study was to demonstrate the effects of atrial natriuretic peptide (ANP) on organic cation transporters (OCTs) expression and activity, and its consequences on dopamine urinary levels, Na+, K+-ATPase activity and renal function. Male Sprague Dawley rats were infused with isotonic saline solution during 120 minutes and randomized in nine different groups: control, pargyline plus tolcapone (P+T), ANP, dopamine (DA), D-22, DA+D-22, ANP+D-22, ANP+DA and ANP+DA+D-22. Renal functional parameters were determined and urinary dopamine concentration was quantified by HPLC. Expression of OCTs and D1-receptor in membrane preparations from renal cortex tissues were determined by western blot and Na+, K+-ATPase activity was determined using in vitro enzyme assay. 3H-DA renal uptake was determined in vitro. Compared to P+T group, ANP and dopamine infusion increased diuresis, urinary sodium and dopamine excretion significantly. These effects were more pronounced in ANP+DA group and reversed by OCTs blockade by D-22, demonstrating that OCTs are implied in ANP stimulated-DA uptake and transport in renal tissues. The activity of Na+, K+-ATPase exhibited a similar fashion when it was measured in the same experimental groups. Although OCTs and D1-receptor protein expression were not modified by ANP, OCTs-dependent-dopamine tubular uptake was increased by ANP through activation of NPR-A receptor and protein kinase G as signaling pathway. This effect was reflected by an increase in urinary dopamine excretion, natriuresis, diuresis and decreased Na+, K+-ATPase activity. OCTs represent a novel target that links the activity of ANP and dopamine together in a common mechanism to enhance their natriuretic and diuretic effects. PMID:27392042

Acute renal failure in rats

International Nuclear Information System (INIS)

Cederholm, C.; Almen, T.; Bergquist, D.; Golman, K.; Takolander, R.; Malmoe Allmaenna Sjukhus

1989-01-01

It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40% (20-130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130% (70-350) after metrizoate, by 220% (50-380) after ioxaglate, by 290 % (60-420) after iopamidol and by 160% (50-330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure. (orig.)

Renal Function Studies with a Scintillation Camera

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Farmelant, M. H.; Genna, S.; Burrows, B. A. [University Hospital and Boston Veterans Administration Hospital, Boston, MA (United States)

1969-05-15

Renal function studies with {sup 131}I-Hippuran have usually been performed with two probes, with flat field collimators, of which the sensitivity is dependent on kidney position. Although a variety of methods have been used to interpret the results, it is almost universally agreed that the relative magnitudes of the curves obtained during the accumulation phase are determined by both the relative blood flow and relative geometrical efficiency of counting. The relative influence of these two factors is not easily ascertained. Because of this limitation in directly assessing relative renal blood flow indirect methods have evolved. From physiological studies in dogs it appears that differences between the kidneys in blood flow produce differences in renal passage time and subsequently differences in the descending portions of the curves. Evaluation of differences in the descending curves in patients has proved highly sensitive in detecting renal vascular disease causing hypertension. However, obstructive disorders of urine outflow also produce alterations in the declining portion of the curve. A scintillation camera provides a detector considerably larger than the kidney and uses parallel hole collimation. This arrangement results in count-rates that are largely independent of kidney position, as shown by phantom studies. Furthermore, sequential scintigraphs can be obtained. Using the Pho-Gamma III (Nuclear Chicago) with 'split' crystal for clinical studies, we have demonstrated that the relative uptake of {sup 131}I-Hippuran by the two kidneys during the accumulation phase differs by less than 15% in normal people. These differences may be related to differences in kidney size or blood flow. Differences greater than this suggest significant differences between the kidneys in renal blood flow if the scintigrams show kidneys of comparable size. The sequential scintigrams have proven to be accurate in differentiating retention of radioisotope due to vascular disease

Diagnostic potential of PET/CT using a {sup 68}Ga-labelled prostate-specific membrane antigen ligand in whole-body staging of renal cell carcinoma: initial experience

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Sawicki, Lino M.; Buchbender, Christian; Boos, Johannes; Antoch, Gerald [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Giessing, Markus [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany); Ermert, Johannes [Juelich Research Center, Institute of Neuroscience and Medicine, INM-5: Nuclear Chemistry, Juelich (Germany); Antke, Christina; Hautzel, Hubertus [University Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Dusseldorf (Germany)

2017-01-15

To evaluate the diagnostic potential of whole-body PET/CT using a {sup 68}Ga-labelled PSMA ligand in renal cell carcinoma (RCC). Six patients with histopathologically proven RCC underwent {sup 68}Ga-PSMA PET/CT. Each PET/CT scan was evaluated in relation to lesion count, location and dignity. SUVmax was measured in primary tumours and PET-positive metastases. Tumour-to-background SUVmax ratios (TBR{sub SUVmax}) were calculated for primary RCCs in relation to the surrounding normal renal parenchyma. Metastasis-to-background SUVmax ratios (MBR{sub SUVmax}) were calculated for PET-positive metastases in relation to gluteal muscle. Five primary RCCs and 16 metastases were evaluated. The mean SUVmax of the primary RCCs was 9.9 ± 9.2 (range 1.7 - 27.2). Due to high uptake in the surrounding renal parenchyma, the mean TBR{sub SUVmax} of the primary RCCs was only 0.2 ± 0.3 (range 0.02 - 0.7). Eight metastases showed focal {sup 68}Ga-PSMA uptake (SUVmax 9.9 ± 8.3, range 3.4 - 25.6). The mean MBR{sub SUVmax} of these PET-positive metastases was 11.7 ± 0.2 (range 4.4 - 28.1). All PET-negative metastases were subcentimetre lung metastases. {sup 68}Ga-PSMA PET/CT appears to be a promising method for detecting RCC metastases. However, no additional diagnostic value in assessing the primary tumour was found. (orig.)

A simple estimation of the renal plasma flow

International Nuclear Information System (INIS)

Shinpo, Takako

1987-01-01

The renal plasma flow was determined conventionally by the excretive ratio to urine using a 131 I-Hippuran renogram. In this report, we proposed the renal clearance, the product of the disappearance rate coefficient and the maximum counts of the bladder, for the simple quantitative value of renal plasma flow. The disappearance rate coefficient was calculated by approximating the exponential function of the initial slope from the disappearance curve of the heart. The renal clearances was compared with the renal plasma flow calculated by the conventional method. The results gave a high correlation coefficient of r = 0.91. The renal clearances can be calculated easily and it offers useful renogram information. (author)

Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix

International Nuclear Information System (INIS)

Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang; Cheon, Gi Jeong

2017-01-01

Using integrated PET/CT, we evaluated the prognostic value of [ 18 F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix. We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [ 18 F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV cervix ) and LN (SUV LN ), and the LN-to-cervical cancer SUV ratio (SUV LN /SUV cervix ) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses. Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV LN / SUV cervix > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV LN /SUV cervix showed significant difference in PFS (log-rank test, P < 0.001). Preoperative SUV LN /SUV cervix measured by [ 18 F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA. (orig.)

Non-invasive imaging of acute renal allograft rejection in rats using small animal F-FDG-PET.

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Stefan Reuter

Full Text Available BACKGROUND: At present, renal grafts are the most common solid organ transplants world-wide. Given the importance of renal transplantation and the limitation of available donor kidneys, detailed analysis of factors that affect transplant survival are important. Despite the introduction of new and effective immunosuppressive drugs, acute cellular graft rejection (AR is still a major risk for graft survival. Nowadays, AR can only be definitively by renal biopsy. However, biopsies carry a risk of renal transplant injury and loss. Most important, they can not be performed in patients taking anticoagulant drugs. METHODOLOGY/PRINCIPAL FINDINGS: We present a non-invasive, entirely image-based method to assess AR in an allogeneic rat renal transplantation model using small animal positron emission tomography (PET and (18F-fluorodeoxyglucose (FDG. 3 h after i.v. injection of 30 MBq FDG into adult uni-nephrectomized, allogeneically transplanted rats, tissue radioactivity of renal parenchyma was assessed in vivo by a small animal PET-scanner (post operative day (POD 1,2,4, and 7 and post mortem dissection. The mean radioactivity (cps/mm(3 tissue as well as the percent injected dose (%ID was compared between graft and native reference kidney. Results were confirmed by histological and autoradiographic analysis. Healthy rats, rats with acute CSA nephrotoxicity, with acute tubular necrosis, and syngeneically transplanted rats served as controls. FDG-uptake was significantly elevated only in allogeneic grafts from POD 1 on when compared to the native kidney (%ID graft POD 1: 0.54+/-0.06; POD 2: 0.58+/-0.12; POD 4: 0.81+/-0.06; POD 7: 0.77+/-0.1; CTR: 0.22+/-0.01, n = 3-28. Renal FDG-uptake in vivo correlated with the results obtained by micro-autoradiography and the degree of inflammatory infiltrates observed in histology. CONCLUSIONS/SIGNIFICANCE: We propose that graft FDG-PET imaging is a new option to non-invasively, specifically, early detect, and follow

Indirect coupling to Na+ of p-aminohippuric acid uptake into rat renal basolateral membrane vesicles

International Nuclear Information System (INIS)

Shimada, H.; Moewes, B.; Burckhardt, G.

1987-01-01

Experiments with basolateral membrane vesicles prepared from rat kidney cortex were performed to study the mechanism by which p-aminohippuric acid (PAH) is taken up across the contraluminal membrane and is concentrated in proximal tubule cells. An inward Na + gradient failed to stimulate [ 3 H]PAH uptake compared with K + or Li + and did not cause intravesicular PAH accumulation above equilibrium distribution. In the absence of Na + , the dicarboxylates glutarate and suberate cis-inhibited and trans-stimulated [ 3 H]PAH uptake, indicating a common transport system. In the presence of Na + , 10 μM glutarate in the incubation medium did not cis-inhibit, but rather stimulated [ 3 H]PAH uptake and caused PAH accumulation above equilibrium distribution (over-shoot). Li + diminished this stimulation, but was without effect on [ 3 H]PAH/PAH- and [ 3 H]PAH/glutarate exchange. The data indicate the coexistence of a Na + -sensitive transport system for dicarboxylates and a Li + -insensitive PAH/dicarboxylate exchanger in the basolateral membrane. The authors propose that dicarboxylates are cotransported with Na + into the cell and subsequently exchange for extracellular PAH at the basolateral membrane. PAH uptake is thereby indirectly coupled to Na + via the Na + /dicarboxylate cotransporter

Early diagnostic value of determination of urinary excretion amount of proteins for renal lesions in pediatric patients with anaphylactoid purpura (AP)

International Nuclear Information System (INIS)

Xu Guocheng; Li Zhiqi; Guo Benbiao; Shen Yina; Mao Shuanggen; Zhang Xinlu

2009-01-01

Objective: To study the early diagnostic value of determination of urinary excretion amourt of proteins for renal damage in pediatric patients with AP. Methods: Morning arine specimen contents of albumin, IgG and β 2 -m (with RIA) as well as serum BUN and creatinine levels were measured in 25 pediatric patients with simple A P, 27 pediatric patients with purpura nephritis (PN) and 32 controls. Results: The urinary contents of proteins in all the patients were significantly higher than those in controls (P 0.05). Conclusion: Changes of urinary excretion of proteins occurred much earlier than changes of BUN and creatinine in purpura patients complicated with renal involvement and might be used as an indicator for early diagnosis. (authors)

Renal scintigraphy in insulin-dependent diabetes mellitus: Early glomerular and urologic dysfunction

International Nuclear Information System (INIS)

Poirier, J.Y.; Moisan, A.; Le Cloirec, J.; Siemen, C.; Yaouanq, J.; Edan, G.; Herry, J.Y.

1990-01-01

Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by intravenous injection of 99mTc-diethylenetriaminepentaacetic acid (DTPA) and 131I-Hippuran in 115 insulin-dependent diabetic patients with albumin excretion rates (AER) less than 200 micrograms/min, and in 45 normal subjects. Separate kidney function and urinary elimination were estimated by renography. GFR was increased in the diabetic patients (152 +/- 24 ml/min/1.73 m2 vs. 128 +/- 15) and correlated significantly with RPF (r = 0.5; p less than 10(-9)). No relationship was found between GFR and the duration of diabetes, blood glucose, HbA1c, or AER. Fifty patients were hyperfiltering with RPF and filtration fraction higher than those in the normofiltering group. Slow intrarenal or pyeloureteral elimination, either unilateral or bilateral, was observed in 3 controls and 60 diabetic subjects (24 hyperfiltering; 36 normofiltering) and did not disappear with the patient in the standing position. In these 60 patients, mean age, duration of diabetes, blood glucose, HbA1c, 24 h albumin excretion rate, and frequency of peripheral or autonomic neuropathy did not differ from patients with normal scintigraphy; GFR was lower in the group with slow elimination, but not significantly so. 99mTc-DTPA renal uptake was symmetric in all the controls; asymmetric renal uptake with asymmetric GFR was observed in 13 patients (7 hyperfiltering; 6 normofiltering) and often associated with slower elimination. No evidence for renal stenotic atheroma or parenchymatous disease was found on the angiopyleoureterography. The results suggest that incipient uropathy is a very common phenomenon that occurs irrespective of glomerular dysfunction

Uptake and metabolism of 12-hydroxyeicosatetraenoic acid (12-HETE) by cultured renal tubular epithelial cells (RTEC)

International Nuclear Information System (INIS)

Gordon, J.A.; Spector, A.A.

1986-01-01

To determine if 12-HETE, a lipoxygenase product that mediates inflammation and tissue injury, can interact with RTEC, confluent Madin Darby Canine Kidney (MDCK) cells were incubated for 2-16 hr with 1.0 μM [ 3 H]-12-HETE. Initial uptake of 12-HETE was rapid; at 16 hrs. 70% of the 12-HETE uptake was incorporated into phospholipids (PL). The distribution among the choline, ethanolamine, inositol, and serine PL was 36, 36, 20 and 8%, respectively. Incubation of MDCK cells with 0.5 to 5.0 μM [ 3 H]-12-HETE for 1 hr indicated linear uptake without evidence of saturation. Incubation with 1.0 μM 12-HETE and 0.25-10.0 μM arachidonic acid for 1 hr revealed no competition for uptake at the lower concentrations but a 40% reduction in 12-HETE uptake at 10.0 μM. Polarity of 12-HETE uptake was indicated by a preference of the basolateral surface over the apical surface by 1.4. After 2 hr, analysis of the medium by reverse phase HPLC revealed that 12-HETE was converted to three polar metabolites which eluted at 25.9, 29.4 and 31.3 min respectively; 12-HETE eluted at 37.5 min. The appearance of these polar metabolites was not prevented by ibuprofen (50 μM) nordihydroguaiaretic acid (30 μM), allopurinol (15 mM), or butylated hydroxytoluene (20 μM). These findings suggest that the lipoxygenase product 12-HETE may affect RTEC through incorporation into membrane PL and/or conversion to polar metabolites

Correlation between Standardized Uptake Value of 68Ga-DOTA-NOC Positron Emission Tomography/Computed Tomography and Pathological Classification of Neuroendocrine Tumors.

Science.gov (United States)

Kaewput, Chalermrat; Suppiah, Subapriya; Vinjamuri, Sobhan

2018-01-01

The aim of our study was to correlate tumor uptake of 68 Ga-DOTA-NOC positron emission tomography/computed tomography (PET/CT) with the pathological grade of neuroendocrine tumors (NETs). 68 Ga-DOTA-NOC PET/CT examinations in 41 patients with histopathologically proven NETs were included in the study. Maximum standardized uptake value (SUV max ) and averaged SUV SUV mean of "main tumor lesions" were calculated for quantitative analyses after background subtraction. Uptake on main tumor lesions was compared and correlated with the tumor histological grade based on Ki-67 index and pathological differentiation. Classification was performed into three grades according to Ki-67 levels; low grade: Ki-67 20. Pathological differentiation was graded into well- and poorly differentiated groups. The values were compared and evaluated for correlation and agreement between the two parameters was performed. Our study revealed negatively fair agreement between SUV max of tumor and Ki-67 index ( r = -0.241) and negatively poor agreement between SUV mean of tumor and Ki-67 index ( r = -0.094). SUV max of low-grade, intermediate-grade, and high-grade Ki-67 index is 26.18 ± 14.56, 30.71 ± 24.44, and 6.60 ± 4.59, respectively. Meanwhile, SUV mean of low-grade, intermediate-grade, and high-grade Ki-67 is 8.92 ± 7.15, 9.09 ± 5.18, and 3.00 ± 1.38, respectively. As expected, there was statistically significant decreased SUV max and SUV mean in high-grade tumors (poorly differentiated NETs) as compared with low- and intermediate-grade tumors (well-differentiated NETs). SUV of 68 Ga-DOTA-NOC PET/CT is not correlated with histological grade of NETs. However, there was statistically significant decreased tumor uptake of 68 Ga-DOTA-NOC in poorly differentiated NETs as compared with the well-differentiated group. As a result of this pilot study, we confirm that the lower tumor uptake of 68 Ga-DOTA-NOC may be associated with aggressive behavior and may, therefore, result in poor prognosis.

Renal denervation: Results of a single-center cohort study; Renale Denervation. Ergebnisse einer Single-Center Kohortenstudie

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Luetkens, J.A.; Thomas, D.; Doerner, J.; Schild, H.H.; Naehle, C.P. [Bonn Univ. (Germany). Dept. of Radiology; Wilhelm, K. [Johanniter Hospital, Bonn (Germany). Dept. of Radiology; Duesing, R. [Hypertension Center, Bonn (Germany); Woitas, R.P.; Hundt, F. [Bonn Univ. (Germany). Dept. of Internal Medicine I

2015-01-15

To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension. Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation. Mean follow-up time between renal denervation and blood pressure re-assessment was 9.5 ± 3.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.3 ± 20.3/103.8 ± 20.4 mmHg and 155.2 ± 20.5/93.7 ± 14.5 mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.7 ± 14.9/89.5 ± 12.1 (p < 0.05). ABPM values remained unchanged (147.9 ± 20.3/90.3 ± 15.6, p > 0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.7 ± 2.0 vs. 4.2 ± 1.2, p = 0.18). No renovascular complications were detected in follow-up MRI. After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension.

Determination of representative renal depth for accurate attenuation corred in measurement of glomerular filtration rate in transplanted kidney

International Nuclear Information System (INIS)

Oh, Soon Nam; Kim, Sung Hoon; Rha, Sung Eun; Chung, Yong An; Yoo, Ie Ryung; Sohn, Hyung Sun; Lee, Sung Young; Chung, Soo Kyo

2002-01-01

To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured DFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depth under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. The transplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are 4.09±0.65 cm in men, and 4.24±0.78 cm in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply

Prognostic value of metabolic indices and bone marrow uptake pattern on preoperative 18F-FDG PET/CT in pediatric patients with neuroblastoma

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Li, Chao; Chen, Suyun; Huang, Shuo; Wu, Shuqi; Zhang, Linlin; Zhang, Fengxian; Wang, Hui [Shanghai Jiao Tong University School of Medicine, Department of Nuclear Medicine, Xinhua Hospital, Shanghai (China); Zhang, Jian [Shanghai Jiao Tong University School of Medicine, Department of Nuclear Medicine, Xinhua Hospital, Shanghai (China); Shanghai Universal Medical Imaging Diagnostic Center, Shanghai (China)

2018-02-15

To evaluate the prognostic value of metabolic parameters and bone marrow uptake (BMU) patterns on pretherapeutic 18-F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in pediatric patients with neuroblastoma (NB). Forty-seven pediatric patients with newly diagnosed neuroblastoma who underwent 18F-FDG PET/CT were retrospectively reviewed. Clinicopathological factors and metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and bone marrow uptake patterns on PET/CT were compared to predict recurrence-free survival (RFS) and overall survival (OS) by univariate and multivariate analysis. During the follow-up period, 27 (57.4%) patients experienced recurrence. MTV (P = 0.001), TLG (P = 0.004) and BMU patterns (P = 0.025) remained significant predictive factors for tumor recurrence, along with tumor size, histology, stage, lactate dehydrogenase (LDH) and other distant metastasis (except bone metastasis). Univariate analysis showed that histology, stage, tumor size (>37.25 cm), other distant metastasis, MTV (>88.10cm{sup 3}) and TLG (>1045.2 g) and BMU patterns correlated with both RFS and OS (P < 0.05). On multivariate analysis, TLG remained the only independent prognostic factor for RFS (P = 0.016) and OS (P = 0.012), and BMU patterns and MTV were statistically significant for OS (P = 0.024 and P = 0.038, respectively). Pretherapeutic 18F-FDG PET/CT can provide reliable prognostic information for neuroblastoma pediatric patients, and patients with high MTV, TLG and focal bone marrow (unifocal and multifocal) uptake on PET/CT may have inferior outcomes during subsequent treatment. (orig.)

Evaluation of gadolinium-EOB-DTPA uptake after portal vein embolization: value of an increased flip angle.

Science.gov (United States)

Geisel, Dominik; Lüdemann, Lutz; Wagner, Clemens; Stelter, Lars; Grieser, Christian; Malinowski, Maciej; Stockmann, Martin; Seehofer, Daniel; Hamm, Bernd; Gebauer, Bernhard; Denecke, Timm

2014-03-01

The optimal sequence for Gd-EOB-DTPA uptake measurement in the liver with the purpose of liver function measurement is still not defined. To prospectively evaluate the effect of an increased flip angle (FA) of a T1-weighted fat-saturated 3D sequence for the measurement of hepatocyte uptake of Gd-EOB-DTPA magnetic resonance imaging (MRI) after right portal vein embolization (PVE). Ten patients who received a PVE prior to an extended hemihepatectomy were examined 14 days after PVE using Gd-EOB-DTPA enhanced MRI of the liver using the standard FA of 10° and the increased FA of 30°. Relative enhancement of the right liver lobe (RLL) was 0.52 ± 0.12 for 10° and 1.41 ± 0.39 for 30°. Relative enhancement of the left liver lobe (LLL) was 0.58 ± 0.11 for 10° and 2.05 ± 0.61 for 30°. Relative enhancement of the RLL was significantly higher for 30° than for 10° (P = 0.009) and significantly higher in the 30° than in the 10° sequences (P = 0.005) for the LLL. A flip angle of 30° increases the contrast between liver partitions with and without portal venous embolization. Thereby, the sensitivity for differences in uptake intensity is increased. This could be of value for a more exact determination of differences in regional liver function and, consequently, the estimation of the future remnant liver function.

Abnormal extraosseous activity in both lungs and stomach in pre-transplant 99mTc-MDP bone scan disappearing after renal transplant

International Nuclear Information System (INIS)

Sonavane, Sunita Tarsarya; Marwah, Atul; Jaiswar, Rajnath; Shah, Hardik

2013-01-01

A chronic kidney disease male patient presenting with bone pains, fever, weakness, and clinically ascites was subjected to four technetium-99m-methylene diphosphonate ( 99m Tc-MDP) bone scans, two before renal transplant and two after renal transplants. Pretransplant bone scan revealed metabolic bone disease with focal insufficiency fractures. Marked extraosseous activity in both lungs and stomach was also visualized. On regular hemodialysis (HD) after 4 months, repeat pretransplant bone scan showed persistent uptake in lungs and stomach, representing altered calcium metabolism with microcalcifications. He underwent human leukocyte antigen (HLA) matched live donor renal transplantation, started on immune-suppression and steroids. Posttransplant bone scan at 20 days revealed no definite interval change, but bone scan performed approximately 17 months posttransplant showed resolving metabolic bone disease and the tracer uptake in the lungs and stomach was no more visualized. Patient clinically followed-up until the date (February 2013) is asymptomatic with serum creatinine of 1.5 mg/dl, no bone scan done. (author)

Scintigraphy of renal transplant

International Nuclear Information System (INIS)

Ramackers, J.M.; Marrast, A.C.; Touraine, J.L.; Peyrin, J.O.

1995-01-01

Scintigraphy is useful for monitoring perfusion and function of renal transplant, as well as for diagnosing miscellaneous surgical. This non-invasive imaging technique, which uses no deleterious products, is an attractive alternative for patients. This is especially true for those patients in early post-transplant course, with immunity depression and often impairment of renal function. Otherwise, multiple indices with a large range of inter-patient values has not favoured a methodological and interpretative consensus. Furthermore, the poor specificity of renogram patterns does not allow for discrimination of all etiologies with only one scintigraphy. Nevertheless, follow-up with iterative scintigraphy may be helpful due to the high intra-patient reproducibility and to the early appreciate change of parameters, according to clinical and histological renal post-transplant outcome. (authors). 43 refs., 8 figs

Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

International Nuclear Information System (INIS)

Pedrosa, Ivan; Rafatzand, Khashayar; Robson, Philip; Alsop, David C.; Wagner, Andrew A.; Atkins, Michael B.; Rofsky, Neil M.

2012-01-01

To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value 2 (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

Renal function and acute heart failure outcome.

Science.gov (United States)

Llauger, Lluís; Jacob, Javier; Miró, Òscar

2018-06-05

The interaction between acute heart failure (AHF) and renal dysfunction is complex. Several studies have evaluated the prognostic value of this syndrome. The aim of this systematic review, which includes non-selected samples, was to investigate the impact of different renal function variables on the AHF prognosis. The categories included in the studies reviewed included: creatinine, blood urea nitrogen (BUN), the BUN/creatinine quotient, chronic kidney disease, the formula to estimate the glomerular filtration rate, criteria of acute renal injury and new biomarkers of renal damage such as neutrophil gelatinase-associated lipocalin (NGAL and cystatin c). The basal alterations of the renal function, as well as the acute alterations, transient or not, are related to a worse prognosis in AHF, it is therefore necessary to always have baseline, acute and evolutive renal function parameters. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients.

Science.gov (United States)

Pan, Pan; Binjie, Hu; Min, Li; Lipei, Fan; Yanli, Ni; Junwen, Zhou; Xianghua, Shi

2014-12-01

This meta-analysis aimed to perform a systematic review on comparing the diagnostic value of serum cystatin C and creatinine for glomerular filtration rate in renal transplant patients. The data was extracted into 2×2 table after the articles were assessed by the tool of QUADAS and heterogeneity analysis. The SROC curve and meta-analysis were performed by MetaDisc1.4. Meta-analysis showed that the serum cystatin C had no heterogeneity (P=0.418, I2=2.2%, DOR=25.03), while creatinine heterogeneity was high (P=0.109, I2=37.5%, DOR=9.11). The values of SEN, SPE and SAUC were calculated as 0.86, 0.70 and 0.9015 for cystatin C, and 0.78, 0.73 and 0.8285 for creatinine individually. This study utilized GFR detection and subgroups analysis by cutoff. The PLR was 6.13 and the NLR was 0.12 for cystatin C, compared to SCr (3.72, 0.32). There was homogeneity among these studies using PENIA testing for cystatin C (χ2=2.61, P=0.4560, I2=0.0%. There were significant correlations among cystatin C , creatinine and glomerular filtration rate (GFR). Cystatin C had more sensitivity but less specificity than creatinine for evaluation of GFR. Cystatin C had strong ability in diagnosing renal function after renal transplant and ruling out diagnostic efficacy.

Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix

Energy Technology Data Exchange (ETDEWEB)

Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of)

2017-10-15

Using integrated PET/CT, we evaluated the prognostic value of [{sup 18}F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix. We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [{sup 18}F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV{sub cervix}) and LN (SUV{sub LN}), and the LN-to-cervical cancer SUV ratio (SUV{sub LN}/SUV{sub cervix}) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses. Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV{sub LN} / SUV{sub cervix} > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV{sub LN}/SUV{sub cervix} showed significant difference in PFS (log-rank test, P < 0.001). Preoperative SUV{sub LN}/SUV{sub cervix} measured by [{sup 18}F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA. (orig.)

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation.

Science.gov (United States)

VonAchen, Paige; Hamann, Jason; Houghland, Thomas; Lesser, John R; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F; Daniels, Mary; Schwartz, Robert S

The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p=0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p=0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p=0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in future clinical trials may improve RDN therapeutic efficacy

CT and MRI diagnosis of renal oncocytoma

International Nuclear Information System (INIS)

Ren Shoujun; Wang Wenjia; Pan Shaohui; Gao Ji; Du Pengfei; Lu Fengxi; Wang Xiaohong

2007-01-01

Objective: To discuss the CT and MRI diagnostic value of renal oncocytoma and to improve the recognition of renal oncocytoma. Methods: Two cases of renal oncocytoma confirmed by pathology were retrospectively analyzed and related papers were reviewed. Results: Two cases were located in renal cortex, with smooth and sharp border, extruding outside of the kidneys. CT showed solid masses with lower density in center area as 'star'. On MRI T 1 WI and T 2 WI they also showed solid masses with low T 1 and high T 2 signal inensity in center area as 'star'. After contrast enhancement, the masses represented moderate enhancement and the central part did not show enhancement. Conclusion: Renal oncocytoma is a kind of rare nephroma provided with some characteristics in CT and MRI. (authors)

Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT

International Nuclear Information System (INIS)

Büsing, Karen A.; Schönberg, Stefan O.; Brade, Joachim; Wasser, Klaus

2013-01-01

Introduction: Chronically altered glucose metabolism interferes with 18 F-FDG uptake in malignant tissue and healthy organs and may therefore lower tumor detection in 18 F-FDG PET/CT. The present study assesses the impact of elevated blood glucose levels (BGL), diabetes, insulin treatment, and obesity on 18 F-FDG uptake in tumors and biodistribution in normal organ tissues. Methods: 18 F-FDG PET/CT was analyzed in 90 patients with BGL ranging from 50 to 372 mg/dl. Of those, 29 patients were diabetic and 21 patients had received insulin prior to PET/CT; 28 patients were obese with a body mass index > 25. The maximum standardized uptake value (SUV max ) of normal organs and the main tumor site was measured. Differences in SUV max in patients with and without elevated BGLs, diabetes, insulin treatment, and obesity were compared and analyzed for statistical significance. Results: Increased BGLs were associated with decreased cerebral FDG uptake and increased uptake in skeletal muscle. Diabetes and insulin diminished this effect, whereas obesity slightly enhanced the outcome. Diabetes and insulin also increased the average SUV max in muscle cells and fat, whereas the mean cerebral SUV max was reduced. Obesity decreased tracer uptake in several healthy organs by up to 30%. Tumoral uptake was not significantly influenced by BGL, diabetes, insulin, or obesity. Conclusions: Changes in BGLs, diabetes, insulin, and obesity affect the FDG biodistribution in muscular tissue and the brain. Although tumoral uptake is not significantly impaired, these findings may influence the tumor detection rate and are therefore essential for diagnosis and follow-up of malignant diseases

{sup 18}F-FDG uptake at the surgical margin after hepatic resection: Patterns of uptake and differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Peungjesada, Silanath [University New Mexico, Department of Radiology, Albuquerque, NM (United States); Aloia, Thomas A. [University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, Houston, TX (United States); Fox, Patricia [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Unit 1411, Houston, TX (United States); Chasen, Beth [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Unit 1483, Houston, TX (United States); Shin, Sooyoung; Loyer, Evelyne M. [University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States); Baiomy, Ali [Cairo University, National Cancer Center, Cairo (Egypt)

2015-08-15

To evaluate the patterns of {sup 18}F-FDG uptake at the surgical margin after hepatectomy to identify features that may differentiate benign and malignant uptake. Patients who had undergone a PET/CT after hepatectomy were identified. Delay between resection and PET/CT, presence of uptake at the surgical margin, pattern of uptake, and maximal standardized value were recorded. The PET/CT findings were correlated with contrast-enhanced CT or MRI. There were 26 patients with increased 18F-FDG uptake; uptake was diffuse in seven and focal in 19. Diffuse uptake was due to inflammation in all cases. Focal uptake was due to recurrence in 12 and inflammation in seven cases. Defining a focal pattern only as a positive for malignancy yielded 100 % sensitivity, 87 % specificity, 37 % false positive rate. As expected, SUV{sub max} was significantly higher for recurrence than inflammation, but did overlap. Contrast-enhanced CT allowed differentiation between malignant and benign uptake in all cases. F-FDG uptake after hepatectomy does not equate to recurrence and yields a high false positive rate. Diffuse uptake did not require additional evaluation in our sample. Focal uptake, however, may be due to recurrence; differentiating benign and malignant nodular uptake relies on optimal contrast-enhanced CT or MRI. (orig.)

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation

Energy Technology Data Exchange (ETDEWEB)

VonAchen, Paige [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Hamann, Jason [Boston Scientific Corporation, Maple Grove, MN (United States); Houghland, Thomas; Lesser, John R.; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F. [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Daniels, Mary [Vital Images/Toshiba, Minnetonka, MN (United States); Schwartz, Robert S., E-mail: rss@rsschwartz.com [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States)

2016-10-15

Objective: The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Background: Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Methods: Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Results: Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p = 0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p = 0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p = 0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Conclusions: Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation

International Nuclear Information System (INIS)

VonAchen, Paige; Hamann, Jason; Houghland, Thomas; Lesser, John R.; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F.; Daniels, Mary; Schwartz, Robert S.

2016-01-01

Objective: The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Background: Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Methods: Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Results: Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p = 0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p = 0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p = 0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Conclusions: Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in

Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

Directory of Open Access Journals (Sweden)

Seval Erhamamcı

2013-08-01

diffuse mild or severe degree of renal cortical uptake (n=20, 43.5%. There was a statistically significant difference in serum creatinine values between mild and severe renal uptake groups (p<0.05. There was also statistically significant difference in serum BUN and creatinine values between patients with severe degree of renal uptake and without renal uptake (p<0.05. Conclusion: The results of the current study has shown that adolescent LT candidates with end-stage CLD had no osseous abnormality on BS. However, all of adult patients exhibited one or one more osseous abnormalities. Typical scintigraphic findings denoting to abnormalities in bone metabolism were generalized decreased osseous uptake, decreased lower extremity osseous uptake, increased periarticular uptake, increased cortical/periosteal uptake indicating hepatic HOA, and other unusual uptake patterns. Hepatocellular carcinoma metastases may present itself as rib metastases linear in pattern. Soft-tissue uptake in the form of diffuse bilateral mild or severe degree of renal uptake and less commonly mild diffuse liver uptake can be observed. Increased renal uptake may be an early marker of renal dysfuntion or a predictor of hepatorenal syndrome.

Extraosseous radiotracer uptake on bone scan in beta-thalassemia: report of one case

International Nuclear Information System (INIS)

Guezguez, M.; Nouira, M.; Sfar, R.; Chatti, K.; Ben Fradj, M.; Ben Ali, K.; Ajmi, S.; Essabbah, H.; Zrour, S.

2009-01-01

Red blood cell transfusion, main therapeutic modality of beta-thalassemia, leads to iron overload which may perturb several metabolic ways. The aim of this paper is to illustrate the uptake abnormalities observed on bone scan of thalassaemic patients and to discuss mechanisms of extraosseous accumulation of the radiopharmaceutical in this pathology. We report a 16-year-old child suffering from beta-thalassemia major undergoing transfusion therapy. A bone scan was indicated to look for osseous infection. This study revealed a little skeletal uptake and abnormal liver, splenic and renal accumulation. A repeat bone scan, performed three weeks later showed a better skeletal uptake which enabled the discovery of focal abnormalities and made the diagnostic easier. The effect of iron overload on radiopharmaceuticals uptake in bone scan is known since 1975. Dissociation of 99m Tc from the carrier ligand due to the presence of iron excess seems the most plausible hypothesis. Free 99m Tc can be bound to other tissular substrates which can explain extraosseous uptake. The normally available pool for bone is reduced and then the skeletal uptake decreased. This report limits considerably the sensitivity of the bone scan. A well-led iron chelation and eventually the use of diuretic drug may guarantee a better quality of bone scan images. (authors)

Worsening renal function in heart failure: the need for a consensus definition.

Science.gov (United States)

Sheerin, Noella J; Newton, Phillip J; Macdonald, Peter S; Leung, Dominic Y C; Sibbritt, David; Spicer, Stephen Timothy; Johnson, Kay; Krum, Henry; Davidson, Patricia M

2014-07-01

Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associated with heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. We present the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injury with some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Water uptake in free films and coatings using the Brasher and Kingsbury equation: a possible explanation of the different values obtained by electrochemical Impedance spectroscopy and gravimetry

International Nuclear Information System (INIS)

Vosgien Lacombre, C.; Bouvet, G.; Trinh, D.; Mallarino, S.; Touzain, S.

2017-01-01

For many years, the water uptake in organic coatings was measured by EIS and/or gravimetry but differences in water content values were found in almost all studies. The Brasher-Kingsbury equation used in the electrochemical analysis (EIS) is often criticized because elementary assumptions may be unvalid. The origin of the discrepancy between both methods is still of interest because many questions remain open and this study aims to provide new insights to these questions. In this work, free films and coatings of a model epoxy-amine system were immersed in a 3 wt.% NaCl solution. The water uptake in free films was evaluated using gravimetric measurements and EIS, using the Basher-Kingsbury equation. The mass of free-films used in the EIS tests was measured and compare to gravimetric measurements while the water uptake (EIS) in free films was compared to that obtained with coatings. It was found that the mass increase of free films tested with EIS was in agreement with gravimetric measurements but was always lower than the water uptake obtained by EIS. Moreover, the water uptake in free films (EIS) was different from that obtained with coatings. In all cases, it was found that the Basher-Kingsbury equation overestimated the water uptake. It appears that the differences between EIS and gravimetric measurements can be analyzed in terms of geometrical effects. Indeed, the swelling in free films and coatings can be monitored by DMA and SECM during ageing. Finally, by mixing the experimental swelling data and the Brasher-Kingsbury equation, the same value of water uptake was obtained by EIS and gravimetry for coatings.

The Renal Arterial Resistance Index Predicts Worsening Renal Function in Chronic Heart Failure Patients

Science.gov (United States)

Iacoviello, Massimo; Monitillo, Francesco; Leone, Marta; Citarelli, Gaetano; Doronzo, Annalisa; Antoncecchi, Valeria; Puzzovivo, Agata; Rizzo, Caterina; Lattarulo, Maria Silvia; Massari, Francesco; Caldarola, Pasquale; Ciccone, Marco Matteo

2016-01-01

Background/Aim The renal arterial resistance index (RRI) is a Doppler measure, which reflects abnormalities in the renal blood flow. The aim of this study was to verify the value of RRI as a predictor of worsening renal function (WRF) in a group of chronic heart failure (CHF) outpatients. Methods We enrolled 266 patients in stable clinical conditions and on conventional therapy. Peak systolic velocity and end diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow, and RRI was calculated. Creatinine serum levels were evaluated at baseline and at 1 year, and the changes were used to assess WRF occurrence. Results During follow-up, 34 (13%) patients showed WRF. RRI was associated with WRF at univariate (OR: 1.13; 95% CI: 1.07–1.20) as well as at a forward stepwise multivariate logistic regression analysis (OR: 1.09; 95% CI: 1.03–1.16; p = 0.005) including the other univariate predictors. Conclusions Quantification of arterial renal perfusion provides a new parameter that independently predicts the WRF in CHF outpatients. Its possible role in current clinical practice to better define the risk of cardiorenal syndrome progression is strengthened. PMID:27994601

Renal and cardiovascular risk predictive value of two different microalbuminuria screening methods in patients with hypertension with/without diabetes in Portugal.

Science.gov (United States)

Polónia, J; Carvalho, D; Nazaré, J; Martins, L; da Silva, P M; Aguiar, C; Manso, M C; Carqueja, T

2016-11-01

MicRoAlbuminuria sCreening survEy (RACE) was a multicentre, observational, cross-sectional study conducted in primary health-care settings of Portugal. Here, we present a post-hoc analysis from the RACE study, assessing the renal and cardiovascular (CV) risk predictive value of two different microalbuminuria (MA) screening methods, nephelometry with 24-h urine (MA-24 h) and Micral test with occasional urine (MicralA) in patients with hypertension (HTN) with/without type 2 diabetes mellitus (T2DM). Out of 3065 patients, 1173 (38.3%) were in the HTN group without T2DM (HTN) and 1892 (61.7%) in the HTN group with T2DM (HTN+T2DM). The overall prevalence of MA was 50.6% determined by MicralA and 22.1% with MA-24 h. Urinary albumin excretion data obtained by both techniques correlated significantly (r s =0.586; Pvalue of 41% and negative predictive value of 97%. With both methods, the presence of MA was independently associated with a higher risk (1.5- to 2.9-fold) of CV and renal organ damage in both HTN and HTN+T2DM groups. MicralA, due to its high sensitivity and negative predictive value, can be considered as a valid and reliable method for MA screening in patients with HTN with/without T2DM.

Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging.

Science.gov (United States)

Mahmud, Mohd Hafizi; Nordin, Abdul Jalil; Ahmad Saad, Fathinul Fikri; Azman, Ahmad Zaid Fattah

2015-10-01

Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging. Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups. BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (Pvalue for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.

The MDP skull uptake test: A new diagnostic tool

International Nuclear Information System (INIS)

Ell, P.J.; Jarritt, P.H.; Cullum, I.; Lui, D.

1984-01-01

An original approach to the measurement of bone turnover is presented. With SPECT, the authors have measured in pgr/ml, the uptake of MDP by the skull in man. The Cleon 710 scanner, ring phantoms and bone biopsies were used for ultimate in vivo/in vitro count recovery correlation and calibration. A normal range for 24 patients was found: 8.5 to 19.5 pgr/ml with a mean of 14. For patients with bony metastases (12), the values were: 22.5 to 50, mean of 30. For 5 patients with osteomalacia, the values were 46 to 68, mean of 62: for 12 patients with hyperparathyroidism, the values were 37 to 48.5, mean of 43. In 3 patients with Pagets disease, the values were 58.5 to 75, with a mean of 65. In 76 patients with metastatic disease to bone, the conventional wholebody bone scan was investigated against the following: 24h wholebody retention of MDP (WBR), skull uptake as described and GFR by Cr-51-DTPA. There is a correlation between GFR and WBR - r=0.67. There is a lesser correlation between GFR and skull uptake - r=0.3. There is no correlation between skull uptake and WBR - r=0.1. The comparison of skull uptake data with normal whole body bone scans leads to a significant proportion of cancer patients with positive skull uptake data. Monostotic disease (especially if metabolic in nature) expresses itself by abnormal skull uptake even if the clinical site of abnormality lies outside the skull. This new technique is ideal as a tool to investigate phosphonate concentration in bone. With it, the authors have shown the effect of specific activity of label on skull uptake, which increases as the specific activity of labelled MDP decreases

Uptake of radionuclides by vegetation at a High Arctic location

International Nuclear Information System (INIS)

Dowdall, M.; Gwynn, J.P.; Moran, C.; O'Dea, J.; Davids, C.; Lind, B.

2005-01-01

Radionuclide levels in vegetation from a High Arctic location were studied and compared to in situ soil concentrations. Levels of the anthropogenic radionuclide 137 Cs and the natural radionuclides 40 K, 238 U, 226 Ra and 232 Th are discussed and transfer factor (TF) values and aggregated transfer (Tag) values are calculated for vascular plants. Levels of 137 Cs in vegetation generally followed the order mosses > lichen > vascular plants. The uptake of 137 Cs in vascular plants showed an inverse relationship with the uptake of 40 K, with 137 Cs TF and Tag values generally higher than 40 K TF and Tag values. 40 K activity concentrations in all vegetation showed little correlation to associated soil concentrations, while the uptake of 238 U, 226 Ra and 232 Th by vascular and non-vascular plants was generally low. - Uptake of the anthropogenic radionuclide 137 Cs is highest for moss species

Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function

DEFF Research Database (Denmark)

Nielsen, Lene Ryom; Mocroft, A.; Kirk, O.

2013-01-01

Background. Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown.Methods. D:A:D study participants with an estimated...... glomerular filtration rate (eGFR) of ≥90 mL/min after 1 January 2004 were followed until they had a confirmed eGFR of ≤70 mL/min (the threshold below which we hypothesized that renal interventions may begin to occur) or ≤60 mL/min (a value indicative of moderately severe chronic kidney disease [CKD...... [95% CI, 1.16-1.28], respectively). Associations were unaffected by censoring for concomitant ARV use but diminished after discontinuation of these ARVs.Conclusions. Tenofovir, ritonavir-boosted atazanavir, and ritonavir-boosted lopinavir use were independent predictors of chronic renal impairment...

18F-FDG uptake in the stomach on screening PET/CT: value for predicting Helicobacter pylori infection and chronic atrophic gastritis

International Nuclear Information System (INIS)

Kobayashi, Shigeki; Ogura, Mayumi; Suzawa, Naohisa; Horiki, Noriyuki; Katsurahara, Masaki; Ogura, Toru; Sakuma, Hajime

2016-01-01

The aim of this study was to determine the value of 18 F-FDG uptake on screening PET/CT images for the prediction of Helicobacter pylori (H. pylori) infection and chronic atrophic gastritis. Among subjects who underwent 18 F-FDG PET/CT for cancer screening from April 2005 to November 2015, PET/CT images were analyzed in 88 subjects who had gastrointestinal fiberscopy within 6 months. The volumes of interest (VOIs) were placed in the fornix, corpus and antrum of the stomach to determine maximal standardized uptake value (SUVmax) and mean SUV (SUVmean). Receiver operating characteristic curve (ROC) analysis was performed to determine the diagnostic performance of SUV indicators in predicting H. pylori infection and chronic atrophic gastritis. SUV indicators of the stomach were significantly higher in subjects with H. pylori infection than those without (from P < 0.001 to P < 0.05). ROC analysis revealed that SUVmean had the highest performance in predicting H. pylori infection (AUC 0.807) and chronic atrophic gastritis (AUC 0.784). SUVmean exhibited the sensitivity of 86.5 % and the specificity of 70.6 % in predicting H. pylori infection, and the sensitivity of 75.0 % and 78.6 % in predicting chronic atrophic gastritis. Assessment of 18 F-FDG uptake in the stomach reflecting active inflammation is useful in predicting patients with H. pylori infection and subsequent chronic atrophic gastritis which is closely associated with the risk of gastric neoplasms

Analysis of renal blood flow and renal volume in normal fetuses and in fetuses with a solitary functioning kidney.

Science.gov (United States)

Hindryckx, An; Raaijmakers, Anke; Levtchenko, Elena; Allegaert, Karel; De Catte, Luc

2017-12-01

To evaluate renal blood flow and renal volume for the prediction of postnatal renal function in fetuses with solitary functioning kidney (SFK). Seventy-four SFK fetuses (unilateral renal agenesis [12], multicystic dysplastic kidney [36], and severe renal dysplasia [26]) were compared with 58 healthy fetuses. Peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the renal artery (RA) were measured; 2D and 3D (VOCAL) volumes were calculated. Renal length and glomerular filtration rate (GFR) were obtained in SFK children (2 years). Compared with the control group, the PSV RA was significantly lower in nonfunctioning kidneys and significantly higher in SFK. Volume measurements indicated a significantly larger volume of SFK compared with healthy kidneys. All but 4 children had GFR above 70 mL/min/1.73 m 2 , and compensatory hypertrophy was present in 69% at 2 years. PSV RA and SFK volume correlated with postnatal renal hypertrophy. No correlation between prenatal and postnatal SFK volume and GFR at 2 years was demonstrated. Low PSV RA might have a predictive value for diagnosing a nonfunctioning kidney in fetuses with a SFK. We demonstrated a higher PSV RA and larger renal volume in the SFK compared with healthy kidneys. © 2017 John Wiley & Sons, Ltd.

[CHRONIC RENAL FAILURE AND PREGNANCY--A CASE REPORT].

Science.gov (United States)

Amaliev, G M; Uchikova, E; Malinova, M

2015-01-01

Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure. Determining the optimum time for authorization birth depends on the condition of the mother, the condition of the fetus and the rate of progression of renal failure, and the deadline the pregnancy should be terminated is 35 weeks. We present a case of a patient with chronic renal failure, with favorable perinatal outcome.

The option value of innovative treatments for non-small cell lung cancer and renal cell carcinoma.