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

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Abstract

Purpose

We propose a quantitative Tc-99m diethylenetriaminepentaacetic acid (DTPA) single-photon emission computed tomography/computed tomography (SPECT/CT) for glomerular filtration rate (GFR) measurement.

Methods

Quantitative SPECT/CT data obtained at 2–3 min post-Tc-99m DTPA injection (370 MBq) were used to determine % injected doses (%IDs) for individual kidneys. The reproducibility of %ID measurement was tested and compared with planar scintigraphy. Cr-51 ethylenediaminetetraacetic acid (EDTA) GFR was used as reference standard. Nine young volunteers, representing normal GFR, and ten older volunteers, reflecting impaired GFR, were enrolled. The established GFR equation derived from these volunteers was applied to 19 renal tumor patients post-partial nephrectomy.

Results

At 2−3 min, %ID was most reproducible with the highest intraclass correlation (ICC) (0.9379) and lowest % coefficient of variation (CV) (6.5259%), which were more reliable than the ICC (0.9368) and %CV (6.7689%) of planar scintigraphy. Cr-51 EDTA GFR (93.16 ± 24.81 ml/min) correlated significantly with %ID (7.66 ± 2.15%, r = 0.7906, p = 0.0001), yielding an equation: Cr-51 EDTA GFR (ml/min) = (%ID × 9.1462) + 23.0653. This equation revealed significant decreases in total and nephrectomized kidney GFR (p = 0.0012 and p < 0.0001, respectively) from preoperative to 3-month postoperative measurements.

Conclusions

Quantitative Tc-99m DTPA SPECT/CT produces reliable and clinically applicable %ID estimates that translate to the GFR of individual kidneys.

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Correspondence to Won Woo Lee.

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Conflicts of Interest

Yeon-koo Kang, So Hyun Park, Min Seok Suh, Seok-Soo Byun, Dong-Wan Chae, and Won Woo Lee declare that they have no conflicts of interest. This study was supported in part by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2015R1D1A1A01059146) and by the Seoul National University Bundang Hospital Research Fund (14–2016-012).

Ethical Approval

The study was approved by an institutional review board and was performed in accordance with the ethical standards set in the 1964 Declaration of Helsinki and its later amendments.

Informed Consents

Informed consent was obtained from all volunteers included in the study.

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Kang, Yk., Park, S., Suh, M.S. et al. Quantitative Single-Photon Emission Computed Tomography/Computed Tomography for Glomerular Filtration Rate Measurement. Nucl Med Mol Imaging 51, 338–346 (2017). https://doi.org/10.1007/s13139-017-0491-8

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  • DOI: https://doi.org/10.1007/s13139-017-0491-8

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