1976 Volume 67 Issue 8 Pages 615-625
Recently, the prevalence of the gamma camera has provided in urology with increased availability of gamma camera renography using various radiopharmaceuticals. Using gamma camera renal images can be obtained in a few minutes and also renograms are depicted by setting regions of interests (ROI) on the each kidney simultaneously. Therefore, one of many advantages of the gamma camera renography is that information on time-course renal function and morphology can be obtained simultaneously.
The clinical study was made on renography by 99mTc-(Sn) DTPA.
One hundred and eighty-six cases (96 males and 90 females) were examined with age of 11 to 97 years old (mean 60.2 years old).
In this study, Searle Pho/Gamma HP gamma camera was used with Data Store Play Back System, Diverging collimator and 32KW Nova Computer System.
The radiopharmaceuticals used were 2 to 10mCi of 99mTc-(Sn) DTPA and 300μCi of 131I-Hippuran.
The results were as follows:
1) Although 99mTc-(Sn) DTPA is a GFR substance, its renal clearance is relatively fast. Therefore, 99mTc-(Sn) DTPA could be applied for dynamic renal study similar to 131I-Hippuran.
2) As gamma camera renograms was depicted after ROI setting on the each kidney, contribution from the extrarenal activity could be excluded. Simultaneous gamma camera images also served to obtain information of renal morphology and the manner of urine flow in the upper urinary tract.
3) 99mTc-(Sn) DTPA renogram was found to be useful to differentiate the obstructive renal disease, when 131I-Hippuran renogram showed obstructive pattern in patients with parenchymal disease.
4) In parenchymal renal disease 99mTc-(Sn) DTPA renogram disclosed pathological changes earlier than 131I-Hippuran renogram.
In obstructive renal disease involving the upper urinary tract, in spite of the apparent improvement of 131I-Hippuran renogram, 99mTc-(Sn) DTPA renogram still revealed the latest state of disease. Therefore, 99mTc-(Sn) DTPA renogram showed more sensitivity in detecting both obstructive and parenchymal renal disease and provide clinicians with useful aid in the follow up studies of operated cases with, for example, obstructive uropathy in the upper urinary tract.
In summary, 99mTc-(Sn) DTPA gamma camera study is found to be an useful aid in clinical urology. This technique is atraumatic, simple and safe even on such cases with poor risk, aged or children.
