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A Practical Approach for Improving Quantitative Assessment of Native Renal Recovery Using Multi-View Tc-99m DTPA Renal Scintigraphy for SLK Patients with 3+ Kidneys

J Zhang1*, (1) Radiology, The Ohio State University, Columbus, OH

Presentations

PO-GePV-M-356 (Sunday, 7/10/2022)   [Eastern Time (GMT-4)]

ePoster Forums

Purpose: The measurement of glomerular filtration rate (GFR) via non-invasive renal scintigraphy in simultaneous liver-kidney transplant (SLK) recipients has been available on certain gamma cameras. However, with the system platform, 1) the renal function is incorrectly split to kidneys when the transplanted kidney(s) is/are added, 2) the total number of kidneys is limited at up to 3, and 3) photon attenuation-correction using native renal depth estimated by representative formulas does not necessarily satisfy the reality. The aim of this study was to mitigate these limitations and improve the accuracy of GFR assessments by developing a practical approach for SLK patients with 3+ kidneys.

Methods: 5 SLK patients were included (3 or 4 kidneys). Dynamic renal scintigraphy with Tc-99m DTPA was performed on a Symbia Evo system (~111MBq, 1s/f for 60 frames then 15s/f for 80 frames), followed by bilateral static scans for abdomen. Counts of ROIs for kidneys and background were exported to an in-house developed program for data processing. Renal depth was determined by A) Gates method (native only) and B) bilateral scans. Photon attenuation-correction, renal-uptake and GFRs were calculated using methods A&B.

Results: Correct renal split function for native and transplanted kidneys was obtained with no limitation of number of kidneys using the in-house developed program (e.g., from system’s 43%-57%-100% to corrected 4.4%-5.9%-89.7% for left-right-transplanted). While depth of transplanted kidneys cannot be estimated by formulas, depth of native kidneys estimated by Gates method was significantly smaller than measured (-22.4%±15%), so were GFR measurements (-25%±17%).

Conclusion: We developed a practical approach to overcome imaging system limitations and improve GFR measurement accuracy when assessing native renal recovery for 3+ kidneys following SLK. For standard of care protocols without CT measurements available, the bilateral scanning is feasible to improve accuracy of renal depth and GFR measurements compared to the current formula.

Keywords

Glomerular Filtration Rate, Nuclear Medicine

Taxonomy

IM/TH- Image Analysis (Single Modality or Multi-Modality): Computer-aided decision support systems (detection, diagnosis, risk prediction, staging, treatment response assessment/monitoring, prognosis prediction)

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