technetium-tc-99m-gluceptate and Carcinoma--Renal-Cell

The differential diagnosis of a solitary photopenic defect in the renal fossa observed at renal scintigraphy is extensive. A case of one of the most unusual causes for this finding, renal agenesis, is presented. Additional cases that illustrate the similarity in the radionuclide appearance of other pathologic entities are also presented. Correlation with clinical findings and other imaging modalities is required to accurately distinguish these conditions.

Topics: Carcinoma, Renal Cell; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Kidney; Kidney Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Pentetic Acid; Radionuclide Imaging; Sugar Acids; Technetium; Technetium Tc 99m Pentetate; Ureteral Obstruction

This study evaluates single-photon renal tomoscintigraphy (SPECT) in the evaluation of renal masses and correlates this modality, where indicated, with computed tomography (CT), ultrasonography (US), angiography (ANGIO) and nuclear magnetic resonance imaging (NMR). Eight patients with renal cortical lesions detected on intravenous urography (IVP) were evaluated by SPECT and planar nuclear imaging using Tc-99m glucoheptonate (GH). Three of these patients were felt particularly likely to have renal tumors and were additionally evaluated with US, CT, ANGIO and NMR. The five patients with nodules on IVP that were not particularly suggestive of malignancy had functioning, benign, renal tissue accounting for their IVP lesions. Four of five were found by planar-GH nuclear imaging, five/five by SPECT-GH. In addition, SPECT-GH allowed better "confidence" in the normal renal tissue diagnosis in three/five cases. Of the three renal lesions that were highly suggestive of malignancy, two were hypernephromas and one was hypertrophied functioning cortical tissue. All three were correctly identified prospectively on SPECT-GH; however, one hypernephroma was missed on planar-GH. NMR, CT, and ANGIO detected only one of two hypernephromas prospectively (US detected both); all four modalities incorrectly diagnosed the hypertrophied tissue suggestive of malignancy.

Topics: Angiography; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Magnetic Resonance Spectroscopy; Organotechnetium Compounds; Sugar Acids; Technetium; Tomography, Emission-Computed; Tomography, X-Ray Computed; Ultrasonography; Urography

A renal mass was correctly identified with Tc-99m sulfur colloid liver-spleen scan and Tc-99m glucoheptonate scintigraphy while CT scan was misinterpreted as showing a hepatic lesion.

Topics: Aged; Carcinoma, Renal Cell; Diagnosis, Differential; Humans; Kidney Neoplasms; Liver Neoplasms; Male; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Technetium Tc 99m Sulfur Colloid