technetium-tc-99m-gluceptate and Kidney-Neoplasms

This article describes the role of nuclear medicine in the evaluation of the genitourinary tract. The technical aspects of radionuclide imaging (radiopharmaceuticals, radiation dosimetry, instrumentation, and method) are briefly presented, and each of the indications for renal scintigraphy--including the evaluation of differential renal function, hypertension, obstruction, renal transplants, masses, trauma, congenital anomalies, vesicoureteral reflux, and infection--are discussed. The relative advantages and disadvantages of radionuclide imaging with respect to alternative radiographic examinations (such as intravenous urography, ultrasonography, CT, angiography, and magnetic resonance imaging) are emphasized wherever applicable.

Topics: Graft Rejection; Humans; Hypertension, Renovascular; Iodohippuric Acid; Kidney; Kidney Function Tests; Kidney Neoplasms; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Male; Organotechnetium Compounds; Pentetic Acid; Postoperative Complications; Pyelonephritis; Radioisotope Renography; Spermatic Cord Torsion; Succimer; Sugar Acids; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Ureteral Obstruction; Urinary Tract; Vesico-Ureteral Reflux

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. 131I OIH, 67gallium, 99mTcDTPA, 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.

Topics: Acute Kidney Injury; Adult; Aged; Embolism; Female; Gallium Radioisotopes; Humans; Iodine Radioisotopes; Iodohippuric Acid; Kidney Failure, Chronic; Kidney Neoplasms; Male; Middle Aged; Nephritis, Interstitial; Organotechnetium Compounds; Pentetic Acid; Pyelonephritis; Radionuclide Imaging; Renal Artery Obstruction; Succimer; Sugar Acids; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

We report a case of renal oncocytoma with a unique scintigraphic pattern. The tumor showed strong avidity for [123I]iodohippurate, but no affinity for [99mTc] glucoheptonate. We offer an explanation for such exceptional scintigraphic finding, which may potentially enable us to make a pre-operative diagnosis of renal oncocytoma in the future.

Topics: Adenoma; Female; Humans; Iodohippuric Acid; Kidney Neoplasms; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium

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 case in which, for the first time, the superior mesenteric artery caused an appearance mimicking vascular tumor on a kidney radionuclide angiogram (RNA) obtained posteriorly, is reported. A subsequent contrast arteriogram showed that the superior mesenteric artery caused that appearance and confusion with possible vascular tumor on RNA. No similar cases with mesenteric blush simulating vascular tumor have been found in the literature. Mesenteric blushes on RNAs obtained posteriorly have been described only in cases of kidney agenesis and post-nephrectomy. This pattern should be kept in mind when interpreting RNAs to avoid subjecting patients to invasive diagnostic procedures.

Topics: Humans; Kidney; Kidney Neoplasms; Male; Mesenteric Arteries; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium

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

Single photon emission computerized tomography (SPECT) was done on two patients with suspected renal masses. Nuclear scintigraphy was equivocal on two tumors readily identified by SPECT. Single photon tomography is cost effective and increases the reliability of nuclear scintigraphy.

Topics: Adenocarcinoma; Adenoma; Adult; Aged; Humans; Kidney; Kidney Neoplasms; Male; Organotechnetium Compounds; Sugar Acids; Technetium; Tomography, Emission-Computed; Ultrasonography

We compared technetium Tc 99m glucoheptonate renal scan with standard renal arteriography in 22 patients with various renal abnormalities. The diagnostic accuracy and degree of image resolution indicates this study is a useful and safe clinical addition to the diagnostic armamentarium.

Topics: Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Renal Artery; Renal Artery Obstruction; Sugar Acids

Tc-99m gluceptate renal imaging was compared with the intravenous urogram in 41 patients. While the specificity of the examination was essentially the same for both techniques, the sensitivity for the detection of renal mass lesions was better with gluceptate imaging. The study suggests the desirability of a shift in emphasis from the IVU to the Tc-99m gluceptate scintigram in the early evaluation of suspected renal mass lesions, and merits further clinical evaluation.

Topics: Adolescent; Adult; Aged; Angiography; Child; Child, Preschool; Diatrizoate Meglumine; Humans; Image Enhancement; Infant; Kidney Cortex; Kidney Diseases; Kidney Neoplasms; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sugar Acids; Technetium; Urography