technetium-tc-99m-medronate and Ureteral-Obstruction

We prospectively evaluated routine bone scintigraphs to determine the prevalence of radiotracer retention in the renal collecting system, and to test the reliability of this finding as an indicator of obstructive uropathy. Post-diuretic renal washout was also measured, to evaluate the use of this procedure after bone scintigraphy. Stasis occurring only in the supine position was excluded by obtaining upright images. The findings on bone scintigraphy were compared with the results of renal sonography. Patients showing persistent pelvicaliceal concentration in the upright position after bone scintigraphy were found to have evidence of obstructive uropathy by sonography or other studies. Furosemide administration was followed by washout of the bone tracer from all kidneys with proven partial ureteral obstruction. Persistent renal pelvicaliceal concentration, in upright images after bone scintigraphy, appears to be a reliable indicator of obstructive uropathy. However, measurement of post-diuretic renal washout, after bone scintigraphy, does not reliably detect obstructive uropathy, and may be misleading if interpreted in the same way as the standard diuretic renogram.

Topics: Aged; Aged, 80 and over; Bone and Bones; Furosemide; Humans; Hydronephrosis; Male; Middle Aged; Posture; Radionuclide Imaging; Technetium Tc 99m Medronate; Ureteral Obstruction

Topics: Child; Female; Furosemide; Humans; Iodohippuric Acid; Male; Organometallic Compounds; Pentetic Acid; Radionuclide Imaging; Technetium Tc 99m Medronate; Technetium Tc 99m Pentetate; Ureteral Obstruction

Topics: Bone and Bones; Follow-Up Studies; Humans; Male; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Ureteral Obstruction

Endometriosis is a common disorder, affecting women in the child-bearing years. While urologic involvement is rare, the bladder is more often affected than the ureter. The authors describe the case of a 30-year-old woman who had unilateral ureteral obstruction secondary to an isolated periureteral retroperitoneal area of endometriosis. The theories of histogenesis are discussed. Current treatment consists of surgery or hormonal manipulation or a combination of the two.

Topics: Adult; Diphosphonates; Endometriosis; Female; Humans; Hydronephrosis; Radionuclide Imaging; Retroperitoneal Neoplasms; Technetium; Technetium Tc 99m Medronate; Ultrasonography; Ureteral Obstruction

Diuretic radionuclide urography is an accurate technique for detecting obstruction as a possible cause of nephroureteral dilatation. This technique was used to evaluate radioisotope retention in the renal pelvis noted on the bone scan of a patient with prostate carcinoma. There was some washout of the pelvic radioactivity following intravenous furosemide, but the half-life was markedly prolonged, allowing the correct diagnosis of partial obstruction to be made.

Topics: Aged; Furosemide; Half-Life; Humans; Kidney Pelvis; Male; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Ureteral Obstruction; Urinary Bladder Neoplasms

Patients with prostatic cancer frequently require evaluation of bony metastases as well as renal function. 99mTc-methylene diphosphonate, a commonly used bone-imaging agent, is about 60 per cent localized in the bony skeleton and about 40 per cent excreted by the kidneys. Immediate imaging after intravenous injection of the isotope may yield high-quality radionuclide nephrourograms, which provide excellent visual and graphic displays of renal anatomy and excretory function. Our preliminary studies suggest that the immediate 99mTc-methylene diphosphonate scan may usefully expand the value of a routine bone scan to screen for ureteral obstruction. Patients with underlying malignancy who require simultaneous evaluation and follow-up of bony metastases and renal function might be conveniently served by the dual functions of the expanded bone scan to include immediate imaging of the kidneys.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Diphosphonates; Humans; Kidney; Kidney Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Ureteral Neoplasms; Ureteral Obstruction

The kidneys are nearly always visible on a routine radionuclide bone scan. To assess the reliability of the bone scan in detecting ureteral obstruction, 220 bone scans and excretory urograms were compared in 53 patients followed serially for prostatic cancer. There were 15 kidneys obstructed on excretory urograms. Only nine were diagnosed as obstructed on the bone scans. Seven of the nine cases of unilaterally obstructed kidneys were detected, whereas only two of the six kidneys in three patients with bilateral obstruction were correctly diagnosed. The results indicate that unilateral obstruction is more likely to be detected, whereas bilateral obstruction is more likely to be missed, on bone scans. Therefore, the routine radionuclide bone scan is an unreliable test for ureteral obstruction.

Topics: Bone Neoplasms; Diphosphonates; Evaluation Studies as Topic; False Negative Reactions; Humans; Male; Prostatic Neoplasms; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Medronate; Ureteral Obstruction; Urography