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Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography
Örebro universitet, Institutionen för hälsovetenskaper. Department of Radiology.
Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro universitet, Institutionen för hälsovetenskaper. Division of Medical Diagnostics.ORCID-id: 0000-0003-3901-2634
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Radiology.ORCID-id: 0000-0003-3253-8967
2018 (Engelska)Ingår i: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 45, nr Suppl. 1, s. S765-S765, artikel-id E-TPW52Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Abstract [en]

Aim: The F+10 method in supine position, which has been implemented at our Nuclear Medicine department since 2015, involves a 30- minute long dynamic acquisition. The diuretic is only administered when necessary and decision is taken by the radiographers in a semi-automated fashion without consulting a physician, by calculating the remaining activity in the kidneys seven minutes post 99mTc-MAG3 injection and comparing the value with an arbitrary threshold of 75 %. If needed, the diuretic is injected three minutes later. The aim of this study was to correlate our method with the established previously used F+20 protocol in adults. Is the currently used threshold of 75% of activity left in any kidney at seven minutes the optimal cut-off value for diuretic administration?

Material and Methods: This is an ongoing retrospective study which include 320 F+20 examinations of adult patients performed during 2013-2015. They were all re-evaluated according to the currently used F+10 method, categorized as requiring diuretic or not and correlated to the original F+20 examination. A ROC-curve was drawn to delineate the best cut-off value for remaining renal activity. Sensitivity, specificity and accuracy were calculated.

Results: Preliminary results indicate that the F+10 re-evaluations with the currently used cut-off value of 75% did not correlate with the original F+20 examinations. In 80% (255 examinations) of the F+10 re-evaluations diuretic would have been considered necessary while only 52% (167 examinations) received diuretics in the original F+20 renographies (sensitivity 1.0, specificity 0.42). However, all the patients who required furosemide in the original F+20 renographies would have received diuretic if they had been imaged with the F+10 protocol. Furthermore, examination time is considerably reduced. After an evaluation of the ROC-curve the optimal cut-off value was 94% (sensitivity 0.92, specificity 0.84, accuracy 0.88). However, by implementing this value, 13 patients (4%) would have been falsely categorized as not requiring diuretic.

Conclusions: The 99mTc-MAG3 renography with the F+10 protocol in supine position is a feasible and acceptable method in clinical practice.

Ort, förlag, år, upplaga, sidor
Springer, 2018. Vol. 45, nr Suppl. 1, s. S765-S765, artikel-id E-TPW52
Nationell ämneskategori
Radiologi och bildbehandling
Identifikatorer
URN: urn:nbn:se:oru:diva-70372DOI: 10.1007/s00259-018-4148-3ISI: 000449266207098OAI: oai:DiVA.org:oru-70372DiVA, id: diva2:1266744
Konferens
31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM'18), Düsseldorf, Germany, October 13-17, 2018
Tillgänglig från: 2018-11-29 Skapad: 2018-11-29 Senast uppdaterad: 2018-11-29Bibliografiskt granskad

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Av författaren/redaktören
Bäck, AnnaFunk, EvaGeijer, Håkan
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Institutionen för hälsovetenskaperInstitutionen för medicinska vetenskaper
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European Journal of Nuclear Medicine and Molecular Imaging
Radiologi och bildbehandling

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