AN EVALUATION OF TC-99(M)-DMSA SPET WITH 3-DIMENSIONAL RECONSTRUCTIONIN 68 PATIENTS WITH VARIED RENAL PATHOLOGY

Sixty-eight patients (135 kidneys) with varied renal pathology were ev aluated with Tc-99(m)-dimercaptosuccinic acid (DMSA) single photon emi ssion tomography (SPET) to determine whether it is possible to detect more renal abnormalities and to reduce the number of false-positives d ue to anatomical variants when compared with planar imaging. The patie nts ranged in age from 1 to 78 years and their pathologies included ur inary tract infection (n = 50), space occupying lesions (n = 5), calcu li (n = 4), hypertension (n = 4) and others (n = 5). Planar scans were pei formed 3 h after the injection of 80 MBq of Tc-99(m)-DMSA and a 6 4 x 20 s acquisition over 360 degrees was used for SPET. High-resoluti on collimation was used for both. Slices were displayed as transaxial, coronal and sagittal and/or oblique sagittal in the plane of the kidn ey. Three-dimensional (3D) images were formed by volume rendering. Eac h kidney was divided into three regions and each region scored separat ely for the presence of an abnormality. Planar scans were reviewed alo ne and then in conjunction with SPET and 3D images. Planar imaging det ected 95 abnormal regions compared with 103 using SPET. SPET reduced t he number of equivocal regions in 8 (12%) patients, The diagnosis was altered by SPET in 17 (4%) regions in 14 (21%) patients. SPET and 3D T c-99(m)-DMSA allow more abnormalities to be detected but also allow mo re specific definition of apparent abnormalities on planar imaging.