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Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography
Örebro University, School of Health Sciences. Department of Radiology.
Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro University, School of Health Sciences. Division of Medical Diagnostics.ORCID iD: 0000-0003-3901-2634
Örebro University, School of Medical Sciences. Department of Radiology.ORCID iD: 0000-0003-3253-8967
2018 (English)In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 45, no Suppl. 1, p. S765-S765, article id E-TPW52Article in journal, Meeting abstract (Other academic) 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.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 45, no Suppl. 1, p. S765-S765, article id E-TPW52
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:oru:diva-70372DOI: 10.1007/s00259-018-4148-3ISI: 000449266207098OAI: oai:DiVA.org:oru-70372DiVA, id: diva2:1266744
Conference
31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM'18), Düsseldorf, Germany, October 13-17, 2018
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2018-11-29Bibliographically approved

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Bäck, AnnaFunk, EvaGeijer, Håkan

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