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Quantitative Analysis of the Technetium 99m-DTPA Captopril Renogram: Contribution of Washout Parameters to the Diagnosis of Renal Artery Stenosis

Section of Nuclear Medicine, Department of Diagnostic Radiology and Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
Nuclear Medicine Service, Veterans Affairs Medical Center, West Haven, Connecticut

Correspondence: For correspondence reprints contact: Holley Dey, MD, Section of Nuclear Medicine, Dept. of Diagnostic Radiology, 333 Cedar St., Suite TE-2, New Haven, CT 06510.

ABSTRACT

Retrospective analysis of precaptopril and postcaptopril DTPA renograms from 88 hypertensive patients was performed to refine the quantitative criteria used to diagnose renal artery stenosis (RAS). Of the 88 patients, 45 had RAS and 43 had normal renal arteries at angiography. Using time-activity curves from the essential hypertensive group, diagnostic washout criteria for a positive DTPA renogram were developed. These were based on the 20 and 30 min/peak activity ratios in each kidney. When the washout criteria were retrospectively applied to patient data as a whole, sensitivity and specificity for RAS were 67% and 79%, respectively. When previously described uptake criteria, based on the time to peak activity in each kidney and the GFR ratio between the kidneys, were applied to the same data, sensitivity and specificity for RAS were 89% and 84%, respectively. Quantitative analysis of the DTPA renogram using the time to peak and GFR ratio was both sensitive and specific for RAS. Measurement of 20 and 30 min/peak renal activity ratios did not improve the accuracy of the test.

This article has been cited by other articles:

				E. J. Fine, Y. Li, and M. D. Blaufox Parenchymal Mean Transit Time Analysis of 99mTc-DTPA Captopril Renography J. Nucl. Med., October 1, 2000; 41(10): 1627 - 1631. [Abstract] [Full Text] [PDF]