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MAG3 Renogram Deconvolution in Kidney Transplantation: Utility of the Measurement of Initial Tracer Uptake

Department of Nuclear Medicine, Lab of Biophysics and Bioengineering; and Department of Nephrology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain

Correspondence: For correspondence or reprints contact: José Martin-Comin, MD, Department of Nuclear Medicine, Hospital Universitari de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

ABSTRACT

The study of renal retention function by deconvolution analysis of renographic curves is useful to calculate quantitative parameters in renal studies. The aim of the work is to evaluate the usefulness of ^99mTc-MAG3 renogram deconvolution in renal function monitoring of kidney graft recipients. Methods: Forty-three kidney grafts and 112 renograms were studied: 41 were diagnosed as functioning graft, 35 as acute tubular necrosis, 24 as acute rejection, 8 as obstruction and 4 as cyclosporin toxicity. The parameters calculated were mean transit time (MTT), time at 20% of renal retention function (T20) and initial uptake (IU). Results: MTT and T20 were significantly longer in obstructives than in functioning grafts (p < 0.001). Initial uptake was significantly lower in acute tubular necrosis (ATN) and acute rejection (p <0.001) and in obstructives (p <0.05) than in functioning grafts. The joint evaluation of MTT and IU allowed to diagnose cases with graft function severely impaired. Conclusion: Initial uptake is useful in evaluating post-transplantation complications and in combination with MTT and T20 reflects renal dysfunction severity.

Key Words: renal transplantation • technetium-99m-MAG3 • deconvolution analysis