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The Journal of Nuclear Medicine Vol. 40 No. 1 60-63
© 1999 by Society of Nuclear Medicine
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Posterior 180° 99mTc-Dimercaptosuccinic Acid Renal SPECT

Nan-Jing Peng, C. Gerry Kwok, Yee-Hsuan Chiou, Gang-Hong Jao, Daw-Guey Tsay, Ren-Shyan Liu and H. William Strauss

Departments of Nuclear Medicine and Pediatrics, Veterans General Hospital, Kaohsiung
Department of Nuclear Medicine, Veterans General Hospital, Taipei
National Yang-Ming University, Taiwan, Republic of China
Division of Nuclear Medicine, Department of Radiology, Stanford University Medical Center, California

Correspondence: For correspondence or reprints contact: Ren-Shyan Liu, MD, Department of Nuclear Medicine, Taipei Veterans General Hospital, 201 s. 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China.

ABSTRACT

As a result of a high percentage of hypoactive upper poles of kidneys in traditional 99mTc-dimercaptosuccinic acid (DMSA) SPECT, a prospective study was conducted using 180° acquisition technique compared with 360° to minimize tissue attenuation. Methods: Anterior 180°, posterior 180° and 360° renal SPECT images were obtained simultaneously using a dual-head camera. Forty-one subjects without renal disease and 16 subjects with 21 cortical defects were included in this study. The total counts of the raw data in the anterior 180°, posterior 180° and full 360° were calculated. Small regions of interest were drawn over the cortex of the kidney on coronal and reoriented sagittal slices. Quantitative evaluation of regional activity was performed on the same frames in all three acquisition methods. Results: Comparison of the total renal counts between the anterior and posterior 180° data showed reduced counts in the anterior 180° data collection (P < 0.01). Visual evaluation of the reconstructed images from anterior 180°, posterior 180° and full 360° data collection showed the best image uniformity in the posterior 180° image. The upper/lower pole ratio in the posterior 180° renal SPECT images increased significantly in comparison to full 360° renal SPECT images (P < 0.01) and anterior 180° SPECT images (P < 0.01). The renal defects were more clearly visualized in the posterior 180° renal SPECT images than the full 360° renal SPECT images. The defect/normal cortex ratios in the posterior 180° renal SPECT images were much lower than those from the full 360° SPECT images (P < 0.01) and those from the anterior 180° SPECT images (P < 0.01). Conclusion: The posterior 180° acquisition technique can avoid the problem of hypoactive upper pole and can be less time consuming in 99mTc-DMSA SPECT images. It also provides superior lesion contrast in the clinical evaluation of patients with renal scarring.

Key Words: kidney • renal scar • SPECT • 99mTc-dimercaptosuccinic acid






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