Utility of SPECT/CT in evaluating post renal transplant complications

Objectives Renal transplatation continues to provide the best quality of life for patients with end stage renal disease, but often post transplant complications are of a major concern. SPECT/CT hybrid cameras provide fusion of anatomic (CT) with physiologic (SPECT) information adding greater value to diagnosis of human diseases with accuracy and confidence. Our objective is to determine usefulness of SPECT/CT in diagnosing complications following renal transplant.

Methods It is a retrospective study of 12 patients who underwent renal transplant procedure. Ten patients were suspected of having urinary leak, one with transplant non-viability and one with infection. Eleven patients were injected with 10mCi of Tc-99m-MAG3 followed by 30 min of dynamic imaging at 30 sec/frame. One patient was injected with 500uCi of In-111 labeled WBC, and at 24 hrs had a whole body scan. After planar imaging, all patients had a 10 sec/stop, 60 stops non-circular SPECT scan each, followed by low dose non-contrast CT scan on a hybrid SPECT/CT system.

Results SPECT/CT demonstrated the presence of a urinary leak in 7 of 10 patients as defined by Tc activity associated with fluid that was outside the confines of the urinary collecting system. SPECT/CT showed no Tc-99m-MAG3 accumulation in the transplanted kidney in the patient with a non-viable renal transplant. In111-WBC SPECT/CT scan demonstrated the presence of a renal transplant abcess in 1 patient.

Conclusions SPECT/CT scanning is useful in diagnosing post renal transplant complications