Abstract
1792
Objectives The spectrum of clinical signs and symptoms of pyelonephritis is diverse. Tc99m DMSA is commonly used in the evaluation of pyelonephritis in children. However, sometimes, it is difficult to determine whether renal cortical defect revealed by DMSA study represent pyelonephritis or a renal scar. In addition, DMSA in recent years suffered a supply shortage. We tried to evaluate the utilization of gallium-67 scan.
Methods A total of 15 children who underwent gallium 67 scan for possible pyelonephritis were included in this retrospective analysis. Nine of them had positive DMSA studies within 10 days of the Gallium 67 scan. SPECT/CT images were acquired on 4 patients. The gallium 67 scans were acquired at 2 time points. The early images were acquired at 24-25 hours post-injection and delayed images were acquired 30-34 hours post-injection. Increased renal activity which was more prominent on the delayed images was interpreted as pyelonephritis.
Results The gallium scan detected 10 patients with pyelonephritis and excluded 4 patients without. In one patient, diffuse but non-uniformly increased renal activity in the transplanted kidney was interpreted as pyelonephritis, which was a false positive because it was later proven as chronic rejection. The overall gallium scan had an accuracy rate of 93.3% (14/15).
Conclusions Gallium scan can still play a role in pediatric patients with suspected pyelonephritis, especially when DMSA scan results are not conclusive.