PT  - JOURNAL ARTICLE
AU  - Liu, Yiyan
AU  - Ghesani, Nasrin V.
AU  - Skurnick, Joan H.
AU  - Zuckier, Lionel S.
TI  - The F+0 Protocol for Diuretic Renography Results in Fewer Interrupted Studies Due to Voiding Than the F-15 Protocol
DP  - 2005 Aug 01
TA  - Journal of Nuclear Medicine
PG  - 1317--1320
VI  - 46
IP  - 8
4099  - http://jnm.snmjournals.org/content/46/8/1317.short
4100  - http://jnm.snmjournals.org/content/46/8/1317.full
SO  - J Nucl Med2005 Aug 01; 46
AB  - Timing of diuretic administration is not universally standardized in renography. Over the past year, our practice has changed from F-15 administration of furosemide to an F+0 protocol. Therefore, we have retrospectively compared these 2 cohorts to assess if the shorter interval between diuretic administration and study completion in the F+0 study results in a greater frequency of patients able to complete the subsequent 30-min dynamic acquisition without disruption due to voiding. Methods: We identified 108 diuretic 99mTc-mercaptoacetyltriglycine renograms performed in the previous 18-mo period. Three patients were given furosemide at 30 min after the radiopharmaceutical and were excluded. Twenty studies in children under 3 y of age were excluded from consideration because voiding is neither restricted in this age group nor does voiding into a diaper cause disruption. Forty milligrams of furosemide were administered to adults, whereas 0.5 mg/kg was given to children. In the first cohort of 56 studies, radiopharmaceutical was administered 15 min after furosemide (F-15), whereas, in the second cohort of 29 patients, it was administered immediately thereafter (F+0). In all cases, patients were asked to void proximal to radiopharmaceutical injection. Dynamic images and renogram curves were inspected for evidence of interruption or voiding midstudy. Statistical significance was determined by a 1-tailed Fisher exact test for proportions, with P < 0.05. Results: The F-15 and F+0 groups of patients were comparable in terms of age, sex, and diuretic amount. In 17 of the F-15 patients, renography was interrupted because of voiding (30%), whereas this occurred in only 3 of the F+0 patients (10%). This difference was significant at the P = 0.033 level. The mean time of voiding was 18.3 min (range, 12–25 min) for F-15 patients and 16 min (range, 12–19 min) for the F+0 group. Conclusion: The F+0 renal diuretic protocol is associated with a significantly lower rate of disruption because of voiding than the F-15 protocol, likely due to the shorter period between diuretic administration and study termination, which results in less bladder distention and discomfort. On the basis of these data, the F+0 protocol appears to be a more tolerable procedure.