Simplified Dynamic Phantom for Pediatric Renography: A Description of Instrument and Its Performance

Document Type : Original Article

Authors

1 Osaka University Hospital

2 Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine

3 Osaka University Graduate School of Medicine

4 Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine Osaka University Graduate School of Medicine Immunology Frontier Research Center

5 Department of Radiology, Osaka University Graduate School of Medicine

6 Department of Molcular Imaging in Medicine,Osaka University Graduate School of Medicine

Abstract

Objective(s): Renography is used for the diagnostic evaluation of pediatric patients with a suspected obstruction of urinary tract or impaired renal function. The recommended dose for children have been released by the European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and Japanese Society of Nuclear Medicine. Since acquisition counts in dynamic scintigraphy are affected by the administered doses and sensitivity of the scintillation camera, the scan procedure should be determined independently. In this study, we constructed simplified dynamic phantom imitating pediatric renography and tested its performance.
Methods: Simplified dynamic phantom consisted of three components (i.e.,infusion, imitated kidney, and drainage sections). The infusion rates (mL/min) were determined by comparing the time activity curves obtained from patients
with normal renal function. The time-points of the maximum counts (Tmax), as well as the two-thirds and one-half of the maximum counts (T2/3 and T1/2) were measured in different doses using the phantom with the best-match infusion rate
and duration, and low-energy general-purpose (LEGP) or low-energy highresolution (LEHR) collimators and applying different attenuations.
Results: The best-match infusion rates of the phantom to imitate the time activity curve of the normal renal function were 42.0, 1.0, 0.6, and 0.3 mL/min in the arterial, secretory, early-excretory, and late-excretory phases, respectively. When 30 MBq, LEHR collimator and non-water-equivalent phantom were applied, Tmax, T2/3, and T1/2 were 242±15.3, 220±10.0 and 317±25.2 seconds, respectively. Using LEGP collimator and (3 MBq of activity) 5-cm water-equivalent phantom, Tmax, T2/3, and T1/2 values were estimated as 242±5.8, 213±11.5, and 310±17.3 sec, respectively.
Conclusion: Our simplified dynamic phantom for pediatric renography could imitate the time activity curves obtained from patients with normal renal function. Tmax, T2/3, and T1/2 could be measured under various settings of dose,collimator, and tissue attenuation.

Keywords

Main Subjects

References

1. O’Reilly P, Aurell M, Britton K, Kletter K, Rosenthal L, Testa T. Consensus on diuresis renography for investigating the dilated upper urinary tract. Radionuclides in Nephrourology Group. Consensus Committee on Diuresis Renography. J Nucl Med. 1996;37(11):1872-6.
2. Taylor A, Nally J, Aurell M, Blaufox M, Dondi M, Dubovsky E, et al. Consensus report on ACE inhibitor renography for detecting renovascular hypertension. Radionuclides in Nephrourology Group. Consensus Group on ACEI Renography. J Nucl Med. 1996;37(11):1876-82.
3. Boubaker A, Prior JO, Meuwly JY, Bischof-Delaloye A. Radionuclide investigations of urinary tract in the era of multimodality imaging. J Nucl Med. 2006;47(11):1819-36.
4. Asaidi M, Eftekhari M, Hozhabrosadati M, Saghari M, Ebrahimi A, Nabipour I, et al. Comparison of methods for determination of glomerular filtration rate: raw and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. Int Urol Nephrol. 2008;40(4):1059-65.
5. Ilhan H, Wang H, Gildehaus F, Wangler C, Herrler T, Todica A, et al. Nephroprotective effects of enalapril after [177Lu]-DOTATATE therapy using serial renal scintigraphies in a murine model of radiationinduced nephropathy. EJNMMI Res. 2016;6:64
6. Blum ES, Porras AR, Biggs E, Tabrizi PR, Sussman RD, Sprague BM, et al. Early detection of ureteropelvic junction obstruction using signal analysis and machine learning: a dynamic Solution to a dynamic Problem. J Urol. 2017;199(3):847-52.
7. Fahey FH, Bom HH, Chiti A, Choi YY, Hunag G, Lassman M, et al. Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 1-statement of the issue and a review of available resource. J Nucl Med. 2015;56(4):646-51.
8. Fahey FH, Bom HH, Chiti A, Choi YY, Hunag G, Lassman M, et al. Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 2-current standards and the path toward global standardization. J Nucl Med. 2016;57(7):1148-57.
9. Gordon I, Piepsz A, Sixt R; Auspices of Paediatric Committee of European Association of Nuclear Medicine. Guidelines for standard and diuretic renogram in children. Eur J Nucl Med. 2001;28(6):1175-88.
10. Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging. 2008;35(9):1748.
11. Gelfand MJ, Parisi MT, Treves ST; Pediatric Nuclear Medicine Dose Reduction Workgroup. Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J Nucl Med. 2011;52(2):318-22.
12. Koizumi K, Masaki H, Matsuda H, Uchiyama M, Okuno M, Oguma E, et al. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures. Ann Nucl Med. 2014;28(5):498-503.
13. Heikkinen JO. New automated physical phantom for renography. J Nucl Med. 2004;45(3):495-9.
14. Sabbir Ahmed AS, Demir M, Kabasakal L, Uslu I. A dynamic renal phantom for nuclear medicine studies. Med Phys. 2005;32(2):530-8.
15. Karagoz I, Erogul O. A new dynamic renal phantom and its application to scintigraphic studies for pixel basis functional radionuclide imaging. Med Eng Phys. 1998;20(6):473-9.
16. Nykanen AO, Rautio PJ, Aarnio JV, Heikkinen JO. Multicenter evaluation of renography with automated physical phantom. Nucl Med Commun. 2014;35(9):977-84.
17. Esteves PF, Taylor A, Manatunga A, Folks RD, Krishnan M, Garcia EV. 99mTc-MAG3 renography: normal values for MAG3 clearance and curve parameters, excretory parameters, and residual urine volume. AJR Am J Raentgenol. 2006;187(6):610-7.
18. Ikekubo K, Hino M, Ito H, Yamamoto K, Torizuka K. The phase I study of 99mTc-MAG3 injection, a dynamic renal imaging agent-evaluation of its safety and biodistribution in normal volunteers. Kaku Igaku. 1993;30(5):507-16.
19. Ishii K, Ishibashi A, Torizuka K. Phase I clinical study of 99mTc-MAG3. Kaku Igaku. 1993;30(2):181-8.
20. Taylor A, Eshima D, Fritzberg AR, Christian PE, Kasina S. Comparison of iodine-131 OIH and technetium-99m MAG3 renal imaging in volunteers. J Nucl Med. 1986;27(6):795-803.
21. Gibson P, Shammas A, Cada M, Licht C, Gupta AA. The role of Tc-99m DTPA nuclear medicine GFR studies in pediatric solid tumor patients. J Pediatr Hematol Oncol. 2013;35(2):108-11.
22. Hubertus J, Plieninger S, Martinovic V, Heinrich M, Schuster T, Burst M, et al. Children and adolescents with ureteropelvic junction obstruction: is an additional voiding cystourethorogram necessary? Results of multi center study. World J Urol. 2013;31(3):683-7.
23. Hsiao EM, Cao X, Zurakowski D, Zukotynski KA, Drubach LA, Grant FD, et al. Reduction in radiation dose in mercaptoacetyltriglycerine renography with enhanced planar processing. Radiology. 2011;261(3):907-15.
24. Smith T, Zanelli D, Veall N. Radiation absorbed dose from technetium-99m DTPA. J Nucl Med. 1987;28(2):240-3.
25. Hazar V, Gungor O, Guven AG, Aydin F, Akbas H, Gungor F, et al. Renal function after hematopoietic stem cell transplantation in children. Pediatr Blood Cancer. 2009;53(2):197-202.
26. Filler G, Sharma AP. How to monitor renal functions in pediatric solid organ transplant recipients. Pediatr Transplant. 2008;12(4):393-401.
27. Boubaker A, Prior JO, Meyrat B, Bischof Delaloye A, McAleer IM, Frey P. Unilateral ureteropelvic junction obstruction in children: long-term followup after unilateral phyeloplasty. J Urol. 2003;170(2):575-9.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 7, Issue 1
January 2019
Pages 38-48

Files

Share

How to cite

Statistics