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Diuretic decision s...
Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography
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- Bäck, Anna, 1976- (författare)
- Örebro universitet,Institutionen för hälsovetenskaper,Department of Radiology
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- Savvopoulos, C. (författare)
- Department of Radiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Funk, Eva, 1953- (författare)
- Örebro universitet,Institutionen för hälsovetenskaper,Division of Medical Diagnostics
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- Geijer, Håkan, 1961- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Radiology
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(creator_code:org_t)
- 2018-09-18
- 2018
- Engelska.
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer. - 1619-7070 .- 1619-7089. ; 45:Suppl. 1, s. S765-S765
- Relaterad länk:
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https://link.springe...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Aim: The F+10 method in supine position, which has been implemented at our Nuclear Medicine department since 2015, involves a 30- minute long dynamic acquisition. The diuretic is only administered when necessary and decision is taken by the radiographers in a semi-automated fashion without consulting a physician, by calculating the remaining activity in the kidneys seven minutes post 99mTc-MAG3 injection and comparing the value with an arbitrary threshold of 75 %. If needed, the diuretic is injected three minutes later. The aim of this study was to correlate our method with the established previously used F+20 protocol in adults. Is the currently used threshold of 75% of activity left in any kidney at seven minutes the optimal cut-off value for diuretic administration?Material and Methods: This is an ongoing retrospective study which include 320 F+20 examinations of adult patients performed during 2013-2015. They were all re-evaluated according to the currently used F+10 method, categorized as requiring diuretic or not and correlated to the original F+20 examination. A ROC-curve was drawn to delineate the best cut-off value for remaining renal activity. Sensitivity, specificity and accuracy were calculated.Results: Preliminary results indicate that the F+10 re-evaluations with the currently used cut-off value of 75% did not correlate with the original F+20 examinations. In 80% (255 examinations) of the F+10 re-evaluations diuretic would have been considered necessary while only 52% (167 examinations) received diuretics in the original F+20 renographies (sensitivity 1.0, specificity 0.42). However, all the patients who required furosemide in the original F+20 renographies would have received diuretic if they had been imaged with the F+10 protocol. Furthermore, examination time is considerably reduced. After an evaluation of the ROC-curve the optimal cut-off value was 94% (sensitivity 0.92, specificity 0.84, accuracy 0.88). However, by implementing this value, 13 patients (4%) would have been falsely categorized as not requiring diuretic.Conclusions: The 99mTc-MAG3 renography with the F+10 protocol in supine position is a feasible and acceptable method in clinical practice.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
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