DTPA and MAG3 scintigraphy in acute renal allograft dysfunction: comparison of diagnostic values

Abstract

AimTo compare scintigraphic renal function parameters according to the radiopharmaceuticals used in acute renal allograft dysfunction and to evaluate their value in early diagnosis. MethodsRenal scintigraphy, Doppler ultrasonography, and renal biopsy were conducted on 28 patients (20 males, 8 females; mean age 33 ± 2 years) with the diagnosis of acute renal dysfunction (ARD). Renal scintigraphy was done by using two different radiopharmaceuticals (Tc-99m DTPA and Tc-99m MAG3) on each patient, on consecutive days. On both days the serum creatinine, blood urea nitrogen, total protein, albumin, and cyclosporine A/tacrolimus levels were measured and creatinine clearance was calculated from blood and the 24-hour urine. On scintigraphic evaluation, the peak to plateau ratio (PPR), Hilson perfusion index (HPI), delta-p (ΔP), vascular washout, transplant perfusion and function index, uptake (R/B), peak time (Tmax), peak half time (T½), and parenchymal retention (R 20/3) parameters were used. The difference between the parameters of both scintigraphic evaluation groups were statistically analysed. ResultsWhile the difference between HPI and R20/3 values was not statistically significant (P > .05), the difference between Tmax and R/B values was found to be significant (P < .05). The most sensitive parameter was found to be PPR for the Tc-99m DTPA group and R/B for the Tc-99m MAG3 group. The sensitivity of Tc-99m DTPA and Tc-99m MAG3 renal scintigraphy studies in determining deterioration of the renal functions was found to be 75% and 57.1%, respectively. ConclusionWhen perfusion and parenchymal function parameters were evaluated together, it was concluded that the performance of Tc-99m DTPA was better in early diagnosis of renal allograft dysfunction.

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