THE KIDNEYS AND HYPERTENSION
Guest Editor: Blaufox M. D. 

The Quarterly Journal of Nuclear Medicine 2002 December;46(4):249-67

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

The basics of renal imaging and function studies

Durand E., Prigent A.

Biophysique et Médecine Nucléaire, C.H.U. Bicêtre Université Paris XI, Assistance Publique - Hôpitaux de Paris Le Kremlin-Bicêtre, France

­Many radio­tracers are avail­able for ­kidney ­studies. ­They are clas­si­fied ­into glo­mer­ular ­tracers (­DTPA, ­EDTA), ­tubular ­tracers (OIH, MAG3) and cor­tical ­tracers (­DMSA, GHA). ­Renal func­tion is ­best ­assessed by glo­mer­ular fil­tra­tion ­rate. ­Camera ­studies pro­vide a rel­a­tive func­tion assess­ment, ­whereas clear­ance tech­niques pro­vide a pre­cise and reli­able assess­ment of abso­lute ­renal func­tion. The com­bi­na­tion of ­both there­fore ­gives a com­pre­hen­sive ­study of glo­mer­ular func­tion. ­Attempts to ­assess abso­lute func­tion ­from ­camera ­studies ­only ­resulted in ­gross inac­cu­racy. ­Tubular ­tracers ­have a ­higher extrac­tion ­rate. ­This ­could be ­used to esti­mate ­renal ­plasma ­flow (by ­assessing the effec­tive ­renal ­plasma ­flow), or to deter­mine rel­a­tive func­tion ­when ­renal func­tion is low, or to ­study the ­urine ­flow in the uri­nary ­tract. Cor­tical ­tracers pro­vide a ­high ­imaging ­quality. ­They are ­more ­adapted to infec­tion assess­ment and rel­a­tive func­tion meas­ure­ments. ­This paper ­reviews the ­most com­monly ­used ­tracers and ­their rela­tion­ship ­with ­renal phys­iology. Tech­niques for ­camera ­static and ­dynamic ­studies and ­plasma and uri­nary clear­ances are ­detailed. Pro­ce­dures ­follow the rec­om­men­da­tions of the ­most ­recent inter­na­tional con­sensus con­fer­ences on the ­topics.