Renal scintigraphy is a diagnostic procedure of choice or a complementary imaging modality in the workup of infants and children/adults with urologic or nephrologic problems. New radiopharmaceuticals and techniques and expert interpretation provide unique renal parenchymal and collecting system functional and anatomical information, which helps in the diagnosis and follow up of congenital or acquired kidney disorders and the quantitation of renal function.
So far we have performed more than 1000 renal procedures in the department of nuclear medicine and PET CT of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre and MRC, Belagavi.
What is renal nuclear medicine scan?
A renal nuclear medical scan is used to diagnose certain kidney diseases. It shows not only what the kidneys look like, but also how well they work. This helps to pinpoint certain health issues much sooner than with other methods.
In this test, images are made to see how blood flows into and out of the kidneys. It shows how urine flows through the kidneys, ureters and bladder. Also, it can estimate how much each kidney is helping to clean the blood! It is important to know how kidneys work.
With Nuclear Medicine Imaging (NMI), it can find the cause of reduced kidney function. For example, it shows problems due to a disease, obstruction (a blockage), or injury.
Before this test, pregnant or nursing mothers should intimate prior hand, and on any medications should be known.
During this test a “tracer” is injected into one of the veins. The tracer has a radioactive “tag” so that it can be followed in the body with special detectors. Right after the tracer is injected, the imaging will begin. A special gamma camera is used to track the radioactivity. Images may be shown on a PC screen and then stored on film.
This test is performed in a hospital or in a health care provider’s office by a nuclear medicine technologist.
After the test
The NM Renal Scan can take 45 minutes to 3 hours, based on the goals of the test. The patient can resume normal activities after completion of the test, as the tracer is removed from the body naturally in urine. This test is safe because it does not have the risk of toxicity or allergic reaction as with IV dyes. Also, it exposes to less radiation than with an X- ray
Various Indications to ponder over for referring physicians:
A. All uropathies, which require evaluation of an individual renal function at diagnosis and during the different phases of surgical or conservative treatment and evaluation of the drainage function. Examples include dilatation immaterial of the cause (e.g. pelvi-ureteric and vesico-ureteric stenosis), bladder dysfunction, complicated duplex kidney, post-trauma, asymmetrical renal function and reflux nephropathy.
B. When dilatation of the collecting system exists, the standard renogram should be complemented by a diuretic renogram.
C. Preceding indirect radionuclide cystography (IRC).
D. Evaluation of sustained systemic hypertension. If the renovascular disease is suspected then angiotensin-converting enzyme (ACE) inhibitor provocation may be used.
E. Renal trauma.
F. Follow-up of renal transplantation. Here the activity of tracer may be increased and a rapid acquisition is required.
There are no contraindications. However, there are limitations: in the presence of poor renal function, accurate estimation of DRF and/or drainage may not be possible. In the presence of marked hydronephrosis, the interpretation of poor drainage is difficult since this could be due to either “partial hold-up” or simply because of the reservoir effect of the dilated system. In the presence of calculus obstruction, a renogram may be undertaken but no furosemide should be administered.