Seminars in Nuclear Medicine
Volume 39, Issue 3 , Pages 156-173 , May 2009

A Renal Protocol for All Ages and All Indications: Mercapto-Acetyl-Triglycine (MAG3) With Simultaneous Injection of Furosemide (MAG3-F0): A 17-Year Experience

  • George N. Sfakianakis, MD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • Corresponding Author InformationAddress reprint requests to George N. Sfakianakis, MD, Department of Nuclear Medicine (D-57), University of Miami School of Medicine, PO Box 016960, Miami, FL 33101
    • ,
  • Efrosyni Sfakianaki, MD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Mike Georgiou, PhD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Aldo Serafini, MD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Shabbir Ezuddin, MD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Russ Kuker, MD

      Affiliations

    • Department of Nuclear Medicine, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Gaston Zilleruelo, MD

      Affiliations

    • Department of Pediatrics/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Jose Strauss, MD

      Affiliations

    • Department of Pediatrics/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Carolyn Abitbol, MD

      Affiliations

    • Department of Pediatrics/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Jayanthi Chandar, MD

      Affiliations

    • Department of Pediatrics/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Wacharee Seeherunvong, MD

      Affiliations

    • Department of Pediatrics/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Jacque Bourgoignie, MD

      Affiliations

    • Department of Medicine/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • David Roth, MD

      Affiliations

    • Department of Medicine/Nephrology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Raymond Leveillee, MD

      Affiliations

    • Department of Urology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Vincent G. Bird, MD

      Affiliations

    • Department of Urology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Norman Block, MD

      Affiliations

    • Department of Urology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Rafael Gosalbez, MD

      Affiliations

    • Department of Urology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Andrew Labbie, MD

      Affiliations

    • Department of Urology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Jorge J. Guerra, MD

      Affiliations

    • Department of Radiology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL
    • ,
  • Jose Yrizarry, MD

      Affiliations

    • Department of Radiology, University of Miami School of Medicine and Jackson Memorial Hospital, Miami, FL

References 

  1. Taylor A, Corrigan PL, Galt J, et al. Measuring Technetium-99m-MAG3 clearance with an improved camera-based method. J Nucl Med. 1995;36:1689–1695
  2. Taylor A. Radionuclide renography: A personal approach. Semin Nucl Med. 1999;29:102–107
  3. Scharf SC, Blaufox D. Radionuclides in evaluation of urinary obstruction. In:  Tauxe WN,  Dubovsky EV editor. Nuclear Medicine in Clinical Urology and Nephrology. New York: Apleton-Century-Crofts Eds; 1985;p. 95–105
  4. O'Reilly P, Testa HJ, Lawson RS, et al. Diuresis renography in equivocal urinary tract obstruction. Br J Urol. 1978;50:76–80
  5. Lockhart JL, Sfakianakis GN, Al-Sheikh W, et al. Animal model to study megaureters non-invasively. J Nucl Med. 1982;128:633–655
  6. Sfakianakis GN, Bourgoignie JJ, Jaffe D, et al. Single-dose captopril scintigraphy in the diagnosis of renovascular hypertension. J Nucl Med. 1987;28:1383–1392
  7. Sfakianakis GN, Damoulaki Sfakianaki E, et al. Single dose captopril scintigraphy in the neonate with renovascular hypertension: Prediction of renal failure, a side effect of captopril therapy. Biol Neonate. 1988;54:246–253
  8. Sfakianakis GN, Sfakianaki E, Bourgoignie J. Renal scintigraphy following angiotensin-converting enzyme inhibition in the diagnosis of renovascular hypertension (captopril scintigraphy). In:  Freeman LM,  Weissman HS editor. Nuclear Medicine Annual. New York: Raven Press; 1988;p. 125–170
  9. Sfakianakis GN, Bourgoignie JJ, Jaffe D. Single-dose captopril scintigraphy in the diagnosis of renovascular hypertension. Kidney Int. 1988;34(suppl 25):5142–5144
  10. Sfakianakis GN, Damoulaki-Sfakianaki E. Nuclear medicine in pediatric urology and nephrology. J Nucl Med. 1988;29:1287–1300
  11. Sfakianakis GN. Renal scintigraphy following angiotensin converting enzyme inhibition in the diagnosis of renovascular hypertension (captopril scintigraphy). J Nucl Med. 1989;17:160–166
  12. Sfakianakis GN, Sfakianaki E, Bourgoignie J. Lasix captopril renography in the diagnosis of renovascular hypertension. Radionucl Nephro- Urol. 1990;79:219–227
  13. Sfakianakis GN, Bourgoignie JJ. Renographic diagnosis of renovascular hypertension with angiotensin converting enzyme inhibition and furosemide. Am J Hypertens. 1991;4:707s–710s
  14. Erbsloh-Miller B, Dumas A, Roth D, et al. Furosemide-131I-Hippuran renography after angiotensin-converting enzyme inhibition for the diagnosis of renovascular hypertension. Am J Med. 1991;90:23–29
  15. Dunnick NR, Sfakianakis GN. Screening for renovascular hypertension. Radiol Clin North Am. 1991;29:497–510
  16. Sfakianakis GN. Nuclear medicine in congenital urinary tract anomalies. In:  Freeman LM editors. Nuclear Medicine Annual. New York: Raven Press; 1991;p. 129–160
  17. Sfakianakis GN, Vonorta K, Zilleruelo G, et al. Scintigraphy in acquired renal disorders. In:  Freeman LM editors. Nuclear Medicine Annual. New York: Raven Press; 1992;p. 157–224
  18. Sfakianakis GN, Bourgoignie JJ, Georgiou MF, et al. Diagnosis of renovascular hypertension with ACE-inhibition scintigraphy. Radiol Clin North Am. 1993;31:831–848
  19. Bourgoignie JJ, Rubbert K, Sfakianakis GN. Angiotensin converting enzyme inhibited renography for the diagnosis of ischemic kidneys. Am J Kidney Dis. 1994;24:665–673
  20. Sfakianakis GN, Zilleruelo G, Cavagnaro F, et al. A prospective comparative DMSA and MAG3 study in acute pyelonephritis. In:  Taylor A,  Nally JV,  Thompson H editor. Radionuclides in Nephrourology. Reston, VA: Society of Nuclear Medicine; 1997;p. 182–184
  21. Sfakianakis GN, Georgiou MF. MAG3 SPECT: A rapid procedure to evaluate the renal parenchyma. J Nucl Med. 1997;38:478–483
  22. Sfakianakis GN, Chandar J, Georgiou MF, et al. Diagnosis of renovascular hypertension from renal ischemia in children with the use of converting enzyme inhibition scintigraphy. Radionucl Nephrourol. 1997;101–104
  23. Chandar JJ, Sfakianakis GN, Zilleruelo GE, et al. ACE-inhibition scintigraphy in the management of hypertension in children. Pediatr Nephrol. 1999;13:493–500
  24. Sfakianakis GN, Carmona AJ, Sharma A, et al. Diuretic MAG3 scintirenography in children with HIV nephropathy: Diffuse parenchymal dysfunction. J Nucl Med. 2000;41:1037–1042
  25. Sfakianakis GN, Cavagnaro F, Zilleruelo G, et al. Diuretic MAG3 scintigraphy (F0) in acute pyelonephritis: The regional parenchymal dysfunction and comparison with DMSA. J Nucl Med. 2000;41:1955–1963
  26. Sfakianakis GN, Cohen DJ, Braunstein RH, et al. MAG3-F0 scintigraphy in decision making for emergency intervention in renal colic after helical CT positive for a urolith. J Nucl Med. 2000;41:1813–1822
  27. Sfakianakis GN, Sfakianaki E. Renal scintigraphy in infants and children. Urology. 2001;57:1167–1177
  28. Bird VG, Gomez-Marin O, Leveillee RJ, et al. A comparison of unenhanced helical computerized tomography findings and renal obstruction determined by furosemide 99m-Technetium mercaptoacetyl-triglycine diuretic scintirenography for patients with acute renal colic. J Urol. 2002;167:1597–1603
  29. Sfakianakis GN, Ihmeidan I, Kyriakides G, et al. Renal blood flow transit time in the study of renal transplants. J Nucl Med. 1985;26:81
  30. Sfakianakis GN, Vuong H, Tapia M, et al. A comprehensive technique for the evaluation of renal transplants with MAG3. J Nucl Med. 1997;38:296
  31. Vuong H, Sfakianakis GN, Tapia M, et al. Comparison of the scintigraphic flow velocity index with the sonographic resistive index in the evaluation of complications of renal transplants. J Nucl Med. 1997;38:49P
  32. Sfakianakis GN, Tapia-Palacios , Gomez-Marin O, et al. MAG3 scintirenography to differentiate ATN, rejection, and nephrotoxicity in renal transplants. J Nucl Med. 1999;40:93P
  33. Slonin JH, Sfakianakis GN. A simplified method for evaluating renal function in 99mTc- MAG3 renography. J Nucl Med. 2001;42:349
  34. Sfakianaki E, Panagakos GM, Rodriquez JA, et al. Evaluation of obstruction in patients with extrarenal pelvis using time zero diuretic renography. J Nucl Med. 2003;44:359
  35. Sfakianaki E, Sfakianakis GN, Mehan A, et al. The predictive value of ACE-inhibition diuretic renal scintigraphy for the effect of angioplasty on renovascular hypertension. J Nucl Med. 2004;45:186P
  36. Arcila GA, Sfakianakis GN, Zilleruelo G, et al. MAG3- F0 scintirenography in the study of children with HIV nephropathy (HIVN) and its response to anti-retroviral therapy (ART). J Nucl Med. 2005;46:22P
  37. Kuker RA, Sfakianakis GN, Poertner S, et al. Novel method to evaluate renal function using MAG3-Fo scintirenography. J Nucl Med. 2006;47:146P
  38. Georgiou MF, Sfakianakis GN. An alternative method for calculation of the split renal function in cases with unilateral severe obstruction. J Nucl Med. 2006;47:359P
  39. Hsiao B, Sfakianaki E, Bird VG, et al. Utilization of MAG3-Fo scintigraphy for stratification of renal colic patients: A practical and social issue. J Nucl Med. 2007;48:126P
  40. Sfakianakis GN, Heiba S, Ganz WI, et al. Diuretic renography with early injection of furosemide, a reliable and cost effective approach. J Nucl Med. 1989;30:841
  41. Sfakianakis GN, Georgiou MS, Cavagnaro F, et al. fast protocols for obstruction (diuretic renography) and for renovascular hypertension (ACE-inhibition). J Nucl Med Technol. 1992;20:193–206
  42. Rubbert-Slawek KA, Sfakianakis GN, Bourgoignie J, et al. Clinical experience with a 1 hour single-visit MAG3-Lasix-Enalaprilat scintigraphy for RVH. J Nucl Med. 1994;35:266P
  43. Sfakianakis GN, Cole C, Georgiou MF, et al. Optimal timing of diuretic administration in diuretic renography. J Nucl Med. 1999;40:51P
  44. Sfakianakis GN, Sfakianaki E, Georgiou MF, et al. A renal protocol for all indications: MAG3 with simultaneous injection of Furosemide (MAG3-F0): A fifteen year experience. J Nucl Med. 2007;48:125P
  45. Wong DC, Rossleigh M, Farnsworth RH. F+0 diuresis renography in infants and children. J Nucl Med. 1999;40:1805–1811
  46. O'Reilly P, Aurell M, Britton K, et al. Consensus for diuresis renography for investigating the dilated upper urinary tract, Paper on Obstruction. J Nucl Med. 1996;37:1872–1876
  47. Taylor A, Nally J, Aurell M, et al. Concensus report on ACE-Inhibitor scintigraphy for detecting renovascular hypertension. J Nucl Med. 1996;37:1876–1882
  48. Dubovsky EV, Russell CD, Bischof-Delaloye A, et al. Report of radionuclides in nephrourology committee for evaluation of transplanted kidney (review of techniques). Semin Nucl Med. 1999;29:175–188
  49. Members of the Society of Fetal Urology and Pediatric Nuclear Medicine Council Members, Society of Nuclear Medicine. The well tempered diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. J Nucl Med. 1992;33:2047–2051
  50. Kalika V, Bard R, Iloreta A, et al. Prediction of renal functional recovery after relief of upper urinary tract obstruction. J Urol. 1981;126:301–305
  51. Grattan-Smith JD, Perez-Bayfield MR, Jones R, et al. MR imaging of kidneys: Functional evaluation using F-15 perfusion imaging. Pediatr Radiol. 2003;33:293–304
  52. Drach GW. Transurethral stone manipulation. Urol Clin North Am. 1983;10:709–717

PII: S0001-2998(08)00135-9

doi: 10.1053/j.semnuclmed.2008.11.001

Seminars in Nuclear Medicine
Volume 39, Issue 3 , Pages 156-173 , May 2009

Article Tools

* Image Usage & Resolution