Renal Scintigraphy in the Acute Care Setting
Section snippets
Time-Zero Diuretic Renal Scintigraphy Protocol (MAG3-F0)
The MAG3-F0 protocol has been in use at our institution for the past 2 decades. It is an ideal protocol because it is safe, fast, easy, convenient for both the patient and the technologist, cost effective, reproducible, and can be used for all renal scintigraphy indications. Mercaptoacetyltriglycine (MAG3) is currently the most efficient radiopharmaceutical approved by the Food and Drug Administration for renal dynamic studies.1, 2 It is mainly a tubular agent with a high overall extraction
Colic
A significant number of emergency room (ER) visits are attributed to renal colic. In the United States, each year, over half a million people seek care in the ER and almost 3 million visits are made to healthcare providers for kidney stone problems.8 The economic impact is enormous, with an estimated $5 billion spent each year in the United States for hospitalizations, procedures to remove stones, and time lost from work.9 It is estimated that 13% of men and 7% of women will be diagnosed with a
Conclusion
In the current practice of medicine, there are many imaging choices for the workup of acutely ill patients. MAG3-F0 diuretic renography is a simple protocol that provides both functional and anatomic information with relatively low radiation dose to the patient. It can be used in adults and children, in native and transplant kidneys, and even in patients with compromised renal function. In this article, we have highlighted the possible applications of renal scintigraphy in the acute care
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Cited by (19)
Role of Functional SPECT and PET in Renal Emergencies
2023, Seminars in Nuclear MedicineACR Appropriateness Criteria® Acute Pyelonephritis: 2022 Update
2022, Journal of the American College of RadiologyCitation Excerpt :According to the literature, renal scintigraphy, specifically Tc-99m DMSA scan, is not beneficial for the diagnosis of APN in adults. In contrast, renal scintigraphy is useful in the pediatric population where there is difficulty in differentiating lower UTI from APN [23]. However, differentiation of lower UTI from APN is less problematic in adults, and pediatric vesicoureteral reflux often resolves in adulthood.
Imaging of Nontraumatic Upper Urinary Tract Emergencies
2020, Seminars in RoentgenologyRadionuclides Diagnostic Techniques
2019, Critical Care Nephrology: Third EditionACR Appropriateness Criteria<sup>®</sup> Acute Pyelonephritis
2018, Journal of the American College of RadiologyCitation Excerpt :Additionally, it is also more difficult to establish the diagnosis on clinical grounds in diabetics because as many as 50% will not have the typical flank tenderness that helps to differentiate pyelonephritis from LUT infection in an otherwise healthy patient [3,4]. Additional higher-risk populations may include those with an anatomic abnormality of the urinary tract, vesicoureteral reflux, renal obstruction, pregnancy, nosocomial infection, infections by treatment-resistant pathogens, transplant recipients, and immunosuppressed patients [5]. Treatment goals include symptom relief, elimination of infection to avoid permanent renal damage (which may lead to scarring, hypertension, and end-stage renal disease), and identification of any precipitating factors to avoid future recurrences [5].
SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0
2018, Seminars in Nuclear MedicineCitation Excerpt :Larger stones (5-8 mm) may not be associated with high-grade obstruction and can be managed conservatively, whereas some small stones (3-5 mm) do result in high-grade obstruction and may need more aggressive management. Obtaining a diuretic renal scan to determine the presence or absence of obstruction while the patient is in the emergency room has been shown to direct patient management.39,40,98,99 One study found that the scan changed the decision to admit or discharge the patient in 30% of cases.99