Consensus report on quality control of quantitative measurements of renal function obtained from the renogram: International consensus committee from the scientific committee of radionuclides in nephrourology
Among all the physiological indices that can be quantified using renography, measurement of renal function is the most basis. These measurements are used to make critical clinical management decisions and, as such, their reliability needs to be quality assured. This article seeks to address each aspect of the renography procedure, with particular emphasis on the effect on measurement of relative renal function. Estimation of individual kidney function is mentioned, but only briefly. A consensus approach was adopted, overseen, and directed by a chairman appointed by the Scientific Committee of the International Radionuclides in Nephro-Urology Group. The chairman selected the panel of experts from eight different countries based on their practical experience in the field. Where evidence exists to support the various recommendations it is given. Otherwise, the stated guidance represents the considered opinion of a body of experts, based on long experience and unpublished data. Some necessary compromises were made to account for the fact that renography is seldom performed solely with the purpose of measuring relative renal function. The technicalities of renography have always been a source of debate in nuclear medicine, which is reflected by the fact that a consensus could simply not be reached on a small number of issues. The structure of the report ensures that these are clearly indicated. This should serve to highlight gaps in our current knowledge, thus helping to direct future research. It is envisaged that the recommendations will be revised on a 2-year cycle to ensure that they remain up to date. An “open” process will be used to encourage participation and ownership. It is hoped that promotion of these guidelines, suitably complemented by audit processes, will raise standards in the practice of gamma camera renography.
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aBiophysics and Nuclear Medicine Department, University Hospital Center of Bicêtre, Assistance Publique-Hôpitaux de Paris, France
bMedical Physics Department, Pilgrim Hospital, Boston, United Kingdom
cDepartment of Nuclear Medicine, St Vincent Medical Center, Portland, OR USA
dDepartment of Clinical Physiology, University Hospital, Linköping, Sweden
eNuclear Medicine Department, Jacobi Medical Center, New York, NY; USA
fDepartment of Radiology, Sapporo JR Hospital, Sapporo, Japan
gDepartment of Diagnostic Radiology, Hammersmith Hospital, London, United Kingdom
nDepartment of Pediatrics, AZ-VUB, Brussels, Belgium
iDepartment of Clinical Physiology and Nuclear Medicine, Skejby University Hospital, Århus, Denmark
kNuclear Medicine, Auckland Hospital, Auckland, New Zealand
lDepartment of Radiology, Division of Nuclear Medicine, Emory University School of Medicine, Atlanta, GA. USA
Address reprint requests to Alain Prigent, MD, Biophysics and Nuclear Medicine Department, University Hospital Center of Bicêtre, 78 rue du General Leclerc, 94275 le Kremlin Bicêtre, France.