title: Utility of posterior oblique views in (99m)Tc-DMSA renal scintigraphy in children.
abstract: OBJECTIVE
  Procedure guidelines suggest that optimal (99m)Tc-dimercaptosuccinic acid (DMSA) planar scintigraphy of the kidney should include right and left posterior oblique views in addition to the posterior projection. However, in a small number of restless children, it is sometimes difficult to get 3 good-quality images. The aim of this study was to evaluate the prevalence of cases in which posterior oblique views were useful for interpreting (99m)Tc-DMSA renal scintigraphy.
  
  
  METHODS
  Three nuclear medicine specialists were asked to interpret 40 (99m)Tc-DMSA renal scans twice, first on the basis of the posterior projection only and then by using the posterior and the right and left posterior oblique views.
  
  
  RESULTS
  The oblique posterior views were considered useful by observers 1 and 2 for 4 kidneys and by observer 3 for 5 kidneys and were considered somewhat useful for up to 7 kidneys. The addition of oblique posterior views changed the interpretation on 5 occasions for observer 1, on 9 occasions for the observer 3, and on no occasion for observer 2. On average, therefore, changes in interpretation occurred for fewer than 6% of the kidneys. Moreover, no relationship was observed between the opinion of the clinicians that oblique views were useful and changes in the scintigraphic interpretations.
  
  
  CONCLUSIONS
  Oblique views were found useful in only a few cases and, even in these cases, did not significantly modify the interpretations. Therefore, when restless children are being imaged, the focus should be on obtaining a good posterior projection, even at the price of not having oblique posterior views.
authors.affiliation: Department of Nuclear Medicine, Centre Hospitalier Universitaire Saint Pierre, Brussels, Belgium.
authors.forename: Françoise
authors.initials: F
authors.lastname: Mannes
authors.forename: Edwige
authors.initials: E
authors.lastname: Bultynck
authors.forename: Nicole
authors.initials: N
authors.lastname: Van Roijen
authors.forename: Linda
authors.initials: L
authors.lastname: Van Der Mauten
authors.forename: Amy
authors.initials: A
authors.lastname: Piepsz
authors.forename: Hamphrey R
authors.initials: HR
authors.lastname: Ham
mesh_terms: D016477:Artifacts; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D009038:Motion; D015588:Observer Variation; D011187:Posture; D011595:Psychomotor Agitation; D011786:Quality Control; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014055:Tomography, Emission-Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid