Functional renal imaging: new trends in radiology and nuclear medicine.
The objective of this work is to compare the characteristics of various techniques for functional renal imaging, with a focus on nuclear medicine and magnetic resonance imaging. Even with low spatial resolution and rather poor signal-to-noise ratio, classical nuclear medicine has the advantage of linearity and good sensitivity. It remains the gold standard technique for renal relative functional assessment. Technetium-99m ((99m)Tc)-labeled diethylenetriamine penta-acetate remains the reference glomerular tracer. Tubular tracers have been improved: (123)I- or (131)I-hippuran, (99m)Tc-MAG3 and, recently, (99m)Tc-nitrilotriacetic acid. However, advancement in molecular imaging has not produced a groundbreaking tracer. Renal magnetic resonance imaging with classical gadolinated tracers probably has potential in this domain but has a lack of linearity and, therefore, its value still needs evaluation. Moreover, the advent of nephrogenic systemic fibrosis has delayed its expansion. Other developments, such as diffusion or blood oxygen level-dependent imaging, may have a role in the future. The other modalities have a limited role in clinical practice for functional renal imaging.
Biophysics and Nuclear Medicine, University Paris Sud, 78 Rue du Général Leclerc, Le Kremlin-Bicêtre Cedex, France. emmanuel.durand@u-psud.fr
Emmanuel
E
Durand
Philippe
P
Chaumet-Riffaud
Nicolas
N
Grenier
D000818:Animals; D003287:Contrast Media / Q000009:adverse effects; D003952:Diagnostic Imaging / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000502:physiology*; D009683:Nuclear Medicine / Q000379:methods* / Q000639:trends; D011849:Radioactive Tracers; D011859:Radiography; D011871:Radiology / Q000379:methods* / Q000639:trends; D011877:Radionuclide Imaging
D003287:Contrast Media; D011849:Radioactive Tracers