title: Influence of early (F+0) intravenous furosemide injection on the split renal function using 99mTc-DTPA renography.
abstract: In busy nuclear medicine departments, the F+0 protocol for diuretic renography is routinely used to shorten the acquisition time. The aim of this study was to evaluate the influence of the F+0 protocol on the split renal function (SRF) during a dynamic renal scan using technetium-99m diethylene triamine pentaacetic acid (Tc-DTPA) compared with that using the standard technetium-99m dimercaptosuccinic acid (Tc-DMSA). A total of 102 patients referred for a dynamic renal scan for varied etiologies were divided into two groups: the F+0 group, comprising 53 patients who were injected with furosemide just before Tc-DTPA injection, and the F+10 group, comprising 49 patients who were injected with the diuretic at the 10th minute after radiotracer injection. All patients were also subjected to a static cortical Tc-DMSA scan with geometric quantification of SRF. A highly significant statistical difference (P<0.001) was obtained on comparing the mean value of the difference in SRF calculated using DTPA and DMSA between the F+0 and F+10 groups, being 5.0±2.6 and 1.5±0.6%, respectively. All 49 patients in the F+10 group had a difference in split function of 5% or less, whereas 17/53 patients representing 32.1% of the F+0 group had a difference in SRF of greater than 5%. Early (F+0) furosemide injection before administration of Tc-DTPA has a significant influence on the estimation of SRF of the diseased kidney (either obstructed or functionally impaired) when compared with furosemide injection after standard Tc-DMSA administration. Care should be taken during interpretation of the scan findings when accurate split function is required.
authors: Department of Nuclear Medicine, Kasr Al-Einy Hospital, Cairo University, Cairo, Egypt. ahmedkandeel@yahoo.com
authors: Ahmed A
authors: AA
authors: Kandeel
authors: Salwa A
authors: SA
authors: Elhossainy
authors: Nahla D
authors: ND
authors: Elsayed
mesh_terms: D000328:Adult; D016477:Artifacts; D005260:Female; D005665:Furosemide / Q000008:administration & dosage* / Q000494:pharmacology*; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D011866:Radioisotope Renography / Q000379:methods*; D012189:Retrospective Studies; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D005665:Furosemide; D016284:Technetium Tc 99m Pentetate