title: A New Quantitative Index for Baseline Renal Transplant Scintigraphy With 99mTc-DTPA in Evaluation of Delayed Graft Function and Prediction of 1-Year Graft Function.
abstract: OBJECTIVE
  The aims of this study were to assess quantitative indices of baseline renal transplant scintigraphy (RTS) with Tc-DTPA for evaluation of delayed graft function (DGF) and prediction of 1-year graft function and to describe a new inclusive index for RTS.
  
  
  METHODS
  A total of 179 patients to whom RTS with Tc-DTPA was performed within 2 days after kidney transplantation were analyzed retrospectively. Hilson perfusion index, perfusion time (ΔP), peak-to-plateau ratio, peak perfusion-to-iliac artery ratio, T½ of graft washout, peak perfusion-to-uptake ratio, and ratio of uptake at 20 to 3 minutes (R20/3) were obtained. In addition, we first described the following formula defined as graft index (GI): GI = (ΔP × arterial peak × plateau)/(perfusion peak × uptake at 3 minutes). At 1 year, a serum creatinine level of more than 1.5 mg/dL was considered to be abnormal. Mann-Whitney U, Spearman coefficient of correlation test, and receiver operating characteristic curve were used for statistical analyses. P < 0.05 was considered statistically significant.
  
  
  RESULTS
  Mean values of all the indices were significant. The most accurate, sensitive, and specific index for both identification of DGF and prediction of 1-year serum creatinine level of more than 1.5 mg/dL was GI. Area under the curve of GI was 0.94 for identification of DGF and 0.79 for 1-year prediction.
  
  
  CONCLUSIONS
  The question is, "Which index is the best indicator?" This study demonstrated that the parameters of ΔP, plateau, arterial peak, perfusion peak, and uptake at 3 minutes of RTS could be assessed together by the formula of GI, which provides more accurate information to identify DGF and predict 1-year graft function.
authors.affiliation: From the *Department of Nuclear Medicine, †Division of Nephrology, Department of Internal Medicine, and ‡Department of Surgery, Ege University Medical Faculty, Izmir, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Yazici
authors.forename: Aylin
authors.initials: A
authors.lastname: Oral
authors.forename: Cenk
authors.initials: C
authors.lastname: Gokalp
authors.forename: Aysegül
authors.initials: A
authors.lastname: Akgün
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Hoscoskun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D051799:Delayed Graft Function / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate
chemical_list: D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate