title: Comparison of planar DMSA scan with an evaluation based on SPECT imaging in the split renal function assessment.
abstract: BACKGROUND
  Validation of the 99mTc-DMSA planar scintigraphy accuracy for split renal function assessment and comparison with evaluation based on SPECT imaging both with and without CT attenuation correction.
  
  
  METHODS
  For split renal function assessment two methods were used: A) planar scintigraphy based on anterior and posterior projections using correction for kidney depth calculated by the geometric mean; B) semi-quantitative evaluation based on SPECT (B1) and attenuation-corrected SPECT/CT (B2) images using locally developed software for kidney segmentation and voxel-based analysis. All three methods were performed with a phantom simulating body including pair of kidneys. For patient study methods A and B1 were applied on a group of 140 children and adolescents with various renal diseases. Renal function ratios were compared both mutually and with physically measured activity ratios in the phantom.
  
  
  RESULTS
  Method A provided results which were closest to measured reference values (average absolute difference of 0.9 percentage points [pp]). Method B1 was noticeably worse (2.1pp), whereas attenuation correction (B2) improved tomography results considerably (1.3 pp). The superiority of planar imaging could be caused among others by differences in creation of planar range of interest compared to tomographic volume of interest. However all the differences were under the threshold of any clinical importance. The comparison between method A and B1 based on patient study also showed differences mostly of none clinical importance.
  
  
  CONCLUSIONS
  Routine evaluation of split renal function using planar technique with correction of the kidney depth is at least equivalent to tomographic evaluation, and there is no need to update the established clinical practice.
authors: Department of Nuclear Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague,. Daniela.Chroustova@vfn.cz.
authors: Daniela
authors: D
authors: Chroustová
authors: Jirí
authors: J
authors: Trnka
authors: Veřa
authors: V
authors: Šírová
authors: Ivana
authors: I
authors: Urbanová
authors: Jan
authors: J
authors: Langer
authors: Jozef
authors: J
authors: Kubinyi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D019047:Phantoms, Imaging; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019783:Technetium Tc 99m Dimercaptosuccinic Acid
keywords: 3D SPECT method analysis; childhood; split renal function ratio; static renal 99mTc-DMSA scintigraphy