Nephrourology and nuclear medicine today
Estorch Cabrera, M.; Carrió Gasset, I.
Archivos Espanoles de Urologia 54(6): 637-648
2001
ISSN/ISBN: 0004-0614 PMID: 11512405 Document Number: 536961
To review the radioisotope studies in Nephrourology that are frequently performed in the Nuclear Medicine Department, their clinical applications and diagnostic yield. Radionuclide studies in Nephrourology allow evaluation of different aspects of renal function after intravenous injection of radioisotopes by blood volume/time (ml/min) measurements (glomerular filtration rate, effective renal plasma flow) or visualization in the form of images or graphic display (renal scintigraphy, sequential study, renography) that permit determination of the differential renal function. A sequential study, diuresis renography or angiotensin converting enzyme (ACE) inhibitor renography can be performed to evaluate the changes in renal function induced by the diuretics or ACE inhibitors. Radionuclide cystography permits detecting vesicoureteric reflux. These radioisotope studies are commonly utilized in detecting reflux nephropathy and renal scarring (renal scintigraphy and radionuclide cystography), obstructive nephropathy (diuresis renography), renovascular hypertension (ACE inhibitor renography) and in evaluating renal transplantation (sequential study, renography, diuresis renography and ACE inhibitor renography). Radionuclide studies have different applications in Nephrourology, some of which are considered to be diagnostic gold standards, such as renal scintigraphy with DMSA to detect cortical anomalies, ACE inhibitor renography to identify hypertensive patients that will not benefit from revascularization surgery and to determine the glomerular filtration rate. Other studies, such as diuretic renography, are not considered to be gold standards due to the lack of standardized protocols.