EANM Technologists’ Guide

Dynamic Renal Imaging (2009)

August 2009

Radionuclide evaluation of the genitourinary system includes quantitative estimates of renal perfusion and function. With the widespread use of ultrasound and computed tomography, the evaluation of renal anatomy by radionuclide imaging has diminished, and the role of nuclear renal imaging has become more confined to functional analysis. Indications for renal scanning include sensitivity to radiographic contrast material, assessment of renal blood flow, and differential or quantitative functional assessment of native and transplanted kidneys. Nuclear techniques have also proved of value in examining ureteral and renal pelvic obstruction, vesicoureteral reflux, and suspected renovascular hypertension.

The diagnoses of urinary tract obstructions and assessment of their functional significance are common indications for radionuclide imaging in adults and children. Obstruction may be suspected based on clinical findings or as an incidental finding of a dilated renal collecting system on IVP, CT, ultrasound or radionuclide renal imaging. Standard imaging techniques, such as IVP and ultrasound, evaluate structure but do not depict urodynamics. This technologist guide focuses on dynamic imaging techniques in obstructive renal pathology. Chapter 1 will bring a clear overview of renal anatomy and function. Chapter 2 is all about the radiopharmaceuticals we can use for dynamic renal imaging. Chapter 3 describes the patient preparation and the imaging protocol. Image and curve interpretation is included in chapter 4. The last chapter (5) is dedicated to special considerations for pediatric patients. I hope that this guide will provide a clearer understanding of dynamic renal imaging in obstructive renal pathology and can be a useful tool in your daily practice.

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