Indications

: Demonstrate kidney size ,shape and position Demonstrate renal tissue function Demonstrate unvisualized kidney in US Demonstrate ectopic kidney Demonstrate space occupying lesion (SOL) Demonstrate renal scarring

99mTc-labeled DMSA (2,3-dimercaptosuccinic acid) is taken up by cells of the proximal tubule with about 35% of the injected activity being localized (bound) in the renal cortex by one hour and 50 % by 6hrs. Adult dose : 2-5 mCi I.V Post injection time 2 hrs Views: ( 5 min per view ) Ant ,post, LPO ,RPO Peak 140 kv. window :20% Collimator : LEHR

 Analysis

: Calculate divided renal function .

 Indications

: Evaluation of renal perfusion and function . Detection of renal collecting system obstruction Renal evaluation for pt with allergy to contrast media Evaluation for renal transplant pt. R/O of reflux

 99mTc-DTPA
Diethylenetriaminepenta-acetic

acid (DTPA) Its molecular characteristics are such that it is cleared from the plasma purely by glomerular filtration 99mTc-MAG3 is preferred for routine renography but DTPA is used when estimating individual kidney GFR (in ml/min) from the renogram .

 99mTc-MAG3
(mercaptoacetyltriglycine) Mainly

tubular function agent Technetium-99m-MAG3 is now the agent of choice for all renographic procedures.

 Adult

dose : Tc DTPA :15-20 mCi I.V Tc-MAG3 : 8-10 mCi I.V Scanning time : immediate for 30 min. Lasix : After 15 min

Provides valuable diagnostic information in the distinction between renal pelvis dilatation and an actual renal pelvis obstruction.

Normal renogram, showing first, second, and third phases.

timeactivity curve (TAC)

perfusion first 2 min . 2 uptake from 2- 6 min 3 excerction after 6 min

 Peak

140 kv Window 20% Collimators : LEAP Frames : 1F/2 sec for 2 min 1F/20 sec for 28 min o views : posterior ( ant . In case of transplant kidney )

 Indications

: Determine of thyroid size ,function and position Evaluation of thyroid nodules Quantitative thyroid uptake Detection of ectopic thyroid tissue Base line for treatment for hyperthyroidism Detection of remnant thyroid tissue post surgery.

Common radionuclides used in thyroid diagnosis and imaging

Nuclide Half-life
Decay Process

I-131

(NaI)

I-123

(NaI)

Tc-99m
(TcO4-)

8 days
Beta 364 keV 81%

13 hours
EC 159 keV 85%

6 hours
IT 140 keV 89%

Principle Abundance

 No

fasting for Tc scanning Fasting at least 3 hrs before uptake study. Off iodine containing drugs including contrast media . The minimum interval between iodine administration and scanning from 1 to 2 weeks , and between IVU or CT should be 4-6 weeks.

 Iodine

containing medications Iodine containing foods Thyroid hormones Anti thyroid drugs Recent radiopharmaceuticals Recent iodinated contrast media

 1-

for sodium pertechnetate NaTcO4 3- 5 mCi I.V 2- for iodine uptake ( 50-100 micro Ci ) of I-131 orally ( scan + uptake ) I-123 sodium iodine(500 Ci) 4-6 hr post Oral or intravenous 123I is cyclotron-produced and has a relatively short half-life of 13.6 hours, it is more expensive.

 Scanning

time : 99m TcO4 : 20 min post injection I- 131 : 24 hrs Peak 140 kv Tc and 364 kv for I-131 Window 20 % Collimator : pin hole for magnification Imaging time : 10 min per view Views : Ant , LAO , RAO

STANDARD

PATIENT

1 Capsule Method (Thyroid count thigh count ) * DCF Standard count room background * 100 = % uptake

Diagnostically, I-131 is generally reserved for whole body imaging in patients with known Hx of thyroid carcinoma

After initial therapy of differentiated thyroid carcinomas (thyroidectomy and iodine-131 ablation of residual thyroid tissue) follow-up is currently based on periodic whole-body scintigraphy.

Metastatic surveys 5-10 mCi for whole body imaging Imaging 3-7 days post