Abstract: Cardio-renal pathophysiology is increasingly investigated in cardiovascular disease but, to our knowledge, no single tool is available for simultaneous imaging and quantitation of cardiac and renal function. Previous observations with Sestamibi suggested that 99mTc tracers may offer the possibility to combine renal and cardiac imaging. Aim of the study was to investigate the feasibility of a cardio-renal single shot study using Tetrofosmin. Methods. Thirtheen patients (8 M, 5 F, mean age 65yr) scheduled for double-day Gated SPECT for cardiac purposes underwent rest dynamic renal imaging after injection of 370 MBq of Tetrofosmin. All patients gave their consent to undergo also a DTPA scintigraphy (74 MBq)1 week apart from Gated SPECT. In 6 patients a Tetrofosmin renal study was also made with adenosine infusion. In all studies, a first pass transit was followed by a renographic phase. For both tracers the renal uptake index as a percentage of the injected dose (UI), the separate renal uptake as a percentage contribution of each kidney to total uptake (SRU), time to peak (TP) and the retention index (20min activity/peak activity, RI) were calculated. Results. Qualitative analysis: compared to DTPA, Tetrofosmin allowed a better renal visualization with a clear upslope phase and peak followed by a washout phase frequently delayed on the right side due to an increasing liver activity. Quantitative analysis: compared to DTPA, Tetrofosmin showed a higher renal uptake on both kidneys (p<0.01); no significant differences were appreciable for SRU or TP whereas a higher right kidney RI was found with Tetrofosmin. Tetrofosmin UI significantly correlated with DTPA UI (p<0.001), serum creatinine (p<0.05) and the Doppler index of renal vascular resistances (p<0.02). Tetrofosmin and DTPA SRU were also significantly correlated (p<0.01). In the 6 patients who underwent the adenosine study a reduction of Tetrofosmin UI (p<0.02) was observed when compared with the baseline study. Conclusions. In cardiovascular patients Tetrofosmin allows the simultaneous investigation of cardiorenal function and vascular reactivity. These relevant information could be combined at low cost in patients referred for Tetrofosmin cardiac studies, especially in those in whom renal perfusion abnormalities may reveal a worse cardiovascular risk profile and prognosis.
Cardio-renal scintigraphy with 99mTc-tetrofosmin: Feasibility and preliminary results in cardiovascular patients
FOMMEI, ENZA;
2007-01-01
Abstract
Abstract: Cardio-renal pathophysiology is increasingly investigated in cardiovascular disease but, to our knowledge, no single tool is available for simultaneous imaging and quantitation of cardiac and renal function. Previous observations with Sestamibi suggested that 99mTc tracers may offer the possibility to combine renal and cardiac imaging. Aim of the study was to investigate the feasibility of a cardio-renal single shot study using Tetrofosmin. Methods. Thirtheen patients (8 M, 5 F, mean age 65yr) scheduled for double-day Gated SPECT for cardiac purposes underwent rest dynamic renal imaging after injection of 370 MBq of Tetrofosmin. All patients gave their consent to undergo also a DTPA scintigraphy (74 MBq)1 week apart from Gated SPECT. In 6 patients a Tetrofosmin renal study was also made with adenosine infusion. In all studies, a first pass transit was followed by a renographic phase. For both tracers the renal uptake index as a percentage of the injected dose (UI), the separate renal uptake as a percentage contribution of each kidney to total uptake (SRU), time to peak (TP) and the retention index (20min activity/peak activity, RI) were calculated. Results. Qualitative analysis: compared to DTPA, Tetrofosmin allowed a better renal visualization with a clear upslope phase and peak followed by a washout phase frequently delayed on the right side due to an increasing liver activity. Quantitative analysis: compared to DTPA, Tetrofosmin showed a higher renal uptake on both kidneys (p<0.01); no significant differences were appreciable for SRU or TP whereas a higher right kidney RI was found with Tetrofosmin. Tetrofosmin UI significantly correlated with DTPA UI (p<0.001), serum creatinine (p<0.05) and the Doppler index of renal vascular resistances (p<0.02). Tetrofosmin and DTPA SRU were also significantly correlated (p<0.01). In the 6 patients who underwent the adenosine study a reduction of Tetrofosmin UI (p<0.02) was observed when compared with the baseline study. Conclusions. In cardiovascular patients Tetrofosmin allows the simultaneous investigation of cardiorenal function and vascular reactivity. These relevant information could be combined at low cost in patients referred for Tetrofosmin cardiac studies, especially in those in whom renal perfusion abnormalities may reveal a worse cardiovascular risk profile and prognosis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
