• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.227-236
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• 1991

Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ were R=0.9190 (p < 0.001), R: 0.9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p < 0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake $^{99m}Tc-DTPA$ had the best correlation with relative glomerular filteration rate of $^{99m}Tc-DTPA$ and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.37-43
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• 2015

Purpose $^{99m}Tc-DMSA$ renal scintigraphy serves as location, size and shape of kidney, so it has been used for diagnosis and passage observation after the operation or treatment. There are 3 methods of calculating the relative renal uptake ratio such as geometric mean of the counts from the anterior and posterior views, arithmetical mean from the only posterior view and posterior view which applied the renal depths. In this study, we seek to correlation between the change of total relative uptake ratio according to different inspection methods of obtaining the renal count rate. Materials and Methods The phantom experiments proceeded 5 times depending on each renal depth with the kidney phantom and tissue equivalent materials. In the clinical research, we investigated 36 adult patients who had visited our hospital from february to october, 2014 and received $^{99m}Tc-DMSA$ renal scan. The equipment was used as a gamma camera named INFINIA (General Electric Healthcare, milwaukee, USA) and we drew the region of interests through semiautomatic method by using Xeleris Ver. 2.1220 of GE. In addition, we obtained the lateral view of kidney to measure the renal depth of each patient. Then the results were compared with 3 methods of calculating relative renal uptake ratio. Results The phantom studies show when the difference between the left ant right kidney depth were less than 1 cm, there were no statistically significant difference among values calculated through anterior and posterior views and only posterior view (P>0.05), while the excess of 1cm, the results showed a statistically significant change in the value (P<0.05). In case of clinical research, the correlation between total relative uptake ratio by obtaining both sides of image and posterior view applied the kidney depth (r=0.999) was higher than by obtaining only posterior view and applying the kidney depth to one side image (r=0.988). Conclusion This study has found that, the difference of calculating total relative uptake ratio compared with obtaining anterior and posterior views and only posterior view. In order to reduce the error, we recommend the method of obtaining anterior and posterior views and is considered to be useful, particularly the patients have similar uptake ratio of left and right kidney and difficulties of measurements of kidney depth.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.24-30
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• 1997

Purpose: To evaluate the diagnositc value of the absolute and relative renal uptake rates on $^{99m}Tc-DMSA$ renal scan of children with febrile UTI. Method: The absolute and relative renal uptake rates of $^{99m}Tc-DMSA$ were checked in 68 children with febrile urinary tract infection (35 with unilateral focal defect; 13 with bilateral focal defect; and 20 with diffuse bilateral defect) and 49 children with afebrile UTI and normal $^{99m}Tc-DMSA$ renal scan as control. Results: The renal absolute uptake rate in the control group were $21.8{\pm}3.9%(right),\;22.2{\pm}3.9%(left),\;and\;44.2{\pm}7.8%(total)$. The absolute uptake rate gradually increased until the age 12 months and then was stationary. In febrile UTI with unilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, both relative and absolute uptake rates were similarly diagnostic ($41.2{\pm}9.7%,\;16.5{\pm}5.4%$ vs $50.0{\pm}2.6%,\;22.0{\pm}3.9%$, p<0.01). In acute pyelonephritis with bilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly more diagnostic than the relative uptake rate[$17.3{\pm}5.3%$ (right), $17.4{\pm}5.3%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$, (left)% p<0.01]. In febrile UTI with bilateral diffuse defects on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly diagnostic than the relative uptake rate [$18.1{\pm}3.9%\;(right),\;18.4{\pm}3.8%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$(left), p<0.01]. Conclusion: In the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was more useful than the relative uptake rate to evaluate bilateral acute pyelonephritis.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.44-49
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• 2003

Purpose : $^{99m}Tc-DMSA$ renal scan can be used in the evaluation of relative renal function and some anatomy. The relative renal function can be assess by measurement of $^{99m}Tc-DMSA$ uptake by the individual kidney. Renal counts

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.25-30
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• 2013

Purpose: To evaluate kidney function, renal relative uptake is very important and is affected by kidney and the setting of background region of interest (ROI). In particular, in the case of patients with hydronephrosis to the naked eyes, such as size, position and shape etc. can be difficult to identify. So according to ROI to be set by user, the results are many differences. This study assumes the ROI of a constant kidney. According to the change of background ROI by analyzing renal relative uptake affect how the results are intended to study. Materials and Methods: From January 2012 to February 2013, we analyzed 27 patients with hydronephrosis who were examined MAG3 test in nuclear medicine department of Samsung medical center. After patients were received intravenous injection of $^{99m}Tc-MAG3$ 185 MBq (5 mCi) data were obtained. While we reconstructed images of patients, we've changed background ROI in the process of setting up ROI. First, in the process of renal processing, automatic ROI which set automatically and background ROI which needed to set manually were compared. Second, we set the ROI position separated by above, lateral and bottom of kidney. Third, background setting time were compared with 1-2 min and 2-3 min. Results: The relative uptake occurred in 3.7%p of the errors on average in Automatic & Manual ROI study. And comparison of background ROI position study, located in the lower position was more accurate results. Above, lateral, bottom each of the values 74.6%, 67.6% and 62.0% showed respectively. The standard value was 59.9%. finally, split function range test doesn't show significant difference. Conclusion: The study shows that relative uptake of kidney is affected in the background ROI. Therefore, it should be set by considering various dependent factors.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.179-183
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• 2011

Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.193-200
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• 2005

Purpose : An atrophic renal scar(RS) is one of the underlying causes for childhood hyper tension and chronic renal failure. The risk factors for atrophic renal scar were evaluated. Methods : 41 children, who presented with first febrile urinary tract Infection at the Ewha Womans University Hospital between 1995 and 2003 and had generalized atrophic RS on $^{99m}Tc-DMSA$ renal scan, were retrospectively studied. Atrophic RS was divided into severe atrophic RS(n=14) if relative uptake on renal scan was below 10$\%$, or mild atrophic RS(n=27) if relative uptake on renal scan was between 10-35$\%$. RS was defined as congenital if the scar was detected on the first renal scan, and as acquired if the scar developed on the follow-up renal scan from acute pyelonephritis of the first renal scan. The control group was consisted of randomly selected 41 children with segmental RS. The risk factors for atrophic RS such as the generation time, VUR, gender and ACE gene polymorphism were evaluated. Results : The age distribution of atrophic RS and segmental RS did not differ significantly (P>0.05). The rate of congenital RS in atrophic RS was 61.0$\%$(25/41), which was significantly higher than 9.8$\%$(4/41) of segmental RS(P<0.01). Atrophic RS developed mote frequently in male children(M:F 68.3$\%$ 31.7$\%$) than segmental RS(M:F 41.4$\%$ .58.5$\%$)(P<0.05). Vesicoureteral reflux(VUR) was found in 92.7$\%$(38/41) of 4he atrophic RS, which was significantly higher than 53.7$\%$(22/41) of segmental RS(P<0.05). In children without VUR, the male to female ratio did not differ between atrophic RS and segmental RS(P>0.05) But in children with VUR, there was a higher proportion of males with severe atrophic RS than segmental RS($85.7\%:45.5\%$) ACE gene polymorphism did not differ between the atrophic and segmental RS groups, irrespective of the presence of VUR(P>0.05). Conclusion : Most atrophic RSs were congenital which could not be preventable postnatally and the major risk factors were VUR and the male gender. ACE gene polymorphism was not the significant risk factor for an atrophic RS. (J Korean Soc Pedialr Nephrol 2005;9:193-200)

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.43-47
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• 2013

Purpose: A duplicated ureter is congenital renal malformations with ureter in two. Patients with duplicated ureter are in force to $^{99m}Tc-DMSA$ scan at surgery before and after. In existing examination, at produce result after $^{99m}Tc-DMSA$ scan, didn't compare to upper pole and lower pole with malformed kidney and compared to only relative uptake ratio. Therefore, this study will examine about utility of set a partial region of interest and to functional recovery of renal cell through change of upper pole uptake ratio of malformed kidney by setting each partial region of interest in upper pole and lower pole of malformed kidney in $^{99m}Tc-DMSA$ examination in surgery before and after. Materials and Methods: Pediatric patients with malformed kidney of incomplete duplicated ureter, 15 patients were enrolled in this study. Scanning were scan 3 to 4 hours after injection of $^{99m}Tc-DMSA$ 1.5 ~ 1.9 MBq/kg. Region of interest were each set in normal kidney, upper pole and lower pole with malformed kidney. Region of interest were set with same condition and method to images of surgery before and after that radio technologist 1 person, resident of nuclear medicine 1 person and doctor of urology together. Therefore, this study were compared to uptake ratio (A: B: C) that normal kidney (A), lower pole of malformed kidney (B) and upper pole of malformed kidney (C) about uptake ratio changes of malformed kidney in follow-up examination of surgery before and after. Results: When compared to 15 patients, uptake ratios were increased 7 persons and decreased 8 persons. Among increased 7 persons, it were periods of follow-up examination that 2 persons were 14 months, 4 persons were 12 months and 1 person was 8 months after surgery. Among decreased 8 persons, it were periods of follow-up examination that 4 persons were 12 months 3 persons were 6 months and 1 persons were 4 months after surgery. Conclusion: Existing study could not see the exact uptake ratio changes of malformed kidney because using only the overall Left-Right kidney uptake ratios. But a setting partial region of interest was able to see exactly what changes in the uptake of each upper pole and lower pole of malformed kidney. Because recovery of renal parenchymal cells is difficult in an evaluation of short period of time, follow-up examination should be made in long period of time. How to set up partial region of interest be thought that it would be useful.

• The Journal of the Korea Contents Association
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• v.16 no.3
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• pp.219-231
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• 2016

$^{99m}Tc$-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to $^{99m}Tc$-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of $^{99m}Tc$-DMSA renal SPECT using high sensitivity all purpose collimator.

• Korean Journal of Veterinary Research
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• v.37 no.2
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• pp.301-310
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• 1997

Diabetes mellitus is associated with a wide range of pathophysiological in the kidney. This study was designed to examine the effects of high glucose concentration on IGF-I binding and glucose transporters in renal proximal tubule cells. The results were as follows : The binding of $^{125}I-IGF-I$ reached the peak at the 30 minutes and gradually decreased by the time dependent manner. The binding of $^{125}I-IGF-I$ was inhibited by the unlabelled IGF-I($10^{-14}{\sim}10^{-8}M$) in a concentration dependent manner. The relative affinity of IGF-I receptor for IGF-I, IGF-II and insulin exhibited typical type 1 binding(IGF-I > insulin > IGF-II). However IGF-II did not compete for the cultured cell membrane $^{125}I-IGF-I$ binding site at $10^{-14}{\sim}10^{-8}M$. Under optimal conditions, IGF-I binding to the membranes from 5mM and 20mM glucose treated cells was analyzed. It was found that 20mM glucose treated cells exhibited higher binding activity for IGF-I. In order to further substantiate this increase in IGF-I binding sites, we performed affinity-labelling studies. The cross-linked cell membrane subjected to SDS-PAGE; labelled material was detected by autoradiography. 20mM glucose treated cells exhibited higher levels. The initial rate of $methyl-{\alpha}-D-glucopyranoside({\alpha}-MG)$ uptake was significantly lower($74.41{\pm}6.71%$) in monolayers treated with 20mM glucose than those of 5mM glucose. However, 3-O-methyl-D-glucose(3-O-MG) uptake was not affected by glucose concentration in culture media. IGF-I significantly increased ${\alpha}-MG$ uptake in both 5mM and 20mM glucose treated cells. However, 3-O-MG uptake was not affected by IGF-I in both conditions. In conclusion, 20mM glucose increased binding sites of $^{125}I-IGF-I$, inhibited Na/glucose cotransporter activity. But 20mM glucose did not change facilitated glucose transporter.