Tc-99m DMSA SPECT for Follow-Up of Non-Operative Treatments in Renal Injuries: A Prospective Single-Center Study
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- Korean Journal of Radiology
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- v.24 no.10
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- pp.1017-1027
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- 2023
Objective: The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. Materials and Methods: This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had non-operatively managed renal injuries and underwent DMSA planar and SPECT imaging 3-6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. Results: SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%-36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m2). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m2 or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. Conclusion: Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.
Agriculture is a primary industry that influenced by the weather or meterological factors more than other industry. Global warming and worldwide climate changes, and unusual weather phenomena are fatal in agricultural industry and human life. Therefore, many previous studies have been made to find the relationship between weather and the productivity of agriculture. Meterological factors also influence on the distribution of agricultural product. For example, price of agricultural product is determined in the market, and also influenced by the weather of the market. However, there is only a few study was made to find this link. The objective of this study is to investigate the effects of meterological factors on the distribution of agricultural products, focusing on the distribution of chinese cabbages. Chinese cabbage is a main ingredient of Kimchi, and basic essential vegetable in Korean dinner table. However, the production of chinese cabbages is influenced by weather and very fluctuating so that the variation of its price is so unstable. Therefore, both consumers and farmers do not feel comfortable at the unstable price of chinese cabbages. In this study, we analyze the real transaction data of chinese cabbage in wholesale markets and meterological factors depending on the variety and geography. We collect and analyze data of meterological factors such as temperatures, humidity, cloudiness, rainfall, snowfall, wind speed, insolation, sunshine duration in producing and consuming region of chinese cabbages. The result of this study shows that the meterological factors such as temperature and humidity significantly influence on the volume and price of chinese cabbage transaction in wholesale market. Especially, the weather of consuming region has greater correlation effects on transaction than that of producing region in all types of chinese cabbages. Among the whole agricultural lifecycle of chinese cabbages, 'seeding - harvest - shipment - wholesale', meterological factors such as temperature and rainfall in shipment and wholesale period are significantly correlated with transaction volume and price of crops. Based on the result of correlation analysis, we make a regression analysis to verify the meterological factors' effects on the volume and price of chines cabbage transaction in wholesale market. The results of stepwise regression analysis are shown in