Prigent A, Cosgriff P, Gates G F, Granerus G, Fine E J, Itoh K, Peters M, Piepsz A, Rehling M, Rutland M, Taylor A
Biophysics and Nuclear Medicine Department, University Hospital Center of Bicêtre, Assistance Publique-Hôpitaux de Paris, France.
Semin Nucl Med. 1999 Apr;29(2):146-59. doi: 10.1016/s0001-2998(99)80005-1.
Among all the physiological indices that can be quantified using renography, measurement of renal function is the most basic. These measurements are used to make critical clinical management decisions and, as such, their reliability needs to be quality assured. This article seeks to address each aspect of the renography procedure, with particular emphasis on the effect on measurement of relative renal function. Estimation of individual kidney function is mentioned, but only briefly. A consensus approach was adopted, overseen, and directed by a chairman appointed by the Scientific Committee of the International Radionuclides in Nephro-Urology Group. The chairman selected the panel of experts from eight different countries based on their practical experience in the field. Where evidence exists to support the various recommendations it is given. Otherwise, the stated guidance represents the considered opinion of a body of experts, based on long experience and unpublished data. Some necessary compromises were made to account for the fact that renography is seldom performed solely with the purpose of measuring relative renal function. The technicalities of renography have always been a source of debate in nuclear medicine, which is reflected by the fact that a consensus could simply not be reached on a small number of issues. The structure of the report ensures that these are clearly indicated. This should serve to highlight gaps in our current knowledge, thus helping to direct future research. It is envisaged that the recommendations will be revised on a 2-year cycle to ensure that they remain up to date. An "open" process will be used to encourage participation and ownership. It is hoped that promotion of these guidelines, suitably complemented by audit processes, will raise standards in the practice of gamma camera renography.
在所有可通过肾图检查进行量化的生理指标中,肾功能测量是最基本的。这些测量结果用于做出关键的临床管理决策,因此,其可靠性需要得到质量保证。本文旨在探讨肾图检查程序的各个方面,特别强调对相对肾功能测量的影响。文中提到了对单个肾功能的评估,但只是简要提及。采用了一种共识方法,由国际肾-泌尿外科放射性核素科学委员会任命的一位主席进行监督和指导。主席根据他们在该领域的实践经验,从八个不同国家挑选了专家小组。在有证据支持各项建议的地方,会给出相应证据。否则,所述指导意见代表了一批专家基于长期经验和未发表数据的深思熟虑的意见。考虑到肾图检查很少仅以测量相对肾功能为目的,因此做出了一些必要的妥协。肾图检查的技术细节一直是核医学领域争论的焦点,这体现在少数问题上根本无法达成共识这一事实。报告的结构确保了这些问题得到明确指出。这应有助于凸显我们当前知识中的差距,从而有助于指导未来的研究。预计这些建议将每两年修订一次,以确保它们与时俱进。将采用“开放”的程序来鼓励参与和自主管理。希望通过审计程序对这些指南进行适当补充后加以推广,能够提高γ相机肾图检查的实践标准。