Department of Family and Community, Saint Louis University, St Louis, MO, USA.
Clin Nucl Med. 2012 Oct;37(10):931-8. doi: 10.1097/RLU.0b013e31826382e9.
The estimation of differential function (DF) in post-renal transplant patients (PRTPs) is challenging because of the different distances of the native kidneys (NKs) and transplant kidney (TK) to the gamma camera and because current commercial software allows evaluation of only 2 kidneys instead of 3. We retrospectively validated a simplified method (SM) to process renal scans and hypothesized that it is comparable with the reference method (RM).
Twelve 99mTc MAG3 renal scintigraphies of 10 PRTPs were performed on a dual-head gamma camera. The RM was a 2-step process, with the left and right NKs being compared with the TK separately. The SM was a 1-step process combining both NKs together. The DF estimates were consistent with geometric means in both methods. Statistical evaluation included linear correlation and Bland-Altman analysis.
The RM and SM showed DF of 78% ± 25% versus 79% ± 27% for the TK and 22% ± 25% versus 21% ± 27% for the NKs (P = 0.3). There was excellent correlation between SM and RM measurements (r = 0.99, P < 0.001). Bland-Altman plot demonstrated a mean difference of 1.2 ± 3.8 at a 95% confidence interval (95% CI) of agreement of -6.2 to + 8.5 for the TK and -1.2 ± 3.8 at a 95% CI of agreement of -8.5 to + 6.2 for the NKs. Only 1 (8%) of 12 scans showed a difference slightly beyond the 95% CI, indicating a good agreement between SM and RM.
The SM offers a simple way to evaluate renal DF in PRTP and shows comparable results with the RM. It may have great potential in clinical practice; however, larger studies are needed to verify and further extend the results of this study.
由于受检者的原肾（NK）和移植肾（TK）与伽马相机的距离不同，并且当前的商业软件仅允许评估 2 个肾脏而不是 3 个肾脏，因此评估肾后移植受者（PRTP）的差异功能（DF）具有挑战性。我们回顾性验证了一种简化方法（SM）来处理肾扫描，并假设该方法与参考方法（RM）相当。
对 10 例 PRTP 的 12 次 99mTc-MAG3 肾闪烁显像进行了双探头伽马相机检查。RM 是一个 2 步过程，分别比较左、右 NK 和 TK。SM 是一个 1 步过程，将两个 NK 结合在一起。两种方法的 DF 估计均与几何平均值一致。统计评估包括线性相关和 Bland-Altman 分析。
RM 和 SM 显示 TK 的 DF 分别为 78%±25%和 79%±27%，NK 的 DF 分别为 22%±25%和 21%±27%（P=0.3）。SM 和 RM 测量值之间存在极好的相关性（r=0.99，P<0.001）。Bland-Altman 图显示，在 95%置信区间（95%CI）为-6.2 至+8.5 的一致性范围内，TK 的平均差值为 1.2±3.8，在 95%CI 为-8.5 至+6.2 的一致性范围内，NK 的平均差值为 1.2±3.8。只有 1 次（8%）扫描显示差异略超出 95%CI，表明 SM 和 RM 之间具有良好的一致性。
SM 提供了一种简单的方法来评估 PRTP 的肾 DF，并且与 RM 具有相当的结果。它在临床实践中可能具有很大的潜力，但是需要更大的研究来验证和进一步扩展本研究的结果。
