Tayal Sachin, Shukla Varun, Venkatachalam Manikandan, Kumar Ajay, Jha Uddeshya Narayan
Department of Nuclear Medicine and Molecular Imaging, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Varanasi, India.
Indian J Nucl Med. 2024 Jul-Aug;39(4):259-264. doi: 10.4103/ijnm.ijnm_2_24. Epub 2024 Nov 18.
With the increasing number of oncology cases and a parallel surge in chemotherapeutic drugs for treatment, the treating physicians conducts nephrotoxicity evaluation to provide a personalized dosing strategy. Of the various tests available, glomerular filtration rate (GFR) under gamma camera with help of Gates method has gained importance, being a good index of overall kidney functions. In addition to this, there has been an alternate and old method for GFR estimation: plasma sampling. We at our Institution conducted both the methods for better evaluation of GFR in cancer patient management.
Comparison of Gates' camera based GFR based on kidney depth correction using Tonessen's method and CT based manual depth calculation with dual time point plasma sampling in cancer patients.
A retrospective study wherein patients' database were evaluated over a period of four months after approval from our Institutional Review Board. Thirty patients were included in the study. GFR was evaluated by two methods: Gates camera based and dual time plasma sampling method. Statistical analysis was done to help evaluate a correlation coefficient between the methods (Gates' method with and without CT based manual depth correction and dual time point plasma sampling).
Our study showed moderate correlation between Gates' camera based GFR and dual time plasma sampling method.
One need to understand the limitation of each method and see if the renal depth corrections can be done with the help of CT or lateral images of NM for near accurate GFR and in case of selecting dual plasma sampling, errors to be minimized in pipetting and sample counting. Hence, it will be better to use both the methods for coming to a conclusion.
随着肿瘤病例数量的增加以及用于治疗的化疗药物相应激增,治疗医生会进行肾毒性评估以提供个性化给药策略。在现有的各种检测方法中,借助盖茨法通过γ相机测定的肾小球滤过率(GFR)作为整体肾功能的良好指标,已变得越来越重要。除此之外,还有一种用于估算GFR的替代且古老的方法:血浆采样。我们所在机构采用这两种方法来更好地评估癌症患者管理中的GFR。
比较癌症患者中使用托内森法基于肾脏深度校正的盖茨相机法测定的GFR与基于CT手动深度计算并结合双时间点血浆采样法测定的GFR。
一项回顾性研究,经我们机构审查委员会批准后,在四个月的时间里对患者数据库进行评估。该研究纳入了30名患者。通过两种方法评估GFR:基于盖茨相机的方法和双时间点血浆采样法。进行统计分析以帮助评估两种方法之间的相关系数(基于CT手动深度校正和未基于CT手动深度校正的盖茨法以及双时间点血浆采样法)。
我们的研究表明基于盖茨相机的GFR与双时间点血浆采样法之间存在中度相关性。
需要了解每种方法的局限性,看看是否可以借助CT或核医学的侧位图像进行肾脏深度校正以获得接近准确的GFR,并且在选择双血浆采样时,要将移液和样本计数中的误差降至最低。因此,最好同时使用这两种方法来得出结论。