Single-shot cardiorenal scintigraphy with 99mTc-tetrofosmin: A dynamic characterization at rest and during adenosine infusion

Enza Fommei, Laura Bruselli, Andrea Ripoli, Alessia Gimelli, Sergio Ghione, Assuero Giorgetti, Annette Kush, Irene D Aragona Tagliavia, Claudio Passino, Paolo Marzullo

Research output: Contribution to journalArticle

Abstract

Renal function is known to be a strong predictor of cardiovascular prognosis, and cardiorenal disease is increasingly investigated in medical research. In this study, we tested the hypothesis that a single combined cardiorenal scintigraphy examination with the perfusion tracer 99mTc-tetrofosmin is feasible and may allow the simultaneous investigation of cardiac and renal pathology in cardiovascular patients. Methods: Thirty patients scheduled for dual-day gated SPECT also gave their informed consent for a renal acquisition after a single injection of 370 MBq of 99mTc-tetrofosmin, at rest (30 patients) or with adenosine (21 patients), and to undergo an additional standard renal study with the glomerular tracer 99mTc-diethylenetriaminepentaacetic acid (DTPA) (74 MBq) after 1wk (24 patients). Kidney images and renograms were obtained. Renal uptake index, expressed as the percentage ratio of kidney counts cumulated over the second minute after injection to the administered dose, was calculated as a functional renal parameter. Time to peak activity and separate kidney percentage uptake (as the percentage contribution of each kidney to total renal uptake) were also calculated. Results: Compared with 99mTc-DTPA, 99mTc-tetrofosmin provided better-quality kidney images, with a higher uptake index (13.17% ± 4.76% vs. 8.33% ± 2.45%, P <0.001) and with comparable separate kidney percentage uptake and times to peak activity. 99mTc-tetrofosmin uptake index was significantly lower in the patients who were more compromised according to renal and cardiovascular functional parameters, and correlated with 99mTc-DTPA uptake index (r = 0.77, P <0.001), serum creatinine (r = 0.59, P <0.005), log brain natriuretic peptide N-terminal levels (r= -0.65, P99mTc-tetrofosmin uptake index (from 14.12% ± 4.50% to 11.81% ± 3.33%, P <0.005) suggesting a decrement in renal perfusion or function. Conclusion: 99mTc-tetrofosmin cardiorenal scintigraphy is feasible at low cost as a single-shot study and may allow both the evaluation of renal morphology and renograms during a cardiac study and the calculation of renal functional parameters.

Original languageEnglish
Pages (from-to)1288-1295
Number of pages8
JournalJournal of Nuclear Medicine
Volume50
Issue number8
DOIs
Publication statusPublished - Aug 1 2009

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Radionuclide Imaging
Adenosine
Kidney
technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
Acids
Perfusion
Injections
Brain Natriuretic Peptide
Single-Photon Emission-Computed Tomography
Informed Consent
Biomedical Research
Creatinine

Keywords

  • Cardiorenal disease
  • Myocardial scintigraphy
  • Renal scintigraphy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Single-shot cardiorenal scintigraphy with 99mTc-tetrofosmin : A dynamic characterization at rest and during adenosine infusion. / Fommei, Enza; Bruselli, Laura; Ripoli, Andrea; Gimelli, Alessia; Ghione, Sergio; Giorgetti, Assuero; Kush, Annette; Tagliavia, Irene D Aragona; Passino, Claudio; Marzullo, Paolo.

In: Journal of Nuclear Medicine, Vol. 50, No. 8, 01.08.2009, p. 1288-1295.

Research output: Contribution to journalArticle

Fommei, E, Bruselli, L, Ripoli, A, Gimelli, A, Ghione, S, Giorgetti, A, Kush, A, Tagliavia, IDA, Passino, C & Marzullo, P 2009, 'Single-shot cardiorenal scintigraphy with 99mTc-tetrofosmin: A dynamic characterization at rest and during adenosine infusion', Journal of Nuclear Medicine, vol. 50, no. 8, pp. 1288-1295. https://doi.org/10.2967/jnumed.109.062646
Fommei, Enza ; Bruselli, Laura ; Ripoli, Andrea ; Gimelli, Alessia ; Ghione, Sergio ; Giorgetti, Assuero ; Kush, Annette ; Tagliavia, Irene D Aragona ; Passino, Claudio ; Marzullo, Paolo. / Single-shot cardiorenal scintigraphy with 99mTc-tetrofosmin : A dynamic characterization at rest and during adenosine infusion. In: Journal of Nuclear Medicine. 2009 ; Vol. 50, No. 8. pp. 1288-1295.
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abstract = "Renal function is known to be a strong predictor of cardiovascular prognosis, and cardiorenal disease is increasingly investigated in medical research. In this study, we tested the hypothesis that a single combined cardiorenal scintigraphy examination with the perfusion tracer 99mTc-tetrofosmin is feasible and may allow the simultaneous investigation of cardiac and renal pathology in cardiovascular patients. Methods: Thirty patients scheduled for dual-day gated SPECT also gave their informed consent for a renal acquisition after a single injection of 370 MBq of 99mTc-tetrofosmin, at rest (30 patients) or with adenosine (21 patients), and to undergo an additional standard renal study with the glomerular tracer 99mTc-diethylenetriaminepentaacetic acid (DTPA) (74 MBq) after 1wk (24 patients). Kidney images and renograms were obtained. Renal uptake index, expressed as the percentage ratio of kidney counts cumulated over the second minute after injection to the administered dose, was calculated as a functional renal parameter. Time to peak activity and separate kidney percentage uptake (as the percentage contribution of each kidney to total renal uptake) were also calculated. Results: Compared with 99mTc-DTPA, 99mTc-tetrofosmin provided better-quality kidney images, with a higher uptake index (13.17{\%} ± 4.76{\%} vs. 8.33{\%} ± 2.45{\%}, P <0.001) and with comparable separate kidney percentage uptake and times to peak activity. 99mTc-tetrofosmin uptake index was significantly lower in the patients who were more compromised according to renal and cardiovascular functional parameters, and correlated with 99mTc-DTPA uptake index (r = 0.77, P <0.001), serum creatinine (r = 0.59, P <0.005), log brain natriuretic peptide N-terminal levels (r= -0.65, P99mTc-tetrofosmin uptake index (from 14.12{\%} ± 4.50{\%} to 11.81{\%} ± 3.33{\%}, P <0.005) suggesting a decrement in renal perfusion or function. Conclusion: 99mTc-tetrofosmin cardiorenal scintigraphy is feasible at low cost as a single-shot study and may allow both the evaluation of renal morphology and renograms during a cardiac study and the calculation of renal functional parameters.",
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AU - Gimelli, Alessia

AU - Ghione, Sergio

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AU - Kush, Annette

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