Celso Dario Ramos MD, Presenter: Nothing to Disclose

Daniel Massaro Onusic DIPLPHYS, Abstract Co-Author: Nothing to Disclose

Sergio Brunetto, Abstract Co-Author: Nothing to Disclose

Barbara Amorim, Abstract Co-Author: Nothing to Disclose

Mariana Lima, Abstract Co-Author: Nothing to Disclose

Allan de Oliveira Santos MD, PhD, Abstract Co-Author: Nothing to Disclose

Elba De Sa Camargo Etchebehere MD, PhD, Abstract Co-Author: Nothing to Disclose

Sara Saad, Abstract Co-Author: Nothing to Disclose

Different functional and structural abnormalities of the kidney are observed in patients with sickle cell anemia (SCA) and aging eventually leads to renal failure in most of these patients. Surprisingly, there is very limited data in the literature reporting the use of 99mTc-DMSA renal scintigraphy in SCA. This study aimed to evaluate the use of planar and SPECT-CT images and 99mTc-DMSA absolute quantification in patients with SCA and compare with glomerular filtration rate (GFR).

Fifteen patients (9 female) aged 24-59 years (45.1 +/-11.4 years) with SCA were studied. Doses of 110 -180 MBq of 99mTc-DMSA and 10-12 MBq of 51Cr-EDTA were simultaneously injected in all patients. After 3 hours planar and SPECT-CT images were obtained using a dedicated multislice SPECT-CT camera. Blood samples were taken 2, 3 and 4 hours after injections and immediately counted in a well counter using the energy window of 99mTc in order to calculate DMSA clearance (DMSAcl). After 1 week (ensuring the 99mTc radioactive decay) the samples were also counted using the energy window of 51Cr to determine 51Cr-EDTA based GFR. Absolute renal uptake of DMSA (DMSAab) was calculated from SPECT-CT images as a percentage of the injected dose, using with CT-based attenuation correction. Correlation curves between DMSAcl, DMSAab and GFR were performed. Planar and SPECT images were visually evaluated for identification of focal lesions in the renal parenchyma.

The quantitative values (mean; minimum and maximum) obtained for the15 patients were: GFR: 83.3 +/- 29.4 mL/min (31.2 and 128.54 mL/min); DMSAcl: 80.7+/- 38.7mL/min (29.5 and 162.0 mL/min) ; DMSAab: 38.6% +/- 3.7% (29.7% and 44.2%). The correlation indices between DMSAcl and GRF and between DMSAab and GRF were respectively r =0.54 (p = 0.84) and r=0.47 (p = 0.91). The images showed focal lesions in the renal parenchyma of 11/15 patients, in 4 of them evident only on SPECT images.

DMSAab using SPECT-CT images correlates with GFR measured by 51Cr-EDTA clearance in patients with SCA. SPECT images are superior to planar images in identifying renal lesions in these patients.

There is very limited data in the literature reporting the use of 99mTc-DMSA renal scintigraphy in sickle cell anemia.

Ramos, C, Onusic, D, Brunetto, S, Amorim, B, Lima, M, Santos, A, Etchebehere, E, Saad, S, 99mTc-DMSA Planar and SPECT-CT Imaging and Quantification in Patients with Sickle Cell Anemia: A Comparison with Glomerular Filtration Rate.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12038415.html