Duc L Nguyen1, Claire de Labriolle-Vaylet2,3, Emmanuel Durand1,4, Philippe X Fernandez5, François Bonnin6, Daniel Deliu7, Florent L Besson1,4, Philippe Chaumet-Riffaud1. 1. Department of Nuclear Medicine, Hôpitaux Universitaires Paris-Sud Bicêtre, Le Kremlin-Bicêtre. 2. Department of Nuclear Medicine, Hôpitaux Universitaires Est Parisien Trousseau. 3. UPMC Université Paris 6, Biophysique, Paris. 4. IR4M - UMR8081, Université Paris-Sud, Université Paris Saclay, Orsay. 5. Department of Nuclear Medicine, Pellegrin University Hospital, Bordeaux. 6. Department of Nuclear Medicine, Centre Hospitalier René Dubos, Pontoise. 7. Department of Nuclear Medicine, Hôpitaux Universitaires Paris-Sud Béclère, Clamart, France.
Abstract
OBJECTIVE: Dynamic renal scintigraphy remains the gold standard for assessing differential renal function (DRF). Recently, technetium-99m-ethylenedicysteine (Tc-EC) was shown to be valuable and had similar quality images as technetium-99m-mercaptoacetyltriglycine (Tc-MAG3). However, its reproducibility has never been confirmed. The aim of this study was to perform the first evaluation of Tc-EC reproducibility for assessing DRF in children who were referred for hydronephrosis or urinary tract dilatation. PATIENTS AND METHODS: A total of 109 patients from three French nuclear medicine departments prospectively underwent dynamic renal scintigraphy with Tc-EC. DRF reproducibility was assessed by different pairs of raters using a multilevel design that integrated local and centralized predefined procedures. RESULTS: Both local and centralized procedures yielded near-excellent inter-rater agreements, with all of the intraclass correlation coefficient values over 0.998. Bland-Altman plots showed a systematic bias of less than 1%, with the corresponding limits of agreements not exceeding the 5% threshold cut-off value that corresponds to the clinical definition of acceptable limits for this purpose. Intrarater agreements were also good to excellent. CONCLUSION: This prospective multicentre study showed that Tc-EC is highly reproducible for assessing DRF in a standard paediatric population, thus validating its use as an alternative to Tc-MAG3 in this setting.
OBJECTIVE: Dynamic renal scintigraphy remains the gold standard for assessing differential renal function (DRF). Recently, technetium-99m-ethylenedicysteine (Tc-EC) was shown to be valuable and had similar quality images as technetium-99m-mercaptoacetyltriglycine (Tc-MAG3). However, its reproducibility has never been confirmed. The aim of this study was to perform the first evaluation of Tc-EC reproducibility for assessing DRF in children who were referred for hydronephrosis or urinary tract dilatation. PATIENTS AND METHODS: A total of 109 patients from three French nuclear medicine departments prospectively underwent dynamic renal scintigraphy with Tc-EC. DRF reproducibility was assessed by different pairs of raters using a multilevel design that integrated local and centralized predefined procedures. RESULTS: Both local and centralized procedures yielded near-excellent inter-rater agreements, with all of the intraclass correlation coefficient values over 0.998. Bland-Altman plots showed a systematic bias of less than 1%, with the corresponding limits of agreements not exceeding the 5% threshold cut-off value that corresponds to the clinical definition of acceptable limits for this purpose. Intrarater agreements were also good to excellent. CONCLUSION: This prospective multicentre study showed that Tc-EC is highly reproducible for assessing DRF in a standard paediatric population, thus validating its use as an alternative to Tc-MAG3 in this setting.
Authors: Nasr Mohamed Mohamed Osman; Moustafa Abdel Kader; Taghreed A E L Aziz Nasr; Mohamed Ahmed Sharawy; Hesham Kamal Habeeb Keryakos Journal: Int J Nephrol Renovasc Dis Date: 2021-01-11