A simple method of producing parenchymal renograms using parametric imaging.

Abstract

Standard dynamic renography procedures are used to produce time-activity curves for defined regions of interest around the kidneys. Further analysis of the acquired data using Fitted Retention and Excretion Equations (FREE) to determine single kidney glomerular filtration rate (GFR) and kidney transit time is performed at the Royal Marsden Hospital, Sutton. The disadvantage of these methods is that the renal function is assessed for the whole kidney and not on a regional basis. The aim of this study was to use parametric imaging to extend the standard analysis so that the parenchyma could be identified and analysed separately from the collecting system. The parenchyma pixel time-activity curves have shorter time-to-peak (TTP) values than the collecting system. TTP parametric images were used to set limits on the TTP values and thus define the parenchyma pixels. The time-activity curves from the parenchyma were further analysed using FREE to produce parametric images of both GFR and effective blood volume. Finally, the original dynamic data were re-analysed so that time-activity and FREE curves were generated for the parenchyma alone. A study of 15 patients (30 kidneys) showed that the extended analysis indicated parenchymal isotope clearance. By comparing the time-activity and FREE curves of the whole kidney with those from the parenchyma alone, a more useful analysis of parenchymal function was obtained. This proved to be particularly useful for patients with pelvi-ureteric junction (PUJ) obstruction.