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Radionuclide Evaluation of the Genitourinary System
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Radionuclide Evaluation of the Genitourinary System

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Questions and Answers

Which property of the glomerulus allows only small molecules to pass through?

  • Impermeability
  • Selective filtration
  • Semipermeable membrane (correct)
  • Tubular secretion
  • What is the main purpose of using radiopharmaceuticals to evaluate renal function and anatomy?

  • To assess renal perfusion and collecting system
  • To quantify glomerular filtration rate (GFR)
  • To image the renal cortex in high resolution
  • All of the above (correct)
  • Which radiopharmaceutical binds to the sulfhydryl groups in the proximal renal tubules?

  • 99mTc-DTPA
  • 99mTc-glucoheptonate
  • 99mTc-DMSA (correct)
  • None of the above
  • What is a disadvantage of using 99mTc-DMSA for renal imaging?

    <p>All of the above</p> Signup and view all the answers

    Which radiopharmaceutical is cleared by both glomerular filtration and renal tubular secretion?

    <p>99mTc-glucoheptonate</p> Signup and view all the answers

    What is the main advantage of using 99mTc-glucoheptonate for renal imaging?

    <p>Allows for assessment of renal perfusion and collecting system</p> Signup and view all the answers

    Which radiopharmaceutical is the only one used for the evaluation of glomerular filtration function?

    <p>99mTc-DTPA</p> Signup and view all the answers

    Which radiopharmaceutical is best suited for high-resolution imaging of the renal cortex?

    <p>99mTc-DMSA</p> Signup and view all the answers

    Which radiopharmaceutical is not effectively used for imaging the ureters or bladder?

    <p>99mTc-DMSA</p> Signup and view all the answers

    Which radiopharmaceutical is used to assess both renal perfusion and the renal collecting system?

    <p>99mTc-glucoheptonate</p> Signup and view all the answers

    Which of the following is NOT a primary mechanism of the excretory function of the kidneys?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    What percentage of renal plasma flow is cleared by glomerular filtration?

    <p>20%</p> Signup and view all the answers

    What is the role of nuclear renal imaging, according to the passage?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for the diminished use of nuclear techniques in the evaluation of renal anatomy?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT an indication for radionuclide scanning, according to the passage?

    <p>Evaluation of suspected renovascular hypertension</p> Signup and view all the answers

    What is the relationship between the two primary mechanisms of the excretory function of the kidneys, according to the passage?

    <p>They are complementary processes, with 20% of renal plasma flow cleared by glomerular filtration and 80% by tubular secretion</p> Signup and view all the answers

    What is the purpose of measuring the 20-minute maximal cortical ratio for 99mTc-MAG3?

    <p>To assess the transit time of the radiopharmaceutical in the kidney</p> Signup and view all the answers

    What is the significance of the clearance of a particular substance per minute (mL/min) as the plasma passes through the kidneys?

    <p>It defines the effective renal plasma flow (ERPF)</p> Signup and view all the answers

    What is the difference between the radionuclide methods of determining GFR and ERPF?

    <p>Plasma sample-based clearances are more tedious and require meticulous attention to detail, while camera-based clearances are more accurate</p> Signup and view all the answers

    What is the normal range for the 20-minute maximal cortical ratio for 99mTc-MAG3?

    <p>0.19 (standard deviation 0.07 and 0.04 for the right and left kidneys)</p> Signup and view all the answers

    What is the relationship between the clearance of insulin and the glomerular filtration rate (GFR)?

    <p>The clearance of insulin, which is entirely filtered, defines the GFR</p> Signup and view all the answers

    What is the relationship between the clearance of para-aminohippurate (PAH) and the effective renal plasma flow (ERPF)?

    <p>The clearance of PAH, which is both filtered and secreted by the tubules, defines the ERPF</p> Signup and view all the answers

    What is the normal glomerular filtration rate (GFR) in mL/min?

    <p>125</p> Signup and view all the answers

    Why does DTPA tend to slightly underestimate the GFR?

    <p>It is bound to plasma proteins</p> Signup and view all the answers

    Which radiopharmaceutical is predominantly cleared by the proximal tubules with minimal filtration?

    <p>Mertiatide (MAG3)</p> Signup and view all the answers

    Why is MAG3 considered to provide more satisfactory images than 99mTc-DTPA?

    <p>Greater extraction efficiency</p> Signup and view all the answers

    Which phase of the kidney scan involves evaluation of renal blood flow and function of native kidneys from the posterior projection?

    <p>Renal perfusion phase</p> Signup and view all the answers

    In which patients is 99mTc-DTPA not considered an ideal agent for demonstrating intraparenchymal renal lesions?

    <p>Patients with renal obstruction</p> Signup and view all the answers

    What is the typical administered activity for adults for 99mTc-MAG3?

    <p>= 10 mCi (370 MBq)</p> Signup and view all the answers

    'Imaging renal perfusion is usually begun as the bolus is visualized in the proximal abdominal aorta' refers to which phase of a kidney scan?

    <p>'Renal perfusion phase'</p> Signup and view all the answers

    'The spleen overlies the left kidney, giving a false impression of asymmetrically increased left renal perfusion' indicates what type of issue in imaging?

    <p>'Biological artifact'</p> Signup and view all the answers

    Which radiopharmaceutical can be used to measure effective renal plasma flow (ERPF)?

    <p>Mertiatide (MAG3)</p> Signup and view all the answers

    What phase of the renogram curve represents the period during minutes 1 through 5 with the peak of the curve?

    <p>Cortical or tubular concentration phase</p> Signup and view all the answers

    Which phase of the renogram curve is characterized by the down slope of the curve and is produced by excretion of the radiopharmaceutical from the kidney and clearance from the collecting system?

    <p>Clearance or excretion phase</p> Signup and view all the answers

    What should be considered abnormal if the relative renal uptake ratio at 2 to 3 minutes is 40% or less in one kidney?

    <p>Half-time excretion</p> Signup and view all the answers

    Which term refers to the time for half of the peak activity to be cleared from the kidney?

    <p>Half-time excretion (T 1/2)</p> Signup and view all the answers

    What is the normal percentage expected for differential cortical retention at 15 minutes after injection in each kidney?

    <p>50%</p> Signup and view all the answers

    What should be taken into account if cortical regions of interest are used and are not of equal size when measuring relative renal function between the two kidneys?

    <p>Differential cortical retention at 15 minutes</p> Signup and view all the answers

    Which part of the renogram curve is helpful in deriving semiquantitative indices and inspecting for alterations in the normal configuration?

    <p>'Long tail' extending to the right</p> Signup and view all the answers

    What is a significant effect of dehydration on renograms?

    <p>'Delayed parenchymal clearance'</p> Signup and view all the answers

    What part of the renogram curve closely correlates with ERPF values?

    <p>Initial uptake slope</p> Signup and view all the answers

    What is indicated by an abnormal renogram curve that shows delayed peak activity, delayed parenchymal clearance, and/or an elevation of the excretion slope?

    <p>Dehydration</p> Signup and view all the answers

    What is the function of the renal perfusion phase in renal imaging studies?

    <p>Thought to contribute the least to functional assessment</p> Signup and view all the answers

    Which radiopharmaceutical is commonly used in renal parenchymal function imaging?

    <p>99mTc-DTPA</p> Signup and view all the answers

    At what time interval is the maximal parenchymal activity typically observed in imaging with 99mTc-MAG3?

    <p>3 to 5 minutes</p> Signup and view all the answers

    What is the purpose of administering furosemide (Lasix) during renal imaging studies?

    <p>To facilitate transit of activity from the renal pelvis to the bladder</p> Signup and view all the answers

    What do renograms provide a graphic representation of?

    <p>Uptake and excretion of a radiopharmaceutical by the kidneys</p> Signup and view all the answers

    When is the information displayed on a renogram curve obtained using agents like 99mTc-MAG3?

    <p>Around 20 to 30 minutes after injection</p> Signup and view all the answers

    How many phases are typically present in a normal computer-generated renogram curve using a tubular radiopharmaceutical?

    <p>Three phases</p> Signup and view all the answers

    Which region of interest might be used to assess the discreteness and adequacy of the injected bolus in a renogram?

    <p>Aortic region</p> Signup and view all the answers

    At what point in time is maximal activity usually observed in both kidneys during normal renal blood flow imaging with technetium-99m diethylenetriamine pentaacetic acid (99mTc-DTPA)?

    <p>5-6 seconds</p> Signup and view all the answers

    What is the main advantage of omitting the renal perfusion phase in renal imaging studies?

    <p>Reduction in patient radiation dose</p> Signup and view all the answers

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