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Cardiorenal scintigraphy with tetrofosmin in the evaluation of cardiorenal disease

¹ Istituto di Medicina Nucleare, Università di Pisa, Pisa, Italy; ² Fondazione CNR-Regione Toscana "Gabriele Monasterio", Pisa, Italy

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Objectives: Renal function is an established predictor of cardiovascular prognosis and subclinical stages of cardiorenal pathology are increasingly investigated. To study myocardial perfusion and renal function simultaneously, we investigated the feasibility of a combined single cardiorenal scintigraphy using Tetrofosmin.

Methods: Twenty-three patients scheduled for double-day Gated SPECT gave their informed consent for a dynamic renal scintigraphy after the injection of 370 MBq of Tetrofosmin in the rest study (23 pts) and during adenosine infusion (15 pts) and for a DTPA study (74 MBq) after one week (21 pts). Kidney images and renograms were obtained. Renal uptake index (UI) as percentage of the injected dose and separate renal uptake (SRU) as the percentage contribution of each kidney to total renal uptake were calculated.

Results: Compared with DTPA, Tetrofosmin showed better kidney images and curves with a higher UI (p<0.001) and comparable SRU. Tetrofosmin UI significantly correlated with DTPA UI (p<0.0001), serum creatinine (p=0.02), left ventricular mass index (p<0.01) and the Doppler index of renal vascular resistances (p<0.01); separate kidney functions evaluated with either tracer (SRU) were closely related to each other (p<0.001). In the patients who underwent the test, adenosine induced a significant decrease in renal Tetrofosmin UI (p<0.005).

Conclusions: The data suggest that 1) cardiorenal scintigraphy with Tetrofosmin is feasible at a low cost in a single-shot study; 2) after appropriate validation it could allow functional renal evaluation in patients referred for cardiac SPECT; 3) the information could be relevant in terms of cardiovascular risk and prognosis.

Research Support: Institutional funds

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Bruselli, L. Articles by Marzullo, P. PubMed Articles by Bruselli, L. Articles by Marzullo, P.