Nuklearmedizin 2020; 59(01): 26-32
DOI: 10.1055/a-1073-6875
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

DMSA-camSPECT/US fusion imaging of children’s kidneys – Proof of feasibility

DMSA-camSPECT/US-Fusionsbildgebung kindlicher Nieren
Falk Gühne
1   Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
,
Friederike Weigel
2   Pediatric Nephrology, Jena University Hospital, Jena, Germany
,
Christian Kühnel
1   Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
,
Philipp Seifert
1   Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
,
Martin Freesmeyer
2   Pediatric Nephrology, Jena University Hospital, Jena, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
19 December 2019 (online)

Abstract

Aim SPECT using Tc-99m-dimercaptosuccinic acid (DMSA-camSPECT) and ultrasound (US) are useful diagnostic modalities in pediatric nephrology. Former studies proved SPECT/US fusion to be a problem-solving tool for thyroid and sentinel lymph node imaging. The purpose of this study was to demonstrate the feasibility of real-time DMSA-camSPECT/US fusion in children and to evaluate the technical implementation.

Methods Subsequent to a clinical indicated DMSA-camSPECT showing a mostly normal result, 10 children received a SPECT/US fusion. The magnetic sensor-navigated equipment allows a real-time superposition of three-dimensional SPECT data to live US images according to the position of the transducer.

Results 100 % of still images and 90 % of cine-loops were sufficient to depict the kidney; at least one sufficient camSPECT/US fusion loop could be accomplished for every kidney examined. Limitations are mainly caused by standard difficulties of conventional US.

Conclusion Real-time DMSA-camSPECT/US is feasible in depiction of renal parenchyma. This newly implemented application broadens the scope of SPECT/US fusion imaging.

Zusammenfassung

Hintergrund SPECT mit Tc-99m-Dimercaptobernsteinsäure (DMSA-camSPECT) und Ultraschall (US) sind wichtige Diagnosemodalitäten in der pädiatrischen Nephrologie. Frühere Studien haben gezeigt, dass die Schilddrüsen- und Sentinel-Lymphknoten-Diagnostik von der SPECT/US-Fusionsbildgebung profitieren kann. Ziel dieser Studie war es, die Realisierbarkeit der Echtzeit-DMSA-camSPECT/US-Fusionsbildgebung kindlicher Nieren zu demonstrieren und deren technische Durchführung zu evaluieren.

Methoden Nach einer klinisch indizierten DMSA-camSPECT mit weitgehend normalem Befund erhielten 10 Kinder eine SPECT/US-Fusionsbildgebung. Auf Grundlage magnetischer Koregistrierung wird die Überlagerung 3-dimensionaler SPECT-Daten mit US-Bildern in Echtzeit möglich.

Ergebnisse Bei allen Standbildern und bei 90 % aller Videoaufnahmen war eine Beurteilung der Nieren möglich, wobei mindestens 1 suffiziente Videoaufnahme für jede untersuchte Niere vorlag. Limitationen der camSPECT/US-Fusionsbildgebung wurden hauptsächlich durch die bekannten Herausforderungen der konventionellen Nierensonografie verursacht.

Schlussfolgerung Die Echtzeit-DMSA-camSPECT/US-Fusionsbildgebung ermöglicht die Darstellung des kindlichen Nierenparenchyms, wodurch der Anwendungsbereich der SPECT/US-Fusionsbildgebung erweitert wird.

 
  • References

  • 1 Tewes S, Peters I, Tiemeyer A. et al. Evaluation of MRI/Ultrasound Fusion-Guided Prostate Biopsy Using Transrectal and Transperineal Approaches. Biomed Res Int 2017; 2017: 2176471
  • 2 Franz T, von Hardenberg J, Blana A. et al. MRI/TRUS fusion-guided prostate biopsy: Value in the context of focal therapy. Urologe A 2017; 56: 208-216
  • 3 Song KD, Lee MW, Rhim H. et al. Percutaneous US/MRI Fusion-guided Radiofrequency Ablation for Recurrent Subcentimeter Hepatocellular Carcinoma: Technical Feasibility and Therapeutic Outcomes. Radiology 2018; 288: 878-886
  • 4 Ahn SJ, Lee JM, Chang W. et al. Clinical utility of real-time ultrasound-multimodality fusion guidance for percutaneous biopsy of focal liver lesions. Eur J Radiol 2018; 103: 76-83
  • 5 Bluemel C, Safak G, Cramer A. et al. Fusion of freehand SPECT and ultrasound: First experience in preoperative localization of sentinel lymph nodes. Eur J Nucl Med Mol Imaging 2016; 43: 2304-2312
  • 6 Freesmeyer M, Winkens T, Kühnel C. et al. 99mTc-Pertechnetate-SPECT/US Hybrid Imaging Enhances Diagnostic Certainty Compared With Conventional Thyroid Imaging With Scintigraphy and Ultrasound. Clin Nucl Med 2018; 43: 747-748
  • 7 Bluemel C, Kirchner P, Kajdi GW. et al. Localization of Parathyroid Adenoma With Real-Time Ultrasound: Freehand SPECT Fusion. Clin Nucl Med 2016; 41: e141-e142
  • 8 Gühne F, Mothes H, Freesmeyer M. Allocation of parathyroid adenoma and suspicious thyroid nodule by real-time (99m)Tc-MIBI SPECT/US fusion imaging. Endocrine 2016; 54: 560-561
  • 9 Maliborski A, Zegadlo A, Placzynska M. et al. The role of modern diagnostic imaging in diagnosing and differentiating kidney diseases in children. Dev Period Med 2018; 22: 81-87
  • 10 Kerecuk L, Schreuder MF, Woolf AS. Renal tract malformations: perspectives for nephrologists. Nat Clin Pract Nephrol 2008; 4: 312-325
  • 11 Piepsz A, Colarinha P, Gordon I. et al. Guidelines for 99mTc-DMSA scintigraphy in children. Eur J Nucl Med 2001; 28: BP37-BP41
  • 12 Enlander D, Weber PM, dos Remedios LV. Renal cortical imaging in 35 patients: superior quality with 99mTc-DMSA. J Nucl Med 1974; 15: 743-749
  • 13 Mori R, Lakhanpaul M, Verrier-Jones K. Diagnosis and management of urinary tract infection in children: summary of NICE guidance. BMJ 2007; 335: 395-397
  • 14 Christian MT, McColl JH, MacKenzie JR. et al. Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography. Arch Dis Child 2000; 82: 376-380
  • 15 Wang YT, Chiu NT, Chen MJ. et al. Correlation of renal ultrasonographic findings with inflammatory volume from dimercaptosuccinic acid renal scans in children with acute pyelonephritis. J Urol 2005; 173: 190-194
  • 16 Nishiyama Y, Kinuya S, Kato T. et al. Nuclear medicine practice in Japan: a report of the eighth nationwide survey in 2017. Ann Nucl Med 2019; DOI: 10.1007/s12149-019-01382-5. . Epub 2019 Jun 24
  • 17 Freesmeyer M, Winkens T, Kühnel C. et al. Technetium-99m SPECT/US Hybrid Imaging Compared with Conventional Diagnostic Thyroid Imaging with Scintigraphy and Ultrasound. Ultrasound Med Biol 2019; DOI: 10.1016/j.ultrasmedbio.2019.01.003. . Epub 2019 Feb 14
  • 18 Freesmeyer M, Gühne F. Clarification of a suspicious thyroid nodule by use of camSPECT/US fusion imaging. Endocrine 2017; 58: 199-200
  • 19 Caravel JP, Francoisjoubert A, Peria O. et al. Registration of Anatomical and Functional Images of the Kidney. Med Nucl 1995; 19: 391-396
  • 20 Galdames FJ, Perez CA, Estevez PA. et al. Registration of renal SPECT and 2.5D US images. Comput Med Imaging Graph 2011; 35: 302-314
  • 21 Freesmeyer M, Opfermann T, Winkens T. Hybrid integration of real-time US and freehand SPECT: proof of concept in patients with thyroid diseases. Radiology 2014; 271: 856-861
  • 22 Rodigas J, Kirsch H, John U. et al. Static and Functional MR Urography to Assess Congenital Anomalies of the Kidney and Urinary Tract in Infants and Children: Comparison With MAG3 Renal Scintigraphy and Sonography. Am J Roentgenol 2018; 211 (01) 193-203