Introduction
• Radionuclide evaluationof the genitourinary system includes
quantitative estimates of renal perfusion and function.
• With the widespread use of MRI, CT, angiography, and Doppler
ultrasound, the evaluation of renal anatomy by nuclear techniques
has diminished, and the role of nuclear renal imaging has become
more confined to functional analysis.
4.
Indications of Genitourinarysystem
Radionuclide scanning
• Assessment of renal blood flow
• Differential or quantitative functional assessment of both native and
transplanted kidneys
• The unavailability of or contraindications to MRI or CT (including
sensitivity to contrast materials).
• Evaluating ureteral or renal pelvic obstruction, vesicoureteral reflux,
• To a lesser extent, suspected renovascular hypertension, with
pharmacologic interventions used when indicated.
• Imaging of genitourinary cancers with PET scanning
• Osseous metastases from prostate cancer
8.
Renal physiology
• Thekidneys are responsible for regulating water and electrolyte
balance, excreting waste, secreting hormones (renin, erythropoietin),
and activating vitamin D. Also clear the plasma and body of waste
products
• Normally, the kidneys receive 20% of cardiac output, with renal plasma
flow (RPF) averaging 600 mL/min.
• The clearance, or rate of disappearance, of a substance can be
measured as:
9.
• Inulin isthe gold standard for glomerular filtration measurement.
• Paraaminohippurate (PAH) is the classic method for measuring ERPF
because its high extraction mirrors the distribution of RPF—20% of
PAH is cleared by glomerular filtration, and 80% is secreted into the
renal tubules.
50.
References
• Harvey A.Ziessma. 2014. The nuclear medicine the requisites, 4th
edition,
Elsevier, Inc
• Fred A. Mettler, Jr. 2019. Essentials of Nuclear Medicine and Molecular
Imaging 7th
edition, Elsevier, Inc.
• Ketrina mekalova, nuclear medicine studies power point slides
#7 Renal plasma flow and function. A, Glomerular filtration. Twenty percent of renal blood flow to the kidney is filtered through the glomerulus. B, Tubular secretion. The remaining 80% of renal plasma flow is secreted into the proximal tubules from the peritubular space.
