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

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.

Key words

DMSA - SPECT - ultrasound - kidney - children

Schlüsselwörter

DMSA - SPECT - Ultraschall - Fusionsbildgebung - Niere

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