Variable threshold levels for estimation of renal uptake of 99mTc-dimercaptosuccinic acid based on single photon emission computed tomography

To calculate renal uptake of 99mTc-dimercaptosuccinic acid (DMSA) more accurately using single photon emission computed tomography (SPECT), it is necessary to estimate values of threshold level, which corresponds to the ratio of kidney to background (BG ratio). Thus the phantom and clinical studies were conducted. Six kinds of renal phantoms of 80 to 339 ml, contained different radioactivity of 37 to 485 MBq were prepared. These phantoms were placed in a larger body phantom filled with 1 to 50% of radioactivity representing background. Clinical application of this method was also performed. Results were as follows. 1) A significant correlation between phantom volumes and estimated volumes obtained using threshold level based on BG ratio calculated on tomographic images was found (r = 0.99). 2) A significant correlation between total counts in estimated volumes and radioactivities in phantoms was recognized (r = 0.94). 3) Known radioactivity in phantoms and radioactivity in estimated volumes were highly related (r = 0.98). 4) Clinical application showed valuable results in patients with renal dysfunction. Thus, this method can calculate more accurate renal uptake of 99mTc-DMSA.