NUCLEAR RENAL SCANS

DTPA Renogram:

  • Ideal, most accurate and reproducible non-invasive technique for measuring GFR
  •  Common indications:
    ● Prospective renal donors
    ● Cancer patients before chemotherapy
    ● Elevated Sr. Creatinine, to document baseline       renal function

EC / MAG3 Renogram:

  • Tubular secretory agent with beer imaging characteristics
  • Common indications:
  • Evaluation of hydronephrosis — obstructed vs non-obstructed systems
    • Assess differential renal function
    • Renal calculus disease – to assess function and    drainage
    • Evaluation Of renovascular hypertension

DMSA Renal scan:

  • Imaging pyelonpephris

  • Commonly used in paediatric population with recurrent urinary tract infections, to differentiate a lower urinary tract infection from pyelonephritis.

Evaluation of thyroid trapping function

● Common indications:
● Assessment of Thyrotoxicosis:
● Can reliably differentiates a subacute thyroiditis (that is self limitng) vs a Graves’ disease (that needs long term treatment).

● Evaluation of thyroid nodules

● Multinodular goiter with low TSH – to diagnose and
manage toxic MNG
● Evaluation of neonatal hypothyroidism
● Thyroid agenesis vs congenital hypothyroidism
● Lingual / ectopic thyroid imaging

Radioiodine therapy:

  • Low dose radioiodine therapy for hyperthyroidism
  • Treatment of choice in patients who do not respond to an thyroid drug trials (for 12 months usually)
  • 5 min single dose treatment (swallow tasteless colourless water-like liquid) has an objective response in more than 80% patients
  • No major adverse effects

High dose radioiodine therapy for thyroid cancers:

  • Standard adjuvant treatment in every case of
    operated thyroid cancer
  • Treatment of choice for metastatic well-
    differentiated thyroid cancers
  • Excellent treatment response with no major adverse effects

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