Comparison of radiation attenuation correction techniques for relative renal function calculation in renal cortical imaging

Benchamat  Phromphao; Sorasak  Wanitchanan; Trai  Chairat; Thunyaluk  Sawatnatee; Tanawat  Sontrapornpol

Authors

Benchamat Phromphao King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Sorasak Wanitchanan Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
Trai Chairat Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
Thunyaluk Sawatnatee King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Tanawat Sontrapornpol King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Keywords:

Attenuation correction, kidney depth, relative renal function, renal cortical imaging

Abstract

Background: A ^99mTc-dimercaptosuccinic acid (^99mTc-DMSA) scan is used for renal cortical imaging, specifically for the detection of renal cortical abnormalities, ectopic kidneys, renal scars, etc. Furthermore, relative renal function (RRF) is performed using ^99mTc-DMSA planar imaging and estimated from the radiopharmaceutical uptake in the kidneys with background subtraction and radiation attenuation correction. Generally, attenuation correction is calculated from mathematical methods using the kidney depth correction (KDC) to obtain an accurate renal function value.

Objectives: This research aimed to study the correlation of the RRF after background subtraction with radiation attenuation correction using the geometric mean (GM) method and KDC according to the BeerLambert law equation.

Methods: Researchers studied the spherical phantom, the kidney phantom, and patients’ data. The phantom and patient data were acquired via gamma camera imaging. In all of the assessments, the background and kidney region of interest were created in planar images for subtracting the background counts and calculating the activity counts in the kidneys. This was used to record and analyze the data and then evaluate the RRF.

Results: For the RRF results with background subtraction and radiation attenuation correction in the phantom studies, the GM method was consistent with the KDC calculated using the Beer–Lambert law equation and the true kidney depth (intraclass correlation coefficient (ICC) > 0.8). The patient studies showed that the RRF results from the GM method correlated with the other KDC methods (R² > 0.95), and the GM method was not significantly different from that of the other KDC calculation methods (P > 0.05, ICC > 0.95).

Conclusion: Radiation attenuation corrected with the GM method and KDC calculation using the Beer– Lambert law equation method can be used to appropriately estimate the RRF in renal cortical imaging.

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