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The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis

BACKGROUND: Gallium-67 scintigraphy has been suggested as a noninvasive method to diagnose acute interstitial nephritis (AIN). However, its diagnostic performance and usefulness remain controversial. METHODS: We retrospectively reviewed the charts of 76 patients who underwent gallium-67 scintigraphy...

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Autores principales: Graham, François, Lord, Martin, Froment, Daniel, Cardinal, Héloise, Bollée, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720207/
https://www.ncbi.nlm.nih.gov/pubmed/26798465
http://dx.doi.org/10.1093/ckj/sfv129
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author Graham, François
Lord, Martin
Froment, Daniel
Cardinal, Héloise
Bollée, Guillaume
author_facet Graham, François
Lord, Martin
Froment, Daniel
Cardinal, Héloise
Bollée, Guillaume
author_sort Graham, François
collection PubMed
description BACKGROUND: Gallium-67 scintigraphy has been suggested as a noninvasive method to diagnose acute interstitial nephritis (AIN). However, its diagnostic performance and usefulness remain controversial. METHODS: We retrospectively reviewed the charts of 76 patients who underwent gallium-67 scintigraphy for a suspicion of AIN. Patients were classified based on kidney biopsy and/or clinical probability of AIN. Gallium-67 scintigraphy results were reinterpreted blindly using both posterior planar and single photon emission computed tomography (SPECT) imaging. Intensity of radioisotope uptake in the kidney was graded from 0 to 5. RESULTS: The diagnosis of AIN was confirmed in 23 patients and excluded in 44. Nine patients with an uncertain diagnosis were excluded from subsequent analysis. A gallium-67 kidney uptake cutoff of 1 gave a negative predictive value of 100%, whereas a cutoff of 5 had an excellent specificity and positive predictive value for the diagnosis of AIN. When using a cutoff of 3, which had previously been used in the literature, we obtained a sensitivity of 61% and a specificity of 75% with posterior planar imaging. The results of both SPECT and posterior planar imaging modalities were comparable. CONCLUSIONS: Gallium-67 scintigraphy may be of interest in patients with a clinical suspicion of AIN, especially in those who are unable to undergo kidney biopsy. However, results need to be interpreted with caution and depend on the intensity of gallium-67 kidney uptake.
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spelling pubmed-47202072016-01-21 The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis Graham, François Lord, Martin Froment, Daniel Cardinal, Héloise Bollée, Guillaume Clin Kidney J Tubulointerstitial Disease Diagnosis BACKGROUND: Gallium-67 scintigraphy has been suggested as a noninvasive method to diagnose acute interstitial nephritis (AIN). However, its diagnostic performance and usefulness remain controversial. METHODS: We retrospectively reviewed the charts of 76 patients who underwent gallium-67 scintigraphy for a suspicion of AIN. Patients were classified based on kidney biopsy and/or clinical probability of AIN. Gallium-67 scintigraphy results were reinterpreted blindly using both posterior planar and single photon emission computed tomography (SPECT) imaging. Intensity of radioisotope uptake in the kidney was graded from 0 to 5. RESULTS: The diagnosis of AIN was confirmed in 23 patients and excluded in 44. Nine patients with an uncertain diagnosis were excluded from subsequent analysis. A gallium-67 kidney uptake cutoff of 1 gave a negative predictive value of 100%, whereas a cutoff of 5 had an excellent specificity and positive predictive value for the diagnosis of AIN. When using a cutoff of 3, which had previously been used in the literature, we obtained a sensitivity of 61% and a specificity of 75% with posterior planar imaging. The results of both SPECT and posterior planar imaging modalities were comparable. CONCLUSIONS: Gallium-67 scintigraphy may be of interest in patients with a clinical suspicion of AIN, especially in those who are unable to undergo kidney biopsy. However, results need to be interpreted with caution and depend on the intensity of gallium-67 kidney uptake. Oxford University Press 2016-02 2015-12-10 /pmc/articles/PMC4720207/ /pubmed/26798465 http://dx.doi.org/10.1093/ckj/sfv129 Text en © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Tubulointerstitial Disease Diagnosis
Graham, François
Lord, Martin
Froment, Daniel
Cardinal, Héloise
Bollée, Guillaume
The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title_full The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title_fullStr The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title_full_unstemmed The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title_short The use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
title_sort use of gallium-67 scintigraphy in the diagnosis of acute interstitial nephritis
topic Tubulointerstitial Disease Diagnosis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720207/
https://www.ncbi.nlm.nih.gov/pubmed/26798465
http://dx.doi.org/10.1093/ckj/sfv129
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