ABSTRACT
Radionuclide examinations of the kidneys include in vitro measurement of plasma clearance of radiopharmaceuticals excreted by the kidneys and imaging examinations of the kidneys and urinary tract: Static and dynamic renal scintigraphy and radionuclide cystography. The main advantage of radionuclide examinations of the kidneys is accuracy of measurement of kidney function. Individual methods are presented with emphasis on their physiological basis, quality control, data processing, and quantitative assessment of the results. Plasma clearance of radiopharmaceuticals filtered by the kidneys currently represents the most accurate index of total renal function, even in its simplest form using a single blood sample collected after a single injection of the radiopharmaceutical. Static renal scintigraphy provides detailed images of functional renal parenchyma and accurate values of relative function of the left and right kidneys. Dynamic renal scintigraphy provides data on entire set of clinically important individual (left and right) kidney functions – perfusion, uptake, transit, and outflow. Accuracy of their assessment depends on proper data acquisition and subsequent data processing. Both regression and model-based methods for the measurement of single-kidney function are presented. Radionuclide cystography is a useful tool for monitoring vesico-ureteral reflux, especially in children. Emerging methods of kidney examination with PET/CT are briefly summarized.
