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  • Title: Correlation of various published radionuclide glomerular filtration rate estimation techniques and proposed paediatric normative data.
    Author: Bhatt MK, Bartlett ML, Mallitt KA, McTaggart S, Ravi Kumar AS.
    Journal: Nucl Med Commun; 2011 Nov; 32(11):1088-94. PubMed ID: 21897307.
    Abstract:
    OBJECTIVE: The aim of this study is to assess the comparability and interchangeability of the radionuclide glomerular filtration rate (GFR) using different published techniques, and propose normative data for paediatrics. METHODS: A total of 476 paediatric oncology patients aged 2-17 years, referred between January 2001 and December 2008 for GFR estimation, were reviewed for any potential cause of renal impairment. Sixty-nine patients met the stringent inclusion criteria, and were included in the study. GFR estimation was carried out using either technetium-99m diethylene triamine penta-acetic acid (⁹⁹mTc-DTPA) or chromium-51 EDTA (⁵¹Cr-EDTA). Multiple GFR results were calculated from the same blood sample data (counts/min/ml), according to previously published GFR estimation techniques using one to three blood samples. These techniques were slope-intercept, slope-only and half life. For slope-intercept techniques, GFR was normalized to body surface area or extracellular fluid volume. RESULTS: The GFR values obtained using different techniques were highly variant. The intraclass correlation (ICC) for different methods was moderate (ICC=0.56-0.66). A reliable empiric formula to allow conversion of GFR values from one technique to another could not be derived because of this variability, with some exceptions. ⁵¹Cr-EDTA yielded the same or lower variability than ⁹⁹mTc-DTPA. The British Nuclear Medicine Society-recommended method had the lowest coefficient of variation, with a mean value of 116 (SD 22) normalized to 1.73 m² for ⁵¹Cr-EDTA using two samples. CONCLUSION: The GFR values obtained from different calculation techniques are not readily interchangeable or comparable, with some exceptions. For both ⁹⁹mTc-DTPA and ⁵¹Cr-EDTA, the British Nuclear Medicine Society-recommended technique appears to be the most robust, with the least coefficient of variation.
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