Document Detail

Key variables for interpreting 99mTc-mercaptoacetyltriglycine diuretic scans: development and validation of a predictive model.
MedLine Citation:
PMID:  21785077     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to facilitate interpretation of (99m)Tc-mercaptoacetyltriglycine (MAG3) diuretic scans by identifying key interpretative variables and developing a predictive model for computer-assisted diagnosis.
MATERIALS AND METHODS: Ninety-seven studies were randomly selected from an archived database of MAG3 baseline and furosemide acquisitions and scan interpretations (obstruction, equivocal finding, or no obstruction) derived from a consensus of three experts. Sixty-one studies (120 kidneys) were randomly chosen to build a predictive model for diagnosing or excluding obstruction. The other 36 studies (71 kidneys) composed the validation group. The probability of normal drainage (no obstruction) at the baseline acquisition and the probability of no obstruction, equivocal finding, or obstruction after furosemide administration were determined by logistic regression analysis and proportional odds modeling of MAG3 renographic data.
RESULTS: The single most important baseline variable for excluding obstruction was the ratio of postvoid counts to maximum counts. Renal counts in the last minute of furosemide acquisition divided by the maximum baseline acquisition renal counts and time to half-maximum counts after furosemide administration in a pelvic region of interest were the critical variables for determining obstruction. The area under the receiver operating characteristic curve (AUC) for predicting normal drainage in the validation sample was 0.93 (standard error, 0.02); sensitivity, 85%; specificity, 93%. The AUC for the diagnosis of obstruction after furosemide administration was 0.84 (standard error, 0.06); sensitivity, 82%; specificity, 83%.
CONCLUSION: A predictive system has been developed that provides a promising computer-assisted diagnosis approach to the interpretation of MAG3 diuretic renal scans; this system has also identified the key variables required for scan interpretation.
Jieqiong Bao; Amita Manatunga; Jose Nilo G Binongo; Andrew T Taylor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Validation Studies    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  197     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-09-27     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  325-33     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Area Under Curve
Diagnosis, Computer-Assisted
Furosemide / diagnostic use
Logistic Models
Middle Aged
Predictive Value of Tests
ROC Curve
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Technetium Tc 99m Mertiatide / diagnostic use*
Ureteral Obstruction / radionuclide imaging*
Grant Support
R01 EB008838/EB/NIBIB NIH HHS; R01 EB008838-07/EB/NIBIB NIH HHS; R01 EB008838-08/EB/NIBIB NIH HHS; R01-EB008838/EB/NIBIB NIH HHS
Reg. No./Substance:
0/Radiopharmaceuticals; 36ITO9SKQJ/Technetium Tc 99m Mertiatide; 7LXU5N7ZO5/Furosemide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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