TEACHING WEBSITE FOR Tc-99m MAG3 DIURETIC RENOGRAPHY
This website is designed to enhance physician understanding and diagnostic accuracy in the interpretation of Tc-99m MAG3 diuretic renography studies. Users can interpret up to ten Tc-99m MAG3 diuretic renography studies and compare their interpretations for each kidney (obstructed, indeterminate, or not obstructed) with the interpretations provided by RENEX, an expert system for diuretic renography, and with the interpretations of three experienced readers. The website assumes users are referring physicians, residents, radiologists, or nuclear medicine physicians with prior exposure to Tc-99m MAG3 diuretic studies. First time users need to create an account (user name and password, upper right hand corner) to access the studies. To function properly, the website has to be viewed in Full Screen Mode on a computer or tablet; function on a smartphone is suboptimal.
This educational website was developed because
a large majority of the estimated 590,000 radionuclide renal scans performed
annually in the United States are conducted at sites that perform fewer than 3
studies per week. Due to the relative infrequency of renal studies,
some individuals may fail to acquire the expertise needed to provide a
competent interpretation. Limited training and experience may
discourage the use of the procedure, lead to incorrect scan interpretation and
negatively impact patient care.
The website is organized into a Home
Page, an introduction page
for Images
and Parameters, a RENEX Introduction page, and a Case
Review page. The Images and
Parameters page contains a sample study with an explanation of relevant
renogram parameters. The RENEX
Introduction page outlines the scoring system and provides a brief
summary of RENEX [1-3]. The Case Review page contains ten Tc-99m MAG3 diuretic studies that may be
reviewed in one or more settings and in any order. The acquisition
protocol consists of separate baseline and furosemide acquisitions, but the
interpretative rational will usually be relevant for acquisition protocols that
administer furosemide before or concurrently with Tc-99m MAG3.
NOTE: The reader is referred to the SNMMI procedure standard/EANM guideline for a more complete description of diuretic renography [4]. As a reminder, the website needs to be viewed in Full Screen Mode for optimal function.
- Garcia EV, Taylor A, Halkar R, Folks R, Krishnan M, Cooke CD, Dubovsky E. RENEX: An expert system for the interpretation of 99m Tc- MAG3 scans to detect renal obstruction. J Nucl Med 2006; 47:320-329 Link to article
- Taylor A, Garcia EV, Binongo JNG, Manatunga A, Halkar R, Folks R, Dubovsky EV. Diagnostic performance of an expert system for interpretation of Tc-99m MAG3 scans in suspected obstruction. J Nucl Med 2008; 49:216-224 Link to article
- Taylor AT, Garcia EV. Computer-assisted diagnosis in renal nuclear medicine: Rationale, methodology and interpretative criteria for diuretic renography. Semin Nucl Med 2014;44:146-158. Link to article
- Taylor AT, Brandon DC, de Palma D, Blaufox MD, Durand E, Erbas B, Grant SF, Hilson A, Morsing A. SNMMI Procedure Standard/EANM Practice Guideline for diuretic renal scintigraphy in adults with suspected upper urinary tract obstruction 1.0. Semin Nucl Med: 2018;48:377-390. Link to article