Background Information:

What are the other Names for the Procedure?

• Kidney Imaging
• Kidney Scan
• Renal Scan

What is Renal Scintigraphy radiology procedure? (General Explanation)

• Renal Scintigraphy is performed to evaluate the function and anatomy of the kidneys using radioisotopes
• Renal Scintigraphy involves injecting radioisotope materials that accumulate in the kidneys and gives out gamma rays, which are detected by gamma cameras. This information is used to produce images of the kidneys to obtain information about the structure and function of the kidneys
• An ultrasound, CT, or MRI scan can also be used to evaluate the kidneys

What part of the Body does the Procedure involve?

A Renal Scintigraphy procedure involves the kidneys and structures associated with kidneys such as the renal arteries.

Why is the Renal Scintigraphy radiology procedure Performed?

A Renal Scintigraphy is used to diagnose a variety of medical conditions affecting the kidney structure and function.

• It is used to determine the narrowing of the renal arteries and perfusion to the kidneys
• Blockages in kidney can be determined by using Diuretic Renal Scintigraphy
• In certain patient populations, the kidneys are the cause of high blood pressure. ACE-inhibitor scintigraphy is used to diagnose this condition by taking images of the kidney before and after taking ACE inhibitor. ACE inhibitors are blood pressure medications
• Cortical Renal Scintigraphy is used to determine the quantum of functioning of kidney tissues
• Renal Scintigraphy is also used in determining conditions related to transplant and kidney failure

What is the Equipment used? (Description of Equipment)

The following equipment is used for Renal Scintigraphy:

• Gamma camera:
  • Radioisotopes injected into the patient’s body gives-off gamma rays
  • A gamma camera, also known as scintillation camera, detects these gamma rays and converts them into images
  • The gamma camera is placed in a metal box and attached to a circular donut-shaped machine, which has an examination table in the middle
  • The patient lies on the examination table and gamma cameras are suspended over and beneath the examination table      
• Single-photon emission computed tomography (SPECT):
  • SPECT is used to produce 3-dimensional images using the gamma camera
  • The gamma camera rotates around the patient’s body to produce the images

What are the Recent Advances in the Procedure?

There have been no recent advances in the Renal Scintigraphy procedure.

What is the Cost of performing the Renal Scintigraphy radiology procedure?

The cost of Renal Scintigraphy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Renal Scintigraphy procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25686542 (assessed on 3/5/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25683739 (assessed on 3/5/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25655484 (assessed on 3/5/2015)

Prior to Renal Scintigraphy radiology procedure:

How does the Renal Scintigraphy radiology procedure work?

A Renal Scintigraphy procedure works in the following manner:

• The radioisotope is injected, swallowed, or inhaled by the patient
• The radioisotope accumulates in the target organ depending on the metabolic activity of the organ
• The accumulated radioisotope material gives-off gamma rays, which are then detected by special gamma cameras. These gamma rays are used by gamma cameras to convert them into images, which provide information about the structure and function of the kidneys
• Areas with higher accumulation of the radiotracer material have a high metabolic activity and are called “hotspots”
• Areas with low accumulation of radiotracer material have low metabolic activity and are called “cold spots”

How is the Renal Scintigraphy radiology procedure Performed?

A Renal Scintigraphy procedure is usually performed as an outpatient procedure at a hospital.

• Prior to imaging, the radioisotope material is injected
• In certain procedures, such as ACE inhibitor Renal Imaging, Diuretic Renal Scintigraphy, and renal perfusion and function imaging, the imaging is started while the radioisotope material is being administered. In Cortical Renal Scintigraphy, imaging is performed 3-4 hours after the radioisotope material injection
• After the injection of the radioisotope material, the patient is positioned on the examination table. An IV line is inserted into the patient’s arm vein
• The gamma camera takes the required images, while the patient is lying on the examination table in a supine position
• The patient may be required to change position during the imaging in order to obtain images from different angles
• After the procedure is complete, the patient is taken to the recovery area

Where is the Procedure Performed?

Renal Scintigraphy is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A radiology technologist performs the Renal Scintigraphy procedure, under the supervision of a radiologist.

How long will the Procedure take?

Depending upon the type of procedure being performed, a Renal Scintigraphy may take 30 minutes to four hours.

Who interprets the Result?

A radiologist interprets the results of the Renal Scintigraphy procedure.

What Preparations are needed, prior to the Procedure?

Following preparations are needed prior to the Renal Scintigraphy procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Patient should notify physician if they are taking any kind of blood thinner medications, such as warfarin (caumadin), heparin, aspirin, clopidogrel, or pradaxa, as it may increase risk of bleeding during the procedure
• The physician should be informed about the patient’s medical conditions, medications, recent hospitalizations, surgeries, and allergies
• Patient may be required to drink extra fluid before the procedure to increase urine production
• Patient may be given diuretic to increase the urine production
• Certain kind of Renal Scintigraphy procedures requires that the bladder be empty. In order to empty the bladder, a urine catheter insertion may be required
• Women should notify their physician if they are pregnant or may be pregnant
• Patient should also inform physician if they are taking any NSAIDs
• Patients may receive additional instructions depending on the procedure being performed

What is the Consent Process before the Procedure?

A physician will request your consent for Renal Scintigraphy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of a Renal Scintigraphy procedure:

• It is a non-invasive procedure
• The procedure not only provides information about the kidney structure, but also about the function
• It is extremely useful in diagnosing a variety of medical conditions affecting the kidneys

Following are the risks of a Renal Scintigraphy procedure:

• Radioisotope material used during the procedure may cause severe allergic reaction in some patient populations
• Risk of cancer caused by radiation during the procedure is very low, as only a small dose of radioisotope is used during the procedure
• The radioisotope injection may cause a little pain and redness of the skin

What are the Limitations of the Renal Scintigraphy radiology procedure?

Following are the limitations of a Renal Scintigraphy procedure:

• These procedures are time-consuming, as a wait period is required for radioisotope accumulation
• Renal Scintigraphy cannot help differentiate between renal cysts and tumors
• A CT or MRI scan provides better resolution of structures then obtained through a Renal Scintigraphy

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Renal Scintigraphy procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
• Is there any medication that needs to be taken for life after the procedure?
• What are the costs involved?

During the Renal Scintigraphy radiology procedure:

What is to be expected during the Renal Scintigraphy radiology procedure?

The following may be expected during the Renal Scintigraphy procedure:

• The patient may feel a slight pain when the IV line is inserted into the arm vein during a Renal Scintigraphy procedure
• The patient may experience a metallic taste in their mouth when the radioisotope is injected
• It is important to remain still during the procedure to obtain good-quality images and the patient may feel a slight discomfort, as they may have to remain in the same position for a long time
• After the images are taken, the patient may have to wait in the waiting area, until the technologist checks to see if any additional images are required

What kind of Anesthesia is given, during the Procedure?

No anesthesia is used during the Renal Scintigraphy procedure.

How much Blood will you lose, during the Procedure?

Since the Renal Scintigraphy procedure is a non-invasive one, no blood is lost during the procedure.

What are the possible Risks and Complications during the Renal Scintigraphy radiology procedure?

The radioisotope material may cause severe allergy reactions in some patient populations, during the Renal Scintigraphy procedure.

What Post-Operative Care is needed at the Healthcare Facility after the Renal Scintigraphy radiology procedure?

No specific post-operative care is needed at healthcare facility after the Renal Scintigraphy procedure.

After the Renal Scintigraphy radiology procedure:

What is to be expected after the Renal Scintigraphy radiology procedure?

• Renal Scintigraphy is a noninvasive procedure and does not require any recovery period after the procedure
• Patient may resume their normal activities immediately after the procedure

When do you need to call your Physician?

If the patient develops an allergic reaction, such as redness, itching, warmth, or swelling around the area of radioisotope injection accompanied by high fever, then they may need to call their physicians.

What Post-Operative Care is needed at Home after the Renal Scintigraphy radiology procedure?

No specific post-operative care is needed at home after the Renal Scintigraphy procedure.

How long does it normally take to fully recover, from the Procedure?

Renal Scintigraphy is a noninvasive procedure that does not require any recovery period. Individuals may resume their normal activities immediately after the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

Renal Scintigraphy procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the Renal Scintigraphy procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Renal Scintigraphy radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Renal Scintigraphy procedure is performed.