Usefulness of gallium-67 scintigraphy for evaluating the histopathological activity in interstitial nephritis.

Mimiko Matsumura, Akira Okada, Hiroaki Yokoyama, Mariko Sekiguchi, Akira Shimizu, Tetsuhiro Tanaka, Masaomi Nangaku, Hideki Takano

Clinical and experimental nephrology 2023 Mar

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Interstitial nephritis is a common cause of renal failure. Gallium-67 scintigraphy is reportedly useful for diagnosing interstitial nephritis; however, its ability to assess disease activity remains unknown. We aimed to analyze the relationship between the renal uptake of gallium-67 and the disease activity in interstitial nephritis. We retrospectively analyzed the data of patients who underwent gallium-67 scintigraphy at a hospital in Tokyo. The renal uptake adjusted for the soft tissues beneath the kidneys was semi-quantitatively evaluated. We compared the renal uptake levels between patients clinically diagnosed with and without interstitial nephritis. Among those undergoing renal biopsy, we evaluated the predictive ability of gallium-67 scintigraphy and analyzed the renal uptake levels regarding the disease activity through a histopathological analysis. We included 143 patients; among them, 30, 17, and 96 patients were clinically diagnosed with interstitial nephritis, other kidney diseases, and non-kidney diseases, respectively. The renal uptake of gallium-67 was the highest among patients with interstitial nephritis. Among the 25 patients who underwent renal biopsy, 15 were pathologically diagnosed with interstitial nephritis. The renal uptake levels showed a high discriminative ability (C-statistic: 0.83). Furthermore, net reclassification improvement with the addition of gallium-67 scintigraphy to N-acetyl-β-D-glucosaminidase for the prediction of interstitial nephritis was 1.14. Histopathological analysis revealed a positive correlation between renal uptake and inflammation in the cortex and peritubular capillaries. This study confirmed the diagnostic value and potential usefulness of gallium-67 scintigraphy for evaluating interstitial nephritis. © 2022. The Author(s), under exclusive licence to The Japanese Society of Nephrology.

Citation

Mimiko Matsumura, Akira Okada, Hiroaki Yokoyama, Mariko Sekiguchi, Akira Shimizu, Tetsuhiro Tanaka, Masaomi Nangaku, Hideki Takano. Usefulness of gallium-67 scintigraphy for evaluating the histopathological activity in interstitial nephritis. Clinical and experimental nephrology. 2023 Mar;27(3):251-261