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. 2023 Mar;27(3):251-261.
doi: 10.1007/s10157-022-02302-0. Epub 2022 Dec 27.

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

Mimiko Matsumura  1   2 , Akira Okada  3   4 , Hiroaki Yokoyama  5 , Mariko Sekiguchi  6 , Akira Shimizu  7 , Tetsuhiro Tanaka  3 , Masaomi Nangaku  3 , Hideki Takano  6
Affiliations

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

Mimiko Matsumura et al. Clin Exp Nephrol. 2023 Mar.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: This study confirmed the diagnostic value and potential usefulness of gallium-67 scintigraphy for evaluating interstitial nephritis.

Keywords: Biopsy; Clinical epidemiology; Gallium-67 scintigraphy; Interstitial nephritis; Radionuclide imaging.

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