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. Author manuscript; available in PMC: 2015 Jun 2.
Published in final edited form as: J Nucl Med. 2014 Mar 3;55(5):786–798. doi: 10.2967/jnumed.113.133454

FIGURE 2.

FIGURE 2

A 57-y-old man with prostate adenocarcinoma had undergone radical cystoprostatectomy and urinary diversion with construction of neobladder from piece of large intestine. Abdominal CT performed 2 y after resection showed mild left-sided hydronephrosis. (A) Reno-gram after administration of 395.9 MBq (10.1 mCi) of 99mTc-MAG3 showed persistent activity within left urinary collecting system; 40 mg of furosemide (Lasix; Sanofi-Aventis) were subsequently administered followed by 20-min acquisition, which showed minimal clearance from collecting system and abnormal T½ of 19 min for left kidney; however, poor drainage may have resulted from relatively high pressure within reservoir and ureteral reflux. (B) Baseline renogram was repeated with 355.6 MBq (9.61 mCi) of 99mTc-MAG3 and again shows accumulation of activity within left collecting system; right kidney is not obstructed. To minimize possibility of reflux, Foley catheter was placed into ileostomy. Postfurosemide renogram showed complete emptying of left collecting system with half-life of 9.9 min, excluding obstruction. In adults with urinary diversion, incidence of reflux is relatively high. Given ease of placing indwelling catheter into ileostomy, protocol for diuretic renogram should include catheterization to maximize diagnostic accuracy. (Reprinted with permission of (25))