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Development and Prospective Evaluation of an Automated Software System for Quality Control of Quantitative ^99mTc-MAG3 Renal Studies

Emory University School of Medicine, Atlanta, Georgia

Correspondence: For correspondence or reprints contact: Russell D. Folks, CNMT, RT (N), Division of Nuclear Medicine, Emory University School of Medicine, 1364 Clifton Rd. NE, Atlanta, GA 30322. E-mail: rfolks{at}emory.edu

Quantitative nuclear renography has numerous potential sources of error. We previously reported the initial development of a computer software module for comprehensively addressing the issue of quality control (QC) in the analysis of radionuclide renal images. The objective of this study was to prospectively test the QC software. Methods: The QC software works in conjunction with standard quantitative renal image analysis using a renal quantification program. The software saves a text file that summarizes QC findings as possible errors in user-entered values, calculated values that may be unreliable because of the patient's clinical condition, and problems relating to acquisition or processing. To test the QC software, a technologist not involved in software development processed 83 consecutive nontransplant clinical studies. The QC findings of the software were then tabulated. QC events were defined as technical (study descriptors that were out of range or were entered and then changed, unusually sized or positioned regions of interest, or missing frames in the dynamic image set) or clinical (calculated functional values judged to be erroneous or unreliable). Results: Technical QC events were identified in 36 (43%) of 83 studies. Clinical QC events were identified in 37 (45%) of 83 studies. Specific QC events included starting the camera after the bolus had reached the kidney, dose infiltration, oversubtraction of background activity, and missing frames in the dynamic image set. Conclusion: QC software has been developed to automatically verify user input, monitor calculation of renal functional parameters, summarize QC findings, and flag potentially unreliable values for the nuclear medicine physician. Incorporation of automated QC features into commercial or local renal software can reduce errors and improve technologist performance and should improve the efficiency and accuracy of image interpretation.

Key Words: renal function; quality control; ^99mTc-MAG3; MAG3 clearance

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				A. Taylor, E. V. Garcia, J. N. G. Binongo, A. Manatunga, R. Halkar, R. D. Folks, and E. Dubovsky Diagnostic Performance of an Expert System for Interpretation of 99mTc MAG3 Scans in Suspected Renal Obstruction J. Nucl. Med., February 1, 2008; 49(2): 216 - 224. [Abstract] [Full Text] [PDF]