The Indonesian Biomedical Journal
Vol 17, No 5 (2025)

Impact of GFR Stratification on Tc-99m DTPA Dose Distribution in Target and Non-Target Organs: A MIRD-Based Comparative Study in Renogram Imaging

Luthfia Qalby (Department of Physics, Faculty of Science and Mathematics, Universitas Diponegoro, Jl. Prof. Jacob Rais, Semarang 50275)
Wahyu Setia Budi (Department of Physics, Faculty of Science and Mathematics, Universitas Diponegoro, Jl. Prof. Jacob Rais, Semarang 50275)
Eko Hidayanto (Department of Physics, Faculty of Science and Mathematics, Universitas Diponegoro, Jl. Prof. Jacob Rais, Semarang 50275)



Article Info

Publish Date
29 Oct 2025

Abstract

BACKGROUND: Renogram using Technetium-99m Diethylene Triamine Pentaacetic Acid (Tc-99m DTPA) is applied to evaluate renal perfusion, glomerular filtration rate (GFR), and urinary excretion. In patients with impaired renal function, delayed tracer elimination may increase accumulation in non-target organs such as the heart and liver, resulting in greater radiation exposure and reduced image quality. Studies examining the relationship between renal function and Tc-99m DTPA dose distribution remain limited, particularly in clinical settings in Indonesia. Therefore, in this study, an organ-level quantitative analysis of Tc-99m DTPA radiopharmaceutical dose distribution and absorbed dose using the Medical Internal Radiation Dose (MIRD) approach based on Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) imaging was performed.METHODS: Thirty adult patients undergoing renogram were categorized into low-GFR (<60 mL/min/1.73 m²) and high-GFR (≥60 mL/min/1.73 m²) groups. Each patient received 4–5 mCi of Tc-99m DTPA intravenously. Organ activities were obtained from regions of interest (ROIs) on SPECT/CT images, and organ-level absorbed doses (mGy) were calculated using the MIRD formalism.RESULTS: In the low-GFR group, tracer retention in non-target organs increased, with absorbed doses up to twofold higher in the heart (0.0002–0.0136 mGy) and liver (0.0010–0.0178 mGy) compared to the high-GFR group. Renal absorbed doses ranged from 0.0001–0.0694 mGy, showing no significant difference between the left and right kidneys, while significant differences were observed in the heart and liver.CONCLUSION: GFR significantly affects the radiopharmaceutical dose distribution and absorbed dose of Tc-99m DTPA. Reduced renal function increases radiation exposure in non-target organs, whereas normal function results in a more localized renal dose distribution.KEYWORDS: Tc-99m DTPA, renogram, MIRD, glomerular filtration rate, absorbed dose, SPECT/CT, nuclear medicine

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