Inaccuracies in quantitative radionuclide renal imaging due to patient position or diverging collimation

Radionuclide renal studies with quantitative measurements in patients confined to intensive care units usually require the use of a 10-inch field-of-view mobile gamma camera and a diverging collimator to image both kidneys simultaneously. The patient must frequently be in the lateral decubitus position so imaging can be performed in the posterior projection. Due to spatial distortion caused by the diverging collimator, variations in detector angulation and kidney depth produce different detection efficiencies for each kidney. Counts in regions of interest over the kidneys were compared as a function of detector angulation and patient position (prone and lateral decubitus). Substantial variations were observed comparing the diverging collimator data to 15-inch field-of view parallel hole acquisitions. Significant variation can also be obtained with parallel hole collimators when the patient's position is changed.