Usefulness of preset count acquisition in pediatric 99m Tc-DMSA planar imaging

Objective This study was aimed at determining the minimum acquisition count to provide diagnosable image quality (DIQ) and investigating the usefulness of preset count acquisition (PCA) for planar images of pediatric 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy. Methods First, we calculated a coefficient of variation (CV) for DIQ with the shortest acquisition time through visual evaluation in 12 pediatric patients who underwent 99m Tc-DMSA scintigraphy. Second, a minimum acquisition count to achieve the CV for DIQ was determined with the single regression analysis using CV as an explanatory variable and the total acquisition count as an objective variable in 81 pediatric patients. Finally, we compared PCA images based on the minimum acquisition count and preset time acquisition (PTA) images for 5 min in terms of the acquisition time, CV, and renal uptake ratio in another 23 pediatric patients. Results The visual evaluation showed that the CV corresponding to DIQ with the shortest acquisition time was 27.1%. The total acquisition count corresponding to DIQ was revealed to be 299,764 in the single regression analysis and was determined to be 300,000 after rounding. The CV and its standard deviation in PCA at 300,000 counts and PTA for 5 min were 26.4 ± 0.6% and 24.8 ± 1.3%, respectively. The standard deviation of CV in PCA at 300,000 counts was smaller than that in PTA for 5 min, indicating little variation in image quality between cases. The acquisition time in PCA at 300,000 counts (3.1 ± 0.7 min) was shorter than that in PTA for 5 min (5.0 ± 0.0 min). The intraclass correlation coefficient between renal uptake ratios for PCA and PTA was 0.98, indicating an extremely high concordance. Conclusions The minimum acquisition count required for the DIQ was 300,000. In addition, PCA at 300,000 counts was demonstrated to be useful by providing stable image quality at the shortest acquisition time.