Radiation-Exposing Imaging: CT, XR, NM

CT Imaging

Specific CT protocols

Genitourinary indications

XR Imaging (Still images + Fluoroscopy)

Kidney/Ureter/Bladder (KUB) plain film

Retrograde pyelogram

Loopogram/Pouchogram

Retrograde urethrogram

Cystography

IV Urography

Angiography

Nuclear Medicine

Radiotracer Indication Notes
99Tc-DTPA Renal obstruction
Renal function
Renovascular hypertension
Ureteral reflux
Dependent on GFR
Excreted through filtration
99Tc-DMSA Cortical defects
Ectopic kidneys
Not good for imaging collecting system
Bound in renal tubules
99Tc-MAG3 Renal plasma flow
Renal obstruction
Renovascular hypertension
Renal transplant function
Cannot evaluate GFR (bound to plasma proteins)
Cleared by tubular secretion
11C-choline mPCa recurrence after treatment Not useful for primary disease
18F-fluciclovine
(Axumin)
99Tc Bone scan for metastatic disease (PCa, RCC, BCa, UTUC) Confirmatory imaging to differentiate cancer from benign lesions
Na18F
68Ga-PSMA mPCa in primary and recurrent cancer
Piflufolastat F-18
68Ga DOTATATE Neuroendocrine tumors Useful for metastatic PCC or extraadrenal tumors, but not benign PCC
111In Pentetreotide
18F-DOPA
(Fluorodopa)
Pheochromocytoma Less sensitive for metastatic disease
18F-Dopamine
(Fluorodopamine)
18F-FDG Identify cancers using aerobic glycolysis Locates areas of increased metabolic activity
Assess for recurrence
123I MIBG Identify pheochromocytoma Preferred over 131I MIBG

Renal scintigraphy

Renal scintigraphy findings

Non-prostatic oncologic imaging (FDG-PET)

Radiation Exposure

Radiation Dosage

Limiting exposure

References