Accuracy of Tc-99m MAG-3 Renogram Scintigraphy in Assessment of Renal Allograft Dysfunction in Correlation with Allograft Biopsy.

27 Aim: To assess the value of perfusion and function parameters of dynamic renogram scintigraphy (RS) compared to renal biopsy (RB) and ultrasonography (US) in assessment of renal allograft dysfunction. Material and Methods: We studies 70 consecutive renal transplant patients who had post transplant RS, RB and US within Results: The study population included 46 (65.7%) living donor (LD) transplant and 24 (34.3%) cadaveric (CAD) transplant with mean graft age of 10.5±33 months (range 1 day to 16.9 years). Biopsy results included 19 acute cell mediated rejection, 3 acute antibody mediated rejection, 2 with chronic antibody mediated rejection, 2 with ischemic changes, 12 with diabetic or hypertensive nephropathy changes, 2 with mesangeal proliferation, 4 with isolated calcineurin inhibitors toxicity and 19 with isolated tubular injury. Patients with rejection or nephropathy on RB had higher perfusion score on RS (0.47±0.83 vs 0.09±0.53; p=0.024) and older graft age (18.9±43.3 vs 0.49±0.59 months; p=0.012). All patients with abnormal biopsy excluding those with isolated tubular injury, still had higher perfusion score and older graft age (0.45±0.43 vs 0.1±0.55; p=0.035) and (18.0±42.3 vs 0.49±0.61 months; p=0.013) respectively. Patients with abnormal PS (>0) had higher mean HS compared to those with normal PS (2.77±0.9 vs 1.83±1.29; p 0) had tendency to higher mean HS (2.58±0.73 vs 1.77±1.29; p 2 were associated with older graft age (27.5±50.3 vs 0.45±0.55 months; p=0.011). Cutoff values of PS˃0 was best to predict rejection or nephropathy on biopsy with sensitivity, specificity, PPV, NPP and accuracy of 31.58%, 96.87%, 92.3%, 54.4% & 61.43% (p