{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T23:21:21Z","timestamp":1773184881298,"version":"3.50.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Nucl Med"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Primary megaureter is a disease defined as the dilatation of the ureter caused by a congenital abnormality of the lower ureteral tract. Adult patients with primary megaureters typically present with no symptoms, making conservative management the preferred treatment. However, if an obstruction is present, we recommend ureteral reimplantation. The major diagnostic challenge is to distinguish which patients need surgical intervention. Ultrasound, computed tomography, and magnetic resonance imaging urogram findings of obstruction may be misleading because they are based on morphological aspects, and persistence of contrast in the upper urinary tract is not specific for obstruction. Renal scintigraphy is the key test for choosing surgical or conservative treatment; historically, the criterion for surgical treatment is the decrease of split renal function (SRF) less than 40%. Unfortunately, SRF might be only an indirect finding of obstruction; otherwise, the 20-minute\/peak ratio may offer urologists an earlier, direct, and reliable index of urine outflow in monitoring ureteral flow. This study suggests that the F\u2009+\u200910(sitting position) test, which measures diuretic renography (DR) in a sitting position, is a new and useful way to find out how well primary megaureters are working for diagnosing and treating them. It focuses on the 20-minute\/peak ratio that can be found when gravity is favorable.<\/jats:p><jats:p>\n          Methods\u2003Twenty-eight adult patients (15 males, 13 females) affected by primary megaureter were retrospectively enrolled. Twenty-six patients had unilateral megaureter, and 2 patients had bilateral megaureter, for a total of 30 megaureters radiologically confirmed (16 left, 14 right). In total, we performed twenty-eight 99mTc-mercaptoacetyltriglycine DR in a sitting position using the F\u2009+\u200910 (sitting position) method. In our series, 17 patients received conservative treatment, and 11 patients underwent ureteral reimplantation.<\/jats:p><jats:p>\n          Results\u2003Based on the 20-minute\/peak ratio values, 17 out of 30 megaureters were diagnosed as obstructed. A discordance between SRF and 20-minute\/peak ratio findings has been seen. No side effects were seen.<\/jats:p><jats:p>\n          Conclusion\u2003A decrease in SRF is an indirect and late index of obstruction. Twenty-minute\/peak ratio measured by DR in sitting position may improve the sensitivity and accuracy of the test for diagnosis of obstructive megaureters.<\/jats:p>","DOI":"10.1055\/s-0045-1802665","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T23:52:11Z","timestamp":1740095531000},"page":"128-137","source":"Crossref","is-referenced-by-count":1,"title":["Diuretic Renography in a Sitting Position with F\u2009+\u200910(sp) Method for Diagnostic Management of Primary Megaureter in Adults"],"prefix":"10.1055","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1764-5230","authenticated-orcid":false,"given":"Girolamo","family":"Tartaglione","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Cristo Re Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8722-9494","authenticated-orcid":false,"given":"Francesco Pio","family":"Ieria","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Cristo Re Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0260-4601","authenticated-orcid":false,"given":"Riccardo","family":"Bertolo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Pediatrics and Gynecology, Urology Unit, University of Verona, Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4788-2982","authenticated-orcid":false,"given":"Pierluigi","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5597-2742","authenticated-orcid":false,"given":"Matteo","family":"Vittori","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"issue":"S 01","key":"ref1","first-page":"S31","article-title":"Paper 4: EUROCAT statistical monitoring: identification and investigation of ten year trends of congenital anomalies in Europe","volume":"91","author":"M Loane","year":"2011","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"key":"ref2","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-642-55831-3_2","volume-title":"The normal ureter","author":"M Claudon","year":"2003"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.juro.2013.03.008","article-title":"Long-term followup of primary nonrefluxing megaureter","volume":"190","author":"D Di Renzo","year":"2013","journal-title":"J Urol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jpurol.2011.05.012","article-title":"Acute pain crisis as a presentation of primary megaureter in children","volume":"8","author":"C B Anderson","year":"2012","journal-title":"J Pediatr Urol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jpurol.2013.09.018","article-title":"British Association of Paediatric Urologists consensus statement on the management of the primary obstructive megaureter","volume":"10","author":"M K Farrugia","year":"2014","journal-title":"J Pediatr Urol"},{"issue":"01","key":"ref6","first-page":"35","article-title":"Voiding cystourethrogram in the diagnosis of vesicoureteric reflux in children with antenatally diagnosed hydronephrosis","volume":"5","author":"R B Nerli","year":"2009","journal-title":"Ther Clin Risk Manag"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5489\/cuaj.8460","article-title":"A quantitative analysis of voiding cystourethrogram features confirms the association between high-grade vesicoureteral reflux with male sex, younger age, and hydronephrosis","volume":"17","author":"A Khondker","year":"2023","journal-title":"Can Urol Assoc J"},{"key":"ref8","volume-title":"The diuresis renogram: how it's done and how to interpret it","author":"R Sajjan","year":"2023"},{"key":"ref9","volume-title":"Hydronephrosis and Hydroureter","author":"R Thotakura","year":"2023"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.2214\/AJR.07.4023","article-title":"Determination of split renal function by 3D reconstruction of CT angiograms: a comparison with gamma camera renography","volume":"191","author":"A L Summerlin","year":"2008","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/j.1464-410X.2004.05052.x","article-title":"Interpretation of the renogram: problems and pitfalls in hydronephrosis in children","volume":"94","author":"A Eskild-Jensen","year":"2004","journal-title":"BJU Int"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.2298\/VSP140818110R","article-title":"Diuretic 99mTc DTPA renography in assessment of renal function and drainage in infants with antenatally detected hydronephrosis","volume":"72","author":"M Radulovi\u0107","year":"2015","journal-title":"Vojnosanit Pregl"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1097\/RLU.0b013e31828da3f5","article-title":"(99m)Tc-MAG3 diuretic renography in diagnosis of obstructive nephropathy in adults: a comparison between F-15 and a new procedure F+10(sp) in seated position","volume":"38","author":"G Tartaglione","year":"2013","journal-title":"Clin Nucl Med"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"221","DOI":"10.5301\/RU.2011.8633","article-title":"(99m)Tc-MAG3 diuretic renography in assessment of obstructive uropathy. The new test F+10SP: a step ahead in the differential diagnosis [in Italian]","volume":"78","author":"M Vittori","year":"2011","journal-title":"Urologia"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1097\/MNM.0000000000001378","article-title":"Advantages of gravity-assisted diuretic renogram: F\u2009+\u200910 (seated position) method","volume":"42","author":"G Tartaglione","year":"2021","journal-title":"Nucl Med Commun"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00247-010-1590-1","article-title":"Obstructive diseases of the urinary tract in children: lessons from the last 15 years","volume":"40","author":"M Riccabona","year":"2010","journal-title":"Pediatr Radiol"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"W882-6","DOI":"10.2214\/AJR.11.6965","article-title":"Optimization of 64-MDCT urography: effect of dual-phase imaging with furosemide on collecting system opacification and radiation dose","volume":"197","author":"O Portnoy","year":"2011","journal-title":"AJR Am J Roentgenol"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.radi.2020.07.002","article-title":"Comparison of quality of urinary bladder filling in CT urography with different doses of furosemide in the work-up of patients with macroscopic hematuria","volume":"27","author":"A Ljungberg","year":"2021","journal-title":"Radiography (Lond)"},{"issue":"11","key":"ref19","first-page":"1872","article-title":"Consensus on diuresis renography for investigating the dilated upper urinary tract","volume":"37","author":"P O'Reilly","year":"1996","journal-title":"J Nucl Med"},{"issue":"03","key":"ref20","first-page":"210","article-title":"Diuresis renography. The need for an additional view after gravity-assisted drainage","volume":"18","author":"M A Rossleigh","year":"1993","journal-title":"Clin Nucl Med"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1464-410X.1978.tb03030.x","article-title":"Diuresis renography in equivocal urinary tract obstruction","volume":"50","author":"P H O'Reilly","year":"1978","journal-title":"Br J Urol"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/j.1464-410X.1992.tb15479.x","article-title":"Diuresis renography. Recent advances and recommended protocols","volume":"69","author":"P H O'Reilly","year":"1992","journal-title":"Br J Urol"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1464-410X.1992.tb15481.x","article-title":"The F-15 diuresis renogram in suspected obstruction of the upper urinary tract","volume":"69","author":"S M Upsdell","year":"1992","journal-title":"Br J Urol"},{"issue":"11","key":"ref24","first-page":"2047","article-title":"The \u201cwell tempered\u201d diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of The Society for Fetal Urology and members of The Pediatric Nuclear Medicine Council--The Society of Nuclear Medicine","volume":"33","author":"J J Conway","year":"1992","journal-title":"J Nucl Med"},{"issue":"11","key":"ref25","first-page":"1805","article-title":"F+0 diuresis renography in infants and children","volume":"40","author":"D C Wong","year":"1999","journal-title":"J Nucl Med"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/MNM.0b013e328318b33f","article-title":"Interobserver reproducibility in reporting on renal cortical scintigraphy in children: a large collaborative study","volume":"30","author":"M C Tondeur","year":"2009","journal-title":"Nucl Med Commun"},{"key":"ref27","doi-asserted-by":"crossref","DOI":"10.1201\/b13933","volume-title":"Functional Imaging in Nephro-Urology","author":"A Prigent","year":"2006"},{"issue":"11","key":"ref28","doi-asserted-by":"crossref","first-page":"3549","DOI":"10.1007\/s00467-023-05938-6","article-title":"Non-surgical management in children with non-refluxing primary megaureter: a systematic review and meta-analysis","volume":"38","author":"K Buder","year":"2023","journal-title":"Pediatr Nephrol"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1053\/j.semnuclmed.2018.02.010","article-title":"SNMMI procedure standard\/EANM practice guideline for diuretic renal scintigraphy in adults with suspected upper urinary tract obstruction 1.0","volume":"48","author":"A T Taylor","year":"2018","journal-title":"Semin Nucl Med"},{"issue":"04","key":"ref30","doi-asserted-by":"crossref","first-page":"309","DOI":"10.2967\/jnmt.121.263654","article-title":"Diuretic renal scintigraphy protocol considerations","volume":"50","author":"K P Banks","year":"2022","journal-title":"J Nucl Med Technol"},{"issue":"12","key":"ref31","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.jpedsurg.2022.05.015","article-title":"Modified technique for robot-assisted laparoscopic infantile ureteral reimplantation for obstructive megaureter","volume":"57","author":"W Zhu","year":"2022","journal-title":"J Pediatr Surg"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s11934-012-0250-4","article-title":"Current status of robot-assisted laparoscopic ureteral reimplantation and reconstruction","volume":"13","author":"E A Phillips","year":"2012","journal-title":"Curr Urol Rep"}],"container-title":["World Journal of Nuclear Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1802665.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T22:37:49Z","timestamp":1746571069000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1802665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":32,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,5,6]]},"published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1802665","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1450-1147","1607-3312"],"issn-type":[{"value":"1450-1147","type":"print"},{"value":"1607-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}