{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:48:41Z","timestamp":1792594121090,"version":"4.5.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Radionuclide shuntography (RS) performed using <jats:sup>99m<\/jats:sup>Tc-DTPA injected into the reservoir of CSF shunts enables evaluation of CSF flow for suspected shunt malfunctions. The goal of this study was to report the authors\u2019 institutional experience with RS and evaluate its utility and associated complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed all RS studies performed between November 2003 and June 2022. Patients with shunted hydrocephalus who were \u2265 18 years of age were included. Patients undergoing RS for evaluation of Ommaya reservoirs were excluded. Demographics, hydrocephalus etiology, presenting symptoms, study results, subsequent management, complications, and intraoperative diagnoses were recorded. Chi-square tests were reported for categorical variables and standard 2 \u00d7 2 contingency methods were used for sensitivity\/specificity analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The authors identified 211 RS procedures performed in 142 patients. The mean age at procedure was 55.6 \u00b1 20.9 years (mean \u00b1 SD). Normal pressure hydrocephalus was the most common hydrocephalus etiology (37.0%), followed by congenital malformations (26.1%) and idiopathic intracranial hypertension (15.6%). Successful radionuclide injection was achieved in 207 studies (98.1%). Shunt patency was confirmed in 63.8% of successful injections, whereas malfunction was demonstrated in 27.1% and abnormally slow flow was seen in 9.2%. RS studies demonstrating shunt malfunction were more likely to result in subsequent revisions than were studies showing patency (86.6% vs 2.9%; p &lt; 0.0001). The overall sensitivity and specificity of RS for detecting shunt malfunction was 92.3% and 96.2%, respectively. The median follow-up time was 29 months, with 151 cases having \u2265 6 months of follow-up. There were no complications or infections attributable to RS in this cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>RS is a useful and safe tool in the workup of shunt malfunction.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.7.jns23455","type":"journal-article","created":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T02:49:32Z","timestamp":1694227772000},"page":"621-626","source":"Crossref","is-referenced-by-count":5,"title":["Radionuclide shuntography for cerebrospinal fluid shunt flow evaluation in adults"],"prefix":"10.3171","volume":"140","author":[{"given":"Khizar R.","family":"Nandoliya","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon P.","family":"Klein","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Alwakeal","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan","family":"Linscheid","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Avery","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Potts","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"},{"name":"Radiology, and"},{"name":"Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosurg","first-page":"877","article-title":"Reducing the risks of proximal and distal shunt failure in adult hydrocephalus: a shunt outcomes quality improvement study","volume":"136","author":"Isaacs AM","year":"2021","unstructured":"Isaacs AM, Ball CG, Sader N,  Reducing the risks of proximal and distal shunt failure in adult hydrocephalus: a shunt outcomes quality improvement study. 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