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We undertook a study to determine the value of gallium imaging of the kidneys in patients who had primary amyloidosis that was manifest clinically by nephrotic syndrome. We studied 28 patients with gallium-67 (67Ga) citrate scans performed 48 hr after injection. Intense (3+ to 4+) uptake was noted in both kidneys in 25 of 28 patients. Renal amyloidosis should be considered in the differential diagnosis when diffuse bilateral renal uptake of [67Ga]citrate is seen in the setting of nephrotic syndrome. Gallium uptake did not differentiate amyloid nephrotic syndrome from other causes of nephrotic syndrome. Renal gallium uptake showed a weak correlation with 24-hr urine protein excretion (p = 0.06).

The Anger longitudinal emission multiplane tomoscanner and a 15-in. Anger camera with multipeak spectroscopic capability were compared in a series of 51 patients. The tomoscanner was preferred in 49%, the camera in 12%, and 39% were equivalent. The tomoscanner preference is statistically significant (p less than .025). These data support the conclusion that the Anger multiplane tomographic scanner is the instrument of choice for gallium-67 imaging.