Article Figures & Data
Figures
- FIGURE 1.
Results from 70 respondents to our 2019 survey about clinical need for 99mTc-DMSA during lack of availability of this agent: “Would your practice be performing 99mTc-DMSA scans now if 99mTc-DMSA were available?” Most respondents confirmed need for 99mTc-DMSA in their clinical practice. Survey was sent to SNMMI All Member Community via SNMMI Connect Communities discussion board (https://communities.snmmi.org). (Adapted from (4).)
- FIGURE 2.
Typical 99mTc-DMSA renal SPECT. Maximum intensity projection shows distribution of renal cortex.
- FIGURE 3.
Retention of tracer principally in left pelvicalyceal system at 4 h after intravenous injection of 99mTc-DMSA, limiting assessment of split renal cortical function. At 4 h, estimated split renal function was 57% of total renal uptake in left kidney and 43% in right kidney. Repeat imaging after several hours provides more accurate determination of split renal cortical function. Tracer is taken up by sulfhydryl groups in brush borders of proximal convoluted tubules. Therefore, tracer remains in renal cortex while activity in urine drains out of renal areas and bladder. At 24 h, estimated split function was 49% of total renal function on left and 51% on right. (Adapted with permission of (19).)
- FIGURE 4.
99mTc-DMSA posterior planar images of infant with right duplex kidney. Images with ultra-high-resolution parallel-hole collimator and with pinhole collimator demonstrate superior spatial resolution with pinhole collimator.
- FIGURE 5.
Coronal (C), transverse (T), and sagittal (S) slices of 99mTc-DMSA SPECT from patient recovering from acute pyelonephritis of upper pole of left kidney. Images were obtained 1 y apart.
- FIGURE 6.
Coronal SPECT slices from same patient processed with full counts (left panel) and with one-quarter number of counts using advanced image processing (right panel). This example demonstrates that it is possible to use fewer counts (and therefore less administered activity) to obtain same diagnostic quality. OSEM 3D = 3-dimensional ordered-subsets expectation maximization.
Tables
No. Indication 1 Detection of permanent renal parenchymal scarring 2 Detection of acute pyelonephritis 3 Detection of parenchymal damage after trauma 4 Characterization of structural renal abnormalities: for example, solitary kidney, duplex kidney, small kidney, dysplastic kidney, horseshoe kidney 5 Detection of ectopic renal tissue, including cross-fused renal ectopia 6 Quantitation of differential (split) renal function 7 Confirmation of nonfunctional multicystic dysplastic kidney 8 Evaluation of unexplained hypertension when there is clinical suspicion for renal disease such as dysplasia or scarring 9 Evaluation of renal parenchymal function in patients with renovascular hypertension before and after revascularization procedures 10 Renal parenchymal function regional assessment in patients with complex renal calculi before and after treatment 11 Surgical decision-making for ureteropelvic junction obstruction or refractory vesicoureteral reflux based on differential renal function 12 Evaluation of renal parenchyma when there is allergy to iodinated CT contrast, and MRI is unavailable/contraindicated (18)
