Technical note| Volume 45, P99-105, January 2018

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Comparison of relative renal functions calculated with 99mTc-DTPA and 99mTc-DMSA for kidney patients of wide age ranges


      • The relative renal function is important in the primary assessment of renal diseases.
      • Both static (99mTc-DMSA) and dynamic (99mTc-DTPA) scintigraphies have been used to calculate the relative renal functions.
      • A positive correlation has been found between the two scanning methods.
      • Except GFR and renogram curves, it is suggested to use 99mTc‑DMSA since it is easy method and less expensive.


      Renal scintigraphy is an imaging method that uses small amount of radioactive materials called radiotracers, a Gamma camera and a computer to evaluate kidney functions and its anatomy. The present work reports the comparison of the relative renal functions (RRF) calculated with technetium-99m dimercaptosuccinic acid (99mTc‑DMSA) and technetium-99m diethylenetriaminepentaacetic acid (99mTc‑DTPA) for kidney patients of ages between 5 months and 71 years. A total of 50 patients including 29 male and 21 female has been selected and studied for renography. The mean RRFs have been found to be 52.68 ± 23.63% and 47.32 ± 23.63% respectively for the left and right kidneys with 99mTc-DMSA measurement. With 99mTc-DTPA the values are 52.74 ± 23.54% and 47.26 ± 23.54% for the same. In bivariate correlation analysis, a significant positive correlation (r = 0.996, P < .001) has been found between the RRFs calculated with the two methods. Following the patients’ diagnosis, in ANOVA test, no difference has been found between the RRFs calculated for the left and right kidneys. In Bland-Altman plots, the mean difference between the two methods has been found to be 0.1 and the correlation limit lies between −4.3 and 4.2. According to the result obtained in the present work, both the 99mTc-DMSA and 99mTc-DTPA scanning methods provide almost the same RRF values. It is, therefore, always not necessary to calculate the RRFs with both the methods. This study suggests that 99mTc-DMSA may be the primary choice for the evaluation of RRF, but if the glomerular filtration rate (GFR) and renogram curve are required, 99mTc-DTPA can be the obvious selection.


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        • Dostbil Zeki
        • Pembegül Necmettin
        • Küçüköner Mehmet
        • Bozkurt Yaar
        • Sancaktutar Ahmet Ali
        • Yildiz Ismail
        • Tekbas Güven
        Comparison of split renal function measured by Tc-DTPA, Tc-MAG3, Tc-DMSA renal scintigraphies in pediatric age groups.
        Clin Rev Opin. 2011; 3: 20-25
        • Hackstein N.
        • Buch T.
        • Rau W.S.
        • Weimer R.
        • Klett R.
        Split renal function measured by triphasic helical CT.
        Eur J Radiol. 2007; 61: 303-309
        • Moran J.K.
        Technetium-99m-EC and other potential new agents in renal nuclear medicine.
        Semin Nucl Med. 1999; 29: 91-101
        • Miyazaki C.
        • Harada H.
        • Shuke N.
        • Okizaki A.
        • Miura M.
        • Hirano T.
        (99m)Tc-DTPA dynamic SPECT and CT volumetry for measuring split renal function in live kidney donors.
        Ann Nucl Med. 2010; 24: 189-195
        • Daniel G.B.
        • Mitchell S.K.
        • Mawby D.
        • Sackman J.E.
        • Schmidt D.
        Renal nuclear medicine: a review.
        Vet Radiol Ultrasound. 1999; 40: 572-587
        • Muller-Suur R.
        • Gutsche H.U.
        Tubular reabsorption of technetium-99m-DMSA.
        J Nucl Med. 1995; 36: 1654-1658
        • Campbell M.G.
        • Powers T.A.
        Renal radionuclides and in vitro quantitation.
        in: Sandler M.P. Coleman R.E. Patton J.A. Wackers F.J. Gottschalk A. Diagnostic nuclear medicine. 4th ed. Lippincott Williams & Wilkins, Philadelphia2003: 851-864
        • Majd M.
        • Rushton H.G.
        Renal cortical scintigraphy in the diagnosis of acute pyelonephritis.
        Semin Nucl Med. 1992; 22: 98-111
        • Hitzel A.
        • Liard A.
        • Dacher J.N.
        • Gardin I.
        • Ménard J.F.
        • Manrique A.
        • et al.
        Quantitative analysis of 99mTc-DMSA during acute pyelonephritis for prediction of long-term renal scarring.
        J Nucl Med. 2004; 45: 285-289
        • Shanon A.
        • Feldman W.
        • McDonald P.
        • Martin D.J.
        • Matzinger M.A.
        • Shillinger J.F.
        • et al.
        Evaluation of renal scars by technetium-labeled dimercaptosuccinic acid scan, intravenous urography, and ultrasonography: a comparative study.
        J Pediatr. 1992; 120: 399-403
        • Itoh K.
        99mTc-MAG3: review of pharmacokinetics, clinical application to renal diseases and quantification of renal function.
        Ann Nucl Med. 2001; 15: 179-190
        • Taniju Çelik
        • Hülya Yalcin
        • Ceylan Günay Emel
        • Aynur Özen
        • Cahit Özer
        Comparison of the relative renal function calculated with 99mTc-diethylenetriaminepentaacetic acid and 99mTc-dimercaptosuccinic acid in children. World.
        J Nucl Med. 2014; 13: 149-153
        • Väsquez Arteaga Marcial
        • Murillo Caballero Victor
        • Marin Rengifo Kelman
        Dosimetry of 99mTc (DTPA, DMSA and MAG3) used in renal function studies of newborns and children.
        Appl Radiat Isot. 2017; (pii: S0969-8043(17)30130-6)
        • Lee W.G.
        • Kim J.H.
        • Kim J.M.
        • Shim K.M.
        • Kang S.S.
        • Chae H.I.
        • et al.
        Renal uptakes of 99mTc-MAG3, 99mTc-DTPA, and 99mTc-DMSA in rabbits with unilateral ureteral obstruction.
        Vivo. 2010; 24: 137-139
        • Domingues F.C.
        • Fujikawa G.Y.
        • Decker H.
        • Alonso G.
        • Pereira J.C.
        • Duarte P.S.
        Comparison of relative renal function measured with either 99mTc-DTPA or 99mTc-EC dynamic scintigraphies with that measured with 99mTc-DMSA static Scintigraphy.
        Int Braz J Urol. 2006; 32: 405-409
        • Itoh K.
        • Asano Y.
        • Kato C.
        • Nakada K.
        • Nagao K.
        • Goto
        • Nonomura T.
        • Furudate M.
        Quantitation of absolute and relative renal uptake using 99mTc-DMSA: sequential change in time and correlation with 99mTc-DTPA uptake.
        Kaku Igaku. 1990; 27: 237-242
      1. Sinclair Patricia. Distance assisted training programme for nuclear medicine technologists, Regional Cooperative Agreement, International Atomic Energy Agency. In: Patterson HE, Hutton BF, editors. Renal Imaging Module 6, Unit 10; 2003. p. 58.

        • Britton K.E.
        • Brown N.J.G.
        • Nimmon C.C.
        Clinical renography: 25 years on.
        Eur J Nucl Med. 1996; 23: 1541-1546
        • De Lange M.J.
        • Piers D.A.
        • Kosterink J.G.
        • van Luijk W.H.
        • Meijer S.
        • de Zeeuw D.
        • et al.
        Renal handling of technetium-99m DMSA: evidence for glomerular filtration and peritubular uptake.
        J Nucl Med. 1989; 30: 1219-1223
        • Nimmo M.J.
        • Merrick M.V.
        • Allan P.L.
        Measurement of relative renal function: a comparison of methods and assessment of reproducibility.
        Br J Radiol. 1987; 60: 861-864