Table of Contents
Hull University Teaching Hospitals NHS Trust - Nuclear Medicine
Uncontrolled if printed
| SOP Code | Title | Review Date |
|---|---|---|
| REF004 | DMSA Renal Imaging Referral Criteria | 2027-06-17 |
| Authorised By | Authorising Role | Authorisation Signature (only on master paper copy) | Date Authorised |
|---|---|---|---|
| Dr N Ahmed | ARSAC Licence Holder | 2024-06-17 |
REF004 - DMSA Renal Imaging Referral Criteria
See REF000 - Referring to Nuclear Medicine (HUTH) for details of how to refer.
Description
Following intravenous injection, Tc99m-DMSA accumulates in the proximal renal tubules with very little washout. Static images of the kidneys can be obtained providing definition of the cortical outline and relative distribution of functional tissue. It can identify areas of cortical scarring. The ratio of radiopharmaceutical uptake between the kidneys provides a measure of divided renal function. By selecting regions of interest within an individual kidney, it is also possible to measure the relative function at these sites, which may be of relevance when a duplex system is present.
| ARSAC Licence Holders | Indication |
|---|---|
| Prof Stephen Richard Underwood | renal imaging |
| Prof Ged Avery | renal imaging |
| Dr Najeeb Ahmed | renal imaging |
| Radiopharmaceutical | |
|---|---|
| Typical Radiation Dose (mSv) | 0.7 |
Staff Entitled to Refer
All UK registered medical practitioners
Supplementary Drugs
Sodium chloride for parenteral use (0.9% w/v).
Contraindications
Pregnancy
A pre-existing urinary tract infection, or infection within the last 4 months may give false results.
Clinical Indications
| Renal parenchymal scarring (at least 4-6 months following an acute UTI) [1][2][3] |
| Acute and chronic renal failure[1] |
| Pyelonephritis[1][2] |
| Unilateral/bilateral renal disease (space-occupying lesions included) [1] |
| Detection of parenchymal damage after trauma [2] |
| Characterization of structural renal abnormalities: e.g. solitary kidney, duplex kidney, small kidney, dysplastic kidney, horseshoe kidney, and pseudo-horseshoe kidney[2] |
| Detection of ectopic renal tissue, including cross-fused renal ectopia[2] |
| Differential renal function[2] |
| Confirmation of non-functional multicystic dysplastic kidney[2] |
| Evaluation of unexplained hypertension when there is clinical suspicion for renal disease such as dysplasia or scarring[2] |
| Evaluation of renal parenchymal function in patients with renovascular hypertension before and after revascularisation procedures[2] |
| Renal parenchymal function regional assessment in patients with complex renal calculi before and after treatment[2] |
| Surgical decision-making for ureteropelvic junction obstruction (UPJO) or refractory VUR based on differential renal function [2] |
| Pre-transplant donor assessment |
