Tc-99m DMSA

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Tc-99m DMSA (dimercaptosuccinic acid) is a technetium radiopharmaceutical used in renal imaging to evaluate renal structure and morphology, particularly in paediatric imaging for detection of scarring and pyelonephritis. DMSA is an ideal agent for the assessment of renal cortex as it binds to the sulfhydryl groups in proximal tubules at the renal cortex with longer retention than other agents. This results in higher concentration and hence much higher resolution with pinhole SPECT imaging. Also, it allows better assessment of differential renal function. It is a static scan as opposed to dynamic DTPA or MAG3 scans.

Characteristics

photon energy: 140 keV
physical half-life: 6 hours
biological half-life: 2.5-3.5 hours
2.3 < pH < 3.5 ^3,4
normal distribution: kidneys (100%)
excretion: renal
target organ: kidneys
pharmacokinetics:
- 40-50% fixed to cortex (greater than glucoheptonate)
- maximal cortical uptake within 3 hours
miscellaneous facts:
- high-resolution imaging with pinhole collimators and SPECT is not possible with DTPA, MAG3 or OIH because of rapid transit times
- Diseases affecting the proximal convoluted tubules such as renal tubular acidosis, Fanconi syndrome and nephrotoxic drugs such as gentamicin and cisplatin also inhibit the DMSA uptake

Uses, doses and timings

Renal cortical imaging

adult dose: 555 MBq (15-20 mCi) IV
paediatric dose ²: 1.85 MBq/kg (0.05 mCi/kg)
- minimum 18.5 MBq (0.5 mCi)
image at 2 hours

+<li>2.3 < pH < 3.5 3,4
+</li>

References changed:

3. M. P. Natale. P&C 5.1. Tecnico di radiologia. Guida completa alla preparazione di test preselettivi e prove pratiche per TSRM. Con software di simulazione. (2019) <a href="https://books.google.co.uk/books?vid=ISBN9788865846483">ISBN: 9788865846483</a>
3. M. P. Natale. P&C 5.1. Tecnico di radiologia. Guida completa alla preparazione di test preselettivi e prove pratiche per TSRM. Con software di simulazione. (2019) <a href="https://books.google.co.uk/books?vid=ISBN9788865846483">ISBN: 9788865846483</a>
3. M. P. Natale. P&C 5.1. Tecnico di radiologia. Guida completa alla preparazione di test preselettivi e prove pratiche per TSRM. Con software di simulazione. (2019) <a href="https://books.google.co.uk/books?vid=ISBN9788865846483">ISBN: 9788865846483</a>
4. Maurizio Dondi, Raffaele Giubbini. Medicina nucleare nella pratica clinica. Con CD-ROM. (2019) <a href="https://books.google.co.uk/books?vid=ISBN9788855527286">ISBN: 9788855527286</a>
3. Matteo Pio Natale. I Test dei concorsi per Tecnico di radiologia. (2014) <a href="https://books.google.co.uk/books?vid=ISBN9788865845172">ISBN: 9788865845172</a>
3. Matteo Pio Natale. I Test dei concorsi per Tecnico di radiologia. (2014) <a href="https://books.google.co.uk/books?vid=ISBN9788865845172">ISBN: 9788865845172</a>

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Tc-99m DMSA

Updates to Article Attributes

Characteristics

Uses, doses and timings

Renal cortical imaging

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