Tc-99m DMSA
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Tc-99m DMSA (2,3 dimercaptosuccinic acid) is a technetium radiopharmaceutical used in renal imaging to evaluate renal structure and morphology, particularly in paediatricpediatric imaging for detection of scarring and pyelonephritis. DMSA is an ideal agent for assessment of the 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. Also, it allows a better assessment of differential renal function. It is a static scan as opposed to dynamic DTPA or MAG3 scans.
Characteristics
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photonPhoton energy: 140 keV -
physicalPhysical half-life: 6 hours -
biologicalBiological half-life: 2.5-3.5 hours - 2.3 < pH < 3.5 3,4
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normalNormal distribution: kidneys(100, Liver (3% that can increase if renal failure) -
excretionExcretion: renal -
targetTarget organ: kidneys -
pharmacokineticsPharmacokinetics:- after the injection, 90% of the 2,3 dimercaptosuccinic acid is bound to plasma proteins 3,4
- 40-50% fixed to cortex (greater than glucoheptonate)
- maximal cortical uptake within 3 hours
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miscellaneousMiscellaneous 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
-<p><strong>Tc-99m DMSA (2,3 dimercaptosuccinic acid)</strong> is a <a href="/articles/technetium-agents">technetium radiopharmaceutical</a> used in renal imaging to evaluate renal structure and morphology, particularly in paediatric imaging for detection of <a href="/articles/renal-scarring">scarring</a> and <a href="/articles/pyelonephritis">pyelonephritis</a>. DMSA is an ideal agent for assessment of the 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 <a href="/articles/single-photon-emission-computed-tomography-spect">SPECT</a>. Also, it allows better assessment of differential renal function. It is a static scan as opposed to dynamic <a href="/articles/tc-99m-dtpa">DTPA</a> or <a href="/articles/tc-99m-mag3">MAG3</a> scans.</p><h4>Characteristics</h4><ul>-<li>photon energy: 140 keV</li>-<li>physical half-life: 6 hours</li>-<li>biological half-life: 2.5-3.5 hours</li>- +<p><strong>Tc-99m DMSA (2,3 dimercaptosuccinic acid)</strong> is a <a href="/articles/technetium-agents">technetium radiopharmaceutical</a> used in renal imaging to evaluate renal structure and morphology, particularly in pediatric imaging for detection of <a href="/articles/renal-scarring">scarring</a> and <a href="/articles/pyelonephritis">pyelonephritis</a>. DMSA is an ideal agent for assessment of the 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 <a href="/articles/single-photon-emission-computed-tomography-spect">SPECT</a>. Also, it allows a better assessment of differential renal function. It is a static scan as opposed to dynamic <a href="/articles/tc-99m-dtpa">DTPA</a> or <a href="/articles/tc-99m-mag3">MAG3</a> scans.</p><h4>Characteristics</h4><ul>
- +<li>Photon energy: 140 keV</li>
- +<li>Physical half-life: 6 hours</li>
- +<li>Biological half-life: 2.5-3.5 hours</li>
-<li>normal distribution: kidneys (100%)</li>-<li>excretion: renal</li>-<li>target organ: kidneys</li>-<li>pharmacokinetics:<ul>-<li>after the injection 90% of the 2,3 dimercaptosuccinic acid is bound to plasma proteins<sup> 3,4</sup>- +<li>Normal distribution: kidneys, Liver (3% that can increase if renal failure)</li>
- +<li>Excretion: renal</li>
- +<li>Target organ: kidneys</li>
- +<li>Pharmacokinetics:<ul>
- +<li>after the injection, 90% of the 2,3 dimercaptosuccinic acid is bound to plasma proteins<sup> 3,4</sup>
-<li>miscellaneous facts: <ul>- +<li>Miscellaneous facts: <ul>
-</ul><h4>Uses, doses and timings</h4><h5>Renal cortical imaging</h5><ul>-<li>adult dose: 555 <a href="/articles/becquerel-si-unit">MBq</a> (15-20 <a href="/articles/curie-unit">mCi</a>) IV</li>-<li>paediatric dose <sup>2</sup>: 1.85 MBq/kg (0.05 mCi/kg)<ul><li>minimum 18.5 MBq (0.5 mCi)</li></ul>- +</ul><h4>Uses, doses, and timings</h4><h5>Renal cortical imaging</h5><ul>
- +<li>Adult dose: 111 <a href="/articles/becquerel-si-unit">MBq</a> (3 <a href="/articles/curie-unit">mCi</a>) IV</li>
- +<li>Paediatric dose <sup>2</sup>: 1.85 MBq/kg (0.05 mCi/kg)<ul><li>minimum 18.5 MBq (0.5 mCi)</li></ul>
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