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DMSA Renal Cortical Scan

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1. DMSA Renal Cortical Scan

DMSA Renal Cortical Scan DMSA Renal Cortical Scan Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 DMSA Renal Cortical Scan DMSA Renal (...) Cortical Scan Aka: DMSA Renal Cortical Scan II. Indications Differentiate itis from Assessment for renal scarring III. Efficacy: Pyelonephritis Diagnosis : 91% : 100% Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "DMSA Renal Cortical Scan." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Radiology About FPnotebook.com is a rapid access

2018 FP Notebook

2. Renal Cortical Scintigraphy (DMSA)

Renal Cortical Scintigraphy (DMSA) 1 BRITISH NUCLEAR MEDICINE SOCIETY Renal Cortical Scintigraphy (DMSA scan) Clinical Guidelines 1. Purpose This guideline must be read in conjunction with the BNMS Generic Guidelines. The purpose of this guideline is to assist specialists in Nuclear Medicine and Radionuclide Radiology in recommending, performing, interpreting and reporting the results of renal cortical scintigraphy (DMSA scan). This guideline will assist individual departments (...) be stated together with the method of calculation (posterior view only or geometric mean). 10. Pitfalls 10.1. Acute and chronic pyelonephritis cannot be distinguished on the cortical scan. If a defect is present 6 months after the last UTI then this is a scar [17] 10.2. A recent UTI may cause temporary reduced uptake or focal defect and a follow-up DMSA scan should be undertaken [17] 10.3. The diagnosis of renal scars is difficult in the infant under 3-6 months of age because of renal immaturity

2011 British Nuclear Medicine Society

3. DMSA Renal Cortical Scan

DMSA Renal Cortical Scan DMSA Renal Cortical Scan Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 DMSA Renal Cortical Scan DMSA Renal (...) Cortical Scan Aka: DMSA Renal Cortical Scan II. Indications Differentiate itis from Assessment for renal scarring III. Efficacy: Pyelonephritis Diagnosis : 91% : 100% Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "DMSA Renal Cortical Scan." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Radiology About FPnotebook.com is a rapid access

2015 FP Notebook

4. The SNMMI and EANM Practice Guideline for Renal Scintigraphy in Adults

the sensitivity of the test. ACE inhibitors should be discontinued for 3 to 7 days 228 before the test. If stopping the drugs is not possible, the study may still be performed. 229 (Fommei, 1993) but the sensitivity is decreased. See the SNMMI guideline on this subject. 230 231 Static Renal Scan (Renal Cortical scintigraphy) 232 a. Radiopharmaceutical: 99m-Tc-DMSA provides the best images. Glucoheptonate may also be 233 used. 234 b. Adult activity: 111 MBq 235 c. Radiation burden: approximately 1mSv (ICRP 80 (...) (renography), and morphological agents (retained in the tubules) are used in 68 the static (cortical) renal scan. 69 Dynamic scans elucidate the uptake and drainage of the radiopharmaceutical and allow the 70 generation of time-activity curves by selection of regions of interest, while static scans image the 71 functional renal tissue and provide useful morphologic information. 72 An understanding of the principles of the test, its limitations and the sources of error is essential 73 to the interpretation

2019 Society of Nuclear Medicine and Molecular Imaging

5. Guidelines on 99mTc-DMSA Scintigraphy in Children

: Evaluation of Tc-99m DMSA renal scans in experimental acute pyelonephritis in piglets. J Urol 1998; part 2: 140:1169-1174. 10. Majd M, Rushton HG, Chandra R et al: Tc-99m DMSA renal cortical scintigraphy to detect experimental acute pyelonephritis in piglets: comparison of planar (pinhole) and SPECT imaging. J Nucl Med 1996; 37:1731-1734. 11. Rossleigh MA, Farnsworth RH, Leighton DM et al: Technetium-99m Dimercaptosuccinic acid scintigraphy studies of renal cortical scarring and renal length. J Nucl Med (...) of cortical abnormalities related to urinary tract infection. Compared to ultrasound and intravenous urography, the sensitivity is high, in both acute and chronic pyelonephritis (3-6) . Lesions are non-specific, since similar lesions can be found in renal abscess, cyst, duplex kidney, and hydronephrosis: the combination of ultrasound and DMSA scintigraphy allows a better differentiation between these clinical situations. In case of noteworthy dilatation of the upper urinary tract, tracer may accumulate

2009 European Association of Nuclear Medicine

6. Oral Methylprednisolone in Pediatric Acute Pyelonephritis Alleviates Renal Scarring (PubMed)

Oral Methylprednisolone in Pediatric Acute Pyelonephritis Alleviates Renal Scarring To determine if glucocorticoids can prevent renal scar formation after acute pyelonephritis in pediatric patients.Patients younger than 16 years diagnosed with their first episode of acute pyelonephritis with a high risk of renal scar formation (ie, inflammatory volume ≥ 4.6 mL on technetium-99m-labeled dimercaptosuccinic acid scan [DMSA] or abnormal renal ultrasonography results) were randomly assigned (...) DMSA result. Renal scarring was found in 33.3% of children treated with MPD and in 60.0% of those who received placebo (P < .05). The median cortical defect volumes on follow-up DMSA were 0.0 mL (range: 0-4.5 mL) and 1.5 mL (range: 0-14.8 mL) for the MPD and placebo groups, respectively (P < .01). Patients in the MPD group experienced faster defervescence after treatment than the placebo group.Adjunctive oral MPD therapy reduced the occurrence and/or severity of renal scarring after acute

2011 EvidenceUpdates

8. Acute Pyelonephritis

and pelvis without IV contrast Usually Not Appropriate O CT abdomen and pelvis without and with IV contrast Usually Not Appropriate ???? CT abdomen and pelvis with IV contrast Usually Not Appropriate ??? CT abdomen and pelvis without IV contrast Usually Not Appropriate ??? Tc-99m DMSA scan kidney Usually Not Appropriate ??? ACR Appropriateness Criteria ® 2 Acute Pyelonephritis Variant 2: Acute pyelonephritis. Complicated patient (eg, diabetes or immunocompromised or history of stones or prior renal (...) in the uncomplicated patient [2]. MRI Abdomen and Pelvis MRI is not indicated for initial evaluation of acute pyelonephritis in the uncomplicated patient [2]. US Color Doppler Kidneys and Bladder Retroperitoneal Ultrasound (US) is not indicated for initial evaluation of acute pyelonephritis in the uncomplicated patient [2]. Tc-99m DMSA Scan Kidney Tc-99m-labeled dimercaptosuccinic acid (DMSA) renal scintigraphy is not indicated for initial evaluation of acute pyelonephritis in the uncomplicated patient [2

2018 American College of Radiology

9. Mangement and Screening of Primary Vesicoureteral Reflux in Children

in the child over one year of age, it is recommended that the child be evaluated for evidence of renal disease and for symptoms suggestive of BBD. Children with higher grades of VUR (i.e. grades III to V) are at greater risk of having renal cortical abnormalities. DMSA scanning can be useful in identifying those with preexisting abnormalities. If CAP is used, reassessment of VUR by cystogram between 12 and 24 months after the prior cystogram is recommended to determine when therapy can be stopped (...) ultrasound to assess the upper urinary tract is recommended. [Based on Panel consensus] Option: DMSA (technetium-99m-labeled dimercaptosuccinic acid) renal imaging can be obtained to assess the status of the kidneys for scarring and function. [Based on review of the data and Panel consensus] × Discussion DMSA (technetium-99m-labeled dimercaptosuccinic acid) renal imaging can provide information regarding the degree of existing renal cortical abnormalities that may affect decision-making. In addition

2017 American Urological Association

10. Effect of percutaneous nephrolithotomy and tract dilatation methods on renal function: assessment by quantitative single-photon emission computed tomography of technetium-99m-dimercaptosuccinic acid uptake by the kidneys. (PubMed)

units, new focal cortical defects on (99m)Tc-DMSA scan were seen in nine patients (18%). In six of these kidneys the site of focal defect corresponded to the access site for tract formation during PCNL (two in group II and four in group III). Total relative uptake and total area of treated kidney, for the entire group, increased from 42.2% and 42.3% preoperatively to 44.12% and 43.9% postoperatively. There was no statistically significant differences between the groups for total uptake and area (...) -DMSA).Seventy-five patients undergoing PCNL between May 2008 and April 2009 were included in this randomized study. Of the 75 patients, 50 were evaluated by QSPECT of (99m)Tc-DMSA examinations before and at 3 to 6 months after surgery. This group of patients were categorized into three groups according to the dilatation technique used: group I (balloon dilator, n = 12 [24%] patients), group II (metal dilator, n = 14 [28%] patients), and group III (Amplatz dilator, n = 24 [48%] patients).Of 50 renal

2010 Journal of endourology / Endourological Society

11. Pediatric 99mTc-DMSA SPECT Performed by Using Iterative Reconstruction with Isotropic Resolution Recovery: Improved Image Quality and Reduced Radiopharmaceutical Activity. (PubMed)

, paired t test). Cortical defects were identified better on OSEM-3D images than on FBP images. Of the 98 kidney SPECT studies analyzed, 19 showed identical cortical defects and 75 showed none at both OSEM-3D and FBP. In four kidneys, OSEM-3D depicted cortical defects that were not seen with FBP. No significant difference in relative renal function between the two methods was observed (P = .973).Compared with FBP, OSEM-3D yielded superior image quality in the evaluation of 99mTc-DMSA renal SPECT data (...) Pediatric 99mTc-DMSA SPECT Performed by Using Iterative Reconstruction with Isotropic Resolution Recovery: Improved Image Quality and Reduced Radiopharmaceutical Activity. To compare two methods of reconstructing technetium 99m (99mTc) dimercaptosuccinic acid (DMSA) renal single photon emission computed tomographic (SPECT) data--ordered subset expectation maximization with three-dimensional resolution recovery (OSEM-3D) and filtered back projection (FBP)--in children in terms of improving image

2009 Radiology

12. Urinary Tract Infection?Child

pertechnetate radionuclide cystography 4 ?? Tc-99m DMSA renal cortical scintigraphy 3 ??? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level Variant 3: Age >6 years, first febrile urinary tract infection with good response to treatment. Radiologic Procedure Rating Comments RRL* US kidneys and bladder 5 This procedure may be appropriate but there was disagreement among panel members on the appropriateness rating as defined by the panel’s (...) median rating. O Voiding cystourethrography 3 ?? Tc-99m pertechnetate radionuclide cystography 3 ?? Tc-99m DMSA renal cortical scintigraphy 2 ??? Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Urinary Tract Infection–Child Variant 4: Child. Atypical (poor response to antibiotics within 48 hours, sepsis, poor urine stream, raised creatinine, or non–E coli UTI) or recurrent febrile urinary tract

2016 American College of Radiology

13. Antinatriuretic phenomena seen in children with acute pyelonephritis may be related to the activation of intrarenal RAAS. (PubMed)

hospital from July 2012 to June 2014. Blood tests [C-reactive protein, white blood cell count, erythrocyte sedimentation rate, and aldosterone (Aldo)] and urine tests [uNa, urine potassium (uK) and FENa] were performed upon admission. All enrolled children underwent a 99m-dimercaptosuccinic acid renal scanning (DMSA) at admission. Areas with cortical defects (AreaCD) and uptake counts (UptakeCD) on their DMSA scans were calculated. Data were compared between children with positive DMSA results (APN

Full Text available with Trip Pro

2018 Medicine

14. Pediatric Radiopharmaceutical Administration: Harmonization

absorbed doses to excess risk of cancer incidence and used these to directly assess the riskoftheprocedure.Thisstudyillustratestheimplementation of a rigorous approach for balancing the benefits of adequate imagequalityagainsttheradiationrisksandalsodemonstrates that weight-based adjustment of the administered activity might be suboptimal. At present, this methodology cannot be applied directly to the case of renal cortical scans in paediatric nuclear medicine, but has a great potential for influencing (...) clinicalpracticein Europe. North American consensus guidelines The currently recom- mended activity remains unchanged as it reflects the current North American clinical practice better than the activities given in the EANM dosagecard. Table 1 Activityvalues and ef- fective doses for renal cortical scanwith 99m Tc-DMSA(ICRP80 [7]) a 1.85MBq/kg b Changestothe2007version(as denotedinorangeinFig.1) c Minimumactivityoftherespec- tiveguideline Age 1 year 5 years 10 years 15 years Adult Nominal weight (kg) 10 19 32 55

2013 Society of Nuclear Medicine and Molecular Imaging

15. Pediatric Radiopharmaceutical Administration

absorbed doses to excess risk of cancer incidence and used these to directly assess the riskoftheprocedure.Thisstudyillustratestheimplementation of a rigorous approach for balancing the benefits of adequate imagequalityagainsttheradiationrisksandalsodemonstrates that weight-based adjustment of the administered activity might be suboptimal. At present, this methodology cannot be applied directly to the case of renal cortical scans in paediatric nuclear medicine, but has a great potential for influencing (...) clinicalpracticein Europe. North American consensus guidelines The currently recom- mended activity remains unchanged as it reflects the current North American clinical practice better than the activities given in the EANM dosagecard. Table 1 Activityvalues and ef- fective doses for renal cortical scanwith 99m Tc-DMSA(ICRP80 [7]) a 1.85MBq/kg b Changestothe2007version(as denotedinorangeinFig.1) c Minimumactivityoftherespec- tiveguideline Age 1 year 5 years 10 years 15 years Adult Nominal weight (kg) 10 19 32 55

2014 European Association of Nuclear Medicine

16. Pediatric Radiopharmaceutical Administration: Harmonization of the 2007 EANM Pediatric Dosage Card (Version 1.5.2008) and the 2010 North America Consensus guidelines

to the case of renal cortical scans in paediatric nuclear medicine, but has a great potential for influencing future updates of the respective recommendations. Fig.1 The modified EANM dosage card. Changes to the 2007 version are highlighted inorange EurJ Nucl Med MolImagingEANM dosage card A reassessment of the data on the effective dose given in ICRP publication 80 [7] shows that the change in the effective dose is between class A and class B given in the paediatric dosage card. In order to make sure (...) . Radionuclidecystography EANM dosagecard Nochanges suggested asitreflectspres- ent clinicalpracticein Europe. North American consensus guidelines The currently recom- mended activity remains unchanged as it reflects the current North American clinical practice better than the activities given in the EANM dosagecard. Table 1 Activityvalues and ef- fective doses for renal cortical scanwith 99m Tc-DMSA(ICRP80 [7]) a 1.85MBq/kg b Changestothe2007version(as denotedinorangeinFig.1) c Minimumactivityoftherespec

2014 European Association of Nuclear Medicine

17. Critical appraisal of the top-down approach for vesicoureteral reflux (PubMed)

accepted. The"top-down approach" (TDA) aims at restricting the number of voiding cystourethrograms (VCUGs) and its associated morbidity while identifying patients with clinically-significant reflux. In this approach, children presenting with febrile UTIs are acutely investigated with dimercapto-succinic acid (DMSA) renal scans to identify patients with renal parenchymal inflammation. Those with evidence of renal affection are offered VCUG and late DMSA scan to identify VUR and permanent renal scarring (...) , respectively. Although TDA could identify clinically-significant VUR with high sensitivity, it is not without limitations. The approach segregates patients based on the presence of DMSA cortical lesions omitting the morbidity and the economic burden of UTI. Additionally, some of DMSA lesions are attributed to congenital dysplasia and unrelated to UTI. Ionizing radiation exposure, financial costs, limited availability of DMSA scans in the acute setting, variability in interpreting the results and low yield

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2017 Investigative and clinical urology

18. Guidelines for standard and diuretic renogram in children

, since values within the normal range may be seen also when there is bilateral renal damage and/or in the presence of chronic renal failure. Values outside this normal range may be seen when there is an uncomplicated unilateral duplex kidney as well as in unilateral renal damage. Ectopic kidney: In the presence of an ectopic kidney, the DRF estimation will underestimate the function of the ectopic kidney in all cases. Either a 99m Tc-DMSA scan with both posterior and anterior projection or a MAG3 (...) tracerreachesthe upper mediastinum. Collimator A low-energy all-purpose collimator is recommended. A dual-head camera is not recommended. Position of detector Position camera with the collimator facing up. The exception to this is in the patient who has undergone renal transplantation when an anterior scan is recommended. Positioning of the child Supine position will minimise renal depth difference and assist in keeping movement to a minimum. To reduce movement, support the child with either sandbags or Velcro

2011 European Association of Nuclear Medicine

19. Radiographic Evaluation of the Pediatric Urinary Tract (Follow-up)

the end of their hospital stay. Approximately 50% of patients younger than 1 year who present with a febrile UTI have VUR, compared with 33% of patients older than 1 year. [ ] Of patients younger than 1 year with VUR, 50% will have evidence of renal lesions on dimercaptosuccinic acid (DMSA) scan; patients older than 1 year old with VUR have a 33% chance of having renal scarring. [ ] This has led some centers to use DMSA scanning as the initial test after a child has a febrile UTI. It is proposed (...) that 50% of VCUGs could be avoided by reserving the study for patients with demonstrated renal injury. [ ] One practical consideration that decreases the utilization of DMSA scanning is the need for significant sedation or general anesthesia in young children in order to obtain adequate images; another is the radiation exposure involved. Areas of diminished perfusion on a DMSA scan during an acute infection do not necessarily correspond to areas that will develop a pyelonephritic scar later. In fact

2014 eMedicine Pediatrics

20. Pyelonephritis (Follow-up)

Infants and Children 2 to 24 Months. Pediatrics . 2011 Aug 28. . Lee YJ, Lee JH, Park YS. Risk Factors for Renal Scar Formation in Infants With First Episode of Acute Pyelonephritis: A Prospective Clinical Study. J Urol . 2012 Jan 18. . Kovanlikaya A, Okkay N, Cakmakci H, et al. Comparison of MRI and renal cortical scintigraphy findings in childhood acute pyelonephritis: preliminary experience. Eur J Radiol . 2004 Jan. 49(1):76-80. . Kavanagh EC, Ryan S, Awan A, et al. Can MRI replace DMSA (...) Months. Pediatrics . 2011 Aug 28. . Wang YT, Chiu NT, Chen MJ, et al. Correlation of renal ultrasonographic findings with inflammatory volume from dimercaptosuccinic acid renal scans in children with acute pyelonephritis. J Urol . 2005 Jan. 173(1):190-4; discussion 194. . [Guideline] Subcommittee on Urinary Tract Infection; Steering Committe on Quality Improvement and Management. Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile

2014 eMedicine Pediatrics

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