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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 Controlled trial quality: uncertain

7. Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2018

) (hypoxia tracer) ? 18 F-FAZA ([ 18 F]fluoroazomycin arabinoside) (hypoxia tracer) ? 18 F-fluoride (more accurate than bone scanning) ? 18 F-flurpiridaz (cardiac) ? 18 F-florbetapir (Amyvid) (dementia imaging) ? 18 F-FDOPA ? 68 Ga-PSMA (prostate-specific membrane antigen) ? 18 F-FACBC (fluciclovine) 3. Published as a full-text article in a peer-reviewed journal. 4. Reported evidence related to change in patient clinical management or clinical outcomes, or reported diagnostic accuracy of PET compared (...) ) of patients. Gajjala et al, 2018 [2] Prospective 61 patients who underwent staging (biopsy-proven, unilateral, newly diagnosed locally advanced breast cancer) FDG PET/CT Serum chemistry, mammogram, 99m Tc-MDP bone scan, US of the abdomen and pelvis, CeCT of the chest and upper abdomen Histopathology, biopsy, FNAC, other imaging studies Distant metastases Sens: 95% Spec: 98% PPV: 95% NPV: 98% Accu: 97% Distant metastases Sens: 65% Spec: 93% PPV: 81% NPV: 84% Accu: 84% PET/CT upstaged 24.6% (15/61

2019 Cancer Care Ontario

9. 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

11. 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

12. 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 Controlled trial quality: uncertain

13. 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

14. 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

15. Paediatric Urology

, analysis and culture 23 3H.3.4.1 Urine sampling 23 3H.3.4.2 Urinalysis 24 3H.3.4.3 Urine culture 25 3H.3.5 Imaging 25 3H.3.5.1 Ultrasound 25 3H.3.5.2 Radionuclide scanning 25 3H.3.5.3 Voiding cystourethrography 25 3H.3.6 Bladder and bowel dysfunction 26 3H.4 Disease management 26 3H.4.1 Administration route 26 3H.4.2 Duration of therapy 26 3H.4.3 Antimicrobial agents 27 3H.4.4 Chemoprophylaxis 29 3H.4.5 Monitoring of UTI 30 3H.5 Conclusions and recommendations for UTI in children 30 3I DAYTIME LOWER (...) Disease management 55 3N.4.1 Extracorporeal shock wave lithotripsy 55 3N.4.2 Percutaneous nephrolithotomy 56 3N.4.3 Ureterorenoscopy 57PAEDIATRIC UROLOGY - LIMITED UPDATE MARCH 2015 5 3N.4.4 Open or laparoscopic stone surgery 57 3N.5 Conclusions and recommendations 58 3O OBSTRUCTIVE PATHOLOGY OF RENAL DUPLICATION: URETEROCELE AND ECTOPIC URETER 59 3O.1 Epidemiology, aetiology and pathophysiology 59 3O.1.1 Ureterocele 59 3O.1.2 Ectopic ureter 59 3O.2 Classification systems 59 3O.2.1 Ureterocele 59 3O

2015 European Association of Urology

16. Urological Infections

diagnosis [83] (LE: 4, GR: C). Colony counts > 10 4 cfu/mL of uropathogens are considered to be indicative of clinically relevant bacteriuria [84] (LE: 2b, GR: C). 3C.4.1.4 Imaging diagnosis Evaluation of the upper urinary tract with ultrasound (US) should be performed to rule out urinary obstruction or renal stone disease (LE: 4, GR: C). Additional investigations, such as an unenhanced helical computed tomography (CT), excretory urography, or dimercaptosuccinic acid (DMSA) scanning, should (...) with renal transplants 13 3B.5.4.8 Immuno-comprised and severely diseased patients, patients with candiduria 13 3B.5.5 Prior to surgery 13 3B.5.6 Pharmacological management 13 3B.6 Follow-up 13 3C CYSTITIS AND PYELONEPHRITIS IN ADULTS 13 3C.1 Introduction 13 3C.2 Epidemiology, aetiology and pathophysiology 14 3C.3 Acute episode of uncomplicated cystitis (lower UTI) in adults 14 3C.3.1 Diagnostic evaluation 14 3C.3.1.1 Clinical diagnosis 14 3C.3.1.2 Differential diagnosis 14 3C.3.1.3 Laboratory diagnosis

2015 European Association of Urology

17. 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

18. 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

Full Text available with Trip Pro

2017 Investigative and clinical urology

19. 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

20. 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

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