• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.237-244
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• 1991

$^{99m}Tc-DMSA$ renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of $^{99m}Tc-DMSA$ renal scan as the groups of symmetric and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of normal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119.4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent $^{99m}Tc-DMSA$ and IVP concommitantly. Among 85 cases of PD in $^{99m}Tc-DMSA$ renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with symmetric small size in $^{99m}Tc-DMSA$ renal stan.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.36-41
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• 2016

Purpose Sentinel lymphoscintigraphy (SLS) was using only $^{99m}Tc-phytate$. If the supply is interrupted temporarily, there is no alternative radiopharmaceuticals. The aim of this study measure the particle size of radiopharmaceuticals and look for radiopharmaceuticals which can be substituted for $^{99m}Tc-phytate$. Materials and Methods The particle size of radiopharmaceuticals were analyzed by a nano-particle analyzer. This study were selected known radiopharmaceuticals to be useful particle size for SLS. We were divided into control and experimental groups using $^{99m}Tc-DPD$, $^{99m}Tc-MAG3$, $^{99m}Tc-DMSA$ with $^{99m}Tc-phytate$. For in-vivo experiment, radiopharmaceuticals were injected intradermally at both foot to perform lymphoscintigraphy. Imaging was acquired to dynamic and delayed static image and observe the inguinal lymph nodes with the naked eye. Results Particle size was measured respectively Phytate 105~255 nm (81.9%), MAG3 91~255 nm (98.7%), DPD 105~342 nm (77.3%), DMSA 164~ 342 nm (99.2%), MAA 1281~2305 nm (90.6%), DTPA 342~1106 nm (79.4%), and HDP 295~955 nm (94%). In-vivo delayed static image, inguinal lymph nodes of all experiment groups and two control groups are visible to naked eye. however, $^{99m}Tc-MAG3$ of control groups is not visible to naked eye. Conclusion We were analyzed to the particle size of the radiopharmaceuticals that are used in in-vivo. Consequently, $^{99m}Tc-DPD$, $^{99m}Tc-DMSA $are possible in an alternative radiopharmaceuticals of emergency.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.235-238
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• 2015

The aims of this study were to evaluate the difference of renal uptake rate in $^{99m}Tc-DMSA$ scan on pediatrics by including the bladder. Phantom and Clinical studies were performed. In the phantom study, we put $^{99m}TcO_4{^-}$ (300uCi, 11 MBq) in 3cups filled with distilled water at the rate 1:1:0, 1:1:0.5, 1:1:1, 1:1:2 and were placed Lt kidney, Rt kidney and bladder position on the table. To acquire the image, we used Symbia-E gamma camera from Siemens with preset count method(400,000 counts). In quantitative analysis, the counts of drawing ROIs on the phantom were analyzed. In clinical studies, we analyzed the 20 pediatrics who were examined by $^{99m}Tc-DMSA$ scan. At first, the images were acquired with both kidney and bladder. Secondly we acquired images after shielding the bladder. And the data were compared using a pared t-test by SPSS(ver.22.0). As a result of renal phantom's experiment, we compared with average of uptake rate(%), 1:1:0 was Lt 43.32%, Rt 45.97%, 1:1:0.5 was Lt 35.79%, Rt 36.89%, 1:1:1 was Lt 29.68%, Rt 31.45% and 1:1:2 was Lt 22.89%, Rt 24.32%. There was no correlation between the zoom and uptake rate. The results of patient were that excluded bladder was $29.83{\pm}8.81%$(Lt), $24.29{\pm}6.66%$(Rt) and included bladder was $26.65{\pm}8.03%$(Lt, $21.78{\pm}6.24%$(Rt). This is deemed statistically significant (p<0.05). Renal uptake rate was undervalued because the counts of bladder were included in the total counts.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.44-49
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• 2003

Purpose : $^{99m}Tc-DMSA$ renal scan can be used in the evaluation of relative renal function and some anatomy. The relative renal function can be assess by measurement of $^{99m}Tc-DMSA$ uptake by the individual kidney. Renal counts

• Childhood Kidney Diseases
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• v.5 no.1
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• pp.22-29
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• 2001

Purpose : 99mTc DMSA renal scan have been widely used not only for tile evaluation of renal scars but also for the diagnosis of acute pyelonephritis. Recent studies have shown SPECT images have higher accuracy than the planar images with some controversy. We evaluated the availability of the SPECT images adding to planar images for the diagnosis of acute pyelonephritis(APN) and renal scar in children with urinary tract infection (UTI). Methods : 130 children with UTI (260 kidney units) and 22 follow-up children (44 kidney units) were included between January 1, 1997 and July 31, 1999 at Ewha University Mokdong Hospital. Planar Anterior and posterior images and SPECT axial and coronal images of 99mTc DMSA renal scan were obtained with Starcam 4000-i U.S.A. GE at 3 hours after 99mTc DMSA I.V. injection. The data were analyzed by Chi square test after Yates's correction. Results : The detection rate of the acute pyelonephritis by SPECT images was 12.3$\%$ higher than that of planar images ($47.7\%\;vs\;35.4\%$) by the patient and 6.9$\%$ higher also ($31.9\%\;vs\;25.4\%$) by the kidney unit. 18 kidney units with negative planar images had focal defect in 10 kidney units (3.8$\%$) and multifocal defect in 8 kidney units (3.1$\%$) on SPECT images, but 1 kidney unit with positive planar image had negative SPECT image. SPECT images were superior to tile planar images in 17.3$\%$. identical in 82.3$\%$ and inferior in 0.4$\%$ to planar image. The detection rate of tile renal scars by SPECT images was 13.7$\%$ higher than planar images by the patient ($68.2\%\;vs\;54.5\%$) and 6.8$\%$ higher also ($43.2\%\;vs\;36.4\%$) by the kidney unit. SPECT images were superior to the planar images in 17.3$\%$ and identical in 82.3$\%$ to planar image. Conclusion SPECT images had shown higher detection rate and better image than planar images for the diagnosis of the acute pyelonephritis and the evaluation of the renal scars. (J. Korean Soc Pediatr Nephrol 5 : 22- 9, 2001)

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.24-30
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• 1997

Purpose: To evaluate the diagnositc value of the absolute and relative renal uptake rates on $^{99m}Tc-DMSA$ renal scan of children with febrile UTI. Method: The absolute and relative renal uptake rates of $^{99m}Tc-DMSA$ were checked in 68 children with febrile urinary tract infection (35 with unilateral focal defect; 13 with bilateral focal defect; and 20 with diffuse bilateral defect) and 49 children with afebrile UTI and normal $^{99m}Tc-DMSA$ renal scan as control. Results: The renal absolute uptake rate in the control group were $21.8{\pm}3.9%(right),\;22.2{\pm}3.9%(left),\;and\;44.2{\pm}7.8%(total)$. The absolute uptake rate gradually increased until the age 12 months and then was stationary. In febrile UTI with unilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, both relative and absolute uptake rates were similarly diagnostic ($41.2{\pm}9.7%,\;16.5{\pm}5.4%$ vs $50.0{\pm}2.6%,\;22.0{\pm}3.9%$, p<0.01). In acute pyelonephritis with bilateral focal defect on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly more diagnostic than the relative uptake rate[$17.3{\pm}5.3%$ (right), $17.4{\pm}5.3%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$, (left)% p<0.01]. In febrile UTI with bilateral diffuse defects on the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was significantly diagnostic than the relative uptake rate [$18.1{\pm}3.9%\;(right),\;18.4{\pm}3.8%\;(left),\;vs\;21.8{\pm}3.9%,\;(right)\;22.2{\pm}3.9%$(left), p<0.01]. Conclusion: In the $^{99m}Tc-DMSA$ renal scan, the absolute uptake rate was more useful than the relative uptake rate to evaluate bilateral acute pyelonephritis.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• The Journal of the Korea Contents Association
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• v.16 no.3
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• pp.219-231
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• 2016

$^{99m}Tc$-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to $^{99m}Tc$-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of $^{99m}Tc$-DMSA renal SPECT using high sensitivity all purpose collimator.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.203-211
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• 2007

Purpose : We attempted to compare the independent factors such as age, sex, C-reactive protein(CRP), and white blood cell count(WBC) in children with radiologic studies and assess the necessity of performing voiding cystourethrography(VCUG). Method : 98 children who have been diagnosed their first time febrile urinary tract infection from Janurary 2002 to Januray 2005 were enrolled. In all patient, the duration of fever which occurred before and after treatment was recorded, and CRP, WBC, $^{99m}Tc$-2,3-dimercaptosuccinic acid($^{99m}Tc$-DMSA) renal scans, renal ultrasound and VCUG were analyzed. Results : Of the 98 children diagnosed with urinary tract infection(UTI), 52 were male and 46 were female. 18 had abnormalities in VCUG, 17 had abnormalities in kidney ultrasound, and 20 had partial defects or diffuse uptake decrease in $^{99m}Tc$-DMSA renal scans. There were no significant relationship between incidence of radiologic abnormalities and age. The risk of renal scar was significantly higher in children who had a longer febrile period before treatment than in those with shorter period. Both CRP and WBC were significantly elevated in children with the radiological abnormalities. A positive of $^{99m}Tc$-DMSA renal scans and renal ultrasound were highly associated with vesicoureteral reflux(VUR). Conclusion : If there are abnormalities in the kidney ultrasound and $^{99m}Tc$-DMSA renal scan of a child with initial UTI, a VCUG is recommended. Even in cases without abnormal findings in $^{99m}Tc$-DMSA renal scan and renal ultrasound, clinical data such as CRP and WBC should be assessed, and VCUG should be Performed for the undetected VUR.

• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.325-331
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• 1990

Radionuclide renal scintigraphies were performed in a 24-year-old man with right renal artery branch stenosis. Captopril enhanced $^{99m}Tc-DTPA$ renal scintigraphy revealed no abnormal finding in the right kidney. But, $^{99m}Tc-DMSA$ renal scintigraphy showed regional cortical photon deficient area corresponding to the area supplied by the stenotic branch artery. The defect size increased in captopril enhanced $^{99m}Tc-DMSA$ renal scintigrphy and nearly disappeared after successful transluminal renal angioplasty. This case suggests that the captopril enhanced $^{99m}Tc-DMSA$ renal scintigraphy may be a useful method in the evaluation of renovascular hypertension, especially due to branch renal srtery stenosis.