DMSA Renal Scan

evaluation of renal cortex
evaluation and quantitation of regional relative fuction
detection and localization of a renal mass
detection and differentation of acute and chronic pyelonephritis
evaluation of renal transplant
evaluation of renal blood supply


Questions asked in Patient History:

List the common questions asked when taking a patient history for this specific procedure.

History of Cancer?
history of kidney disease (kidney stones, infections)?
do you have both kidneys?
any recent or planned operations?
have you had a kidney transplant?
do you have any pain? if so where?
experiencing nausea or vomitting?
experiencing urinary frequency or urgency?
any blood in your urine?
are you diabetic?
any cardiac disease?
do you have any high blood pressure?
have you had any recent labratory tests?
are you pregnant or breastfeeding?

Radiopharmaceutical information:
  • Radionuclide: Tc-99m
  • Radiopharmaceutical: DMSA
  • Adult dosing: 5mCi
  • Pediatric dosing: 50microCi/kg
  • Method of administration: IV
  • Method of Localization: compartmental --> cortical binding
  • Physical Half-life: 6 hours

Patient Preparation:

What does the patient need to do prior to coming for the procedure?
patient should be well hydrated
patient should void prior to imaging beginning
discontinue ACE inhibitors or angiotensin II receptor blockers (ARB)

Side Effects:

Will the patient feel any different during or after the procedure?

Equipment Used:
Type of Camera or Probe: Gamma Camera
Collimator used: Pinhole for pediatric patients or LEHR

Acquisition Setup:

Photopeak(s): 140keV

Window(s): 20%

Dynamic: View(s)
Matrix: 128x128
Time/Frame: 2 seconds per frame for 2 minutes
Number of Frames:

Statics: View(s)
Matrix: 128x128
Total Counts or Duration: 500,000 counts

Whole body: View(s)
Scan Speed:
Start/stop points:

180 or 90 degree configuration
Total Rotation: 180 or 360 : 360
Starting point:
Matrix: 256x256
Time/Azmuiths 20-25 seconds per stop
Number of Azmuiths: 64



Describe the procedure from verifying the requisition to completing the scan. Include any patient instructions pre- or post- injection/scan, delays between injection and imaging, and any side effects.

Normal Uptake and common varients:
Insert an image of a normal scan. Describe the normal uptake, and any normal varients visualized.
both kidneys visualized about the same size and intensities
bilateral smooth renal contour

Abnormal Uptake and causes:
Insert an image of an abnormal scan. Describe the abnormal uptake, and the cause of the abnormal uptake.

one or both kidneys not visualized
one or both enlarged kidney or decreased activitiy --> pylenephritis
asymmetric activity indicates renal artery stenosis
gallbladder visualizes is renal failure

Insert an image with an artifact, and explain what the artifact is.

increased liver uptake with decreased kidney uptake --> breakdown of radiopharmaceutical
some patients don't have both kidneys
patient still on ACE inhibitor or ARB
dehyrdation = decreased kidney to liver ratio
misalignment on positioning


Shackett, Pete. "Nuclear Medicine Technology: Procedures and Quick Refrences" p.244-247.