What is dynamic renal scintigraphy?

From the Guidelines

Dynamic renal scintigraphy is a non-invasive nuclear medicine imaging procedure that assesses kidney function by evaluating perfusion, glomerular filtration, and urinary flow in real-time. This procedure is valuable in renal transplantation as it provides a means to evaluate transplant function qualitatively and screen for surgical complications, allowing for the separation of function of the graft from residual function of the native kidneys or any remaining prior failed graft 1.

Key Aspects of Dynamic Renal Scintigraphy

• It involves the use of radionuclide tests to assess the three sequential phases of renal function: perfusion, nephron extraction and excretion of the tracer, and urinary flow assessment through tracer drainage 1.
• The test can be particularly helpful in evaluating the return of function after acute tubular necrosis (ATN) or rejection, as it provides functional information that blood creatinine levels and radiographic studies cannot offer in the same timeframe 1.
• Dynamic renal scintigraphy is advantageous because it offers a baseline study for future comparison, especially when performed prior to patient discharge from the hospital after renal transplantation 1.

Clinical Application and Patient Considerations

• The procedure typically involves injecting a radioactive tracer into a vein, followed by sequential imaging to track the tracer's movement through the kidneys and into the bladder.
• Patients should be well-hydrated and inform their doctor about any medications, allergies, or pregnancy status before undergoing the procedure.
• The radiation exposure from dynamic renal scintigraphy is minimal and considered safe for most patients, making it a valuable diagnostic tool for assessing kidney function and related conditions.

From the FDA Drug Label

Technetium Tc 99m mertiatide is a renal imaging agent for use in the diagnosis of congenital and acquired abnormalities, renal failure, urinary tract obstruction, and calculi in adults and pediatric patients. It is a diagnostic aid in providing renal function, split function, renal angiograms, and renogram curves for whole kidney and renal cortex.

Dynamic renal scintigraphy refers to a diagnostic imaging procedure that uses a radioactive tracer, such as technetium-99m MAG3, to evaluate renal function and structure. The key aspects of this procedure include:

• Providing renal function information
• Evaluating split function of the kidneys
• Creating renal angiograms
• Generating renogram curves for the whole kidney and renal cortex This information is based on the use of technetium-99m MAG3 2.

From the Research

Definition of Dynamic Renal Scintigraphy

• Dynamic renal scintigraphy is a powerful imaging method that provides both functional and anatomic information about the kidneys 3.
• It is particularly useful in the acute care setting, where it can be used to evaluate patients with native and transplant kidneys 3.
• The technique involves the use of radiotracers, such as technetium-99m-mercaptoacetyltriglycine (Tc-MAG3) or technetium-99m-ethylenedicysteine (Tc-EC), to assess renal function and perfusion 4, 5.

Clinical Applications

• Dynamic renal scintigraphy can be used to diagnose and manage various kidney disorders, including renal colic, urinary tract infections, and acute renal failure 3.
• It can also be used to evaluate patients with obstructive uropathies, such as ureteropelvic junction obstruction or ureterovesical junction obstruction 6.
• The technique can provide detailed information about renal function, including split renal function, which can be useful in preoperative evaluation and surgical planning 6.

Technical Aspects

• Dynamic renal scintigraphy typically involves a 25-minute renal diuretic protocol, with simultaneous intravenous injection of furosemide 3.
• The technique can be performed using planar scintigraphy or single-photon emission computed tomography (SPECT)/CT 6.
• Time-activity curves (TACs) can be generated from the isolated kidney volumes of interest to assess renal function and perfusion 6.

Reproducibility and Normal Ranges

• Dynamic renal scintigraphy with Tc-EC has been shown to be highly reproducible for assessing differential renal function (DRF) in children 5.
• Normal ranges for renal function parameters, such as Tmax and T1/2, have been established for 99mTc-EC renal scintigraphy 7.
• These normal ranges can be useful in interpreting the results of dynamic renal scintigraphy and diagnosing kidney disorders 7.