Tc-99m DMSA

Dr Jeremy Jones et al.

Tc-99m DMSA (dimercaptosuccinic acid) is a technetium radiopharmaceutical used in renal imaging to evaluate renal structure and morphology, particularly in paediatric imaging for detection of scarring and pyelonephritis. DMSA is an ideal agent for the assessment of renal cortex as it binds to the sulfhydryl groups in proximal tubules at the renal cortex with longer retention than other agents. This results in higher concentration and hence much higher resolution pinhole SPECT imaging. Also, it allows better assessment of differential renal function.  It is a static scan as opposed to dynamic DTPA or MAG3 scans.

Characteristics

  • photon energy: 140 keV
  • physical half-life: 6 hours
  • biological half-life:
  • normal distribution: kidneys (100%)
  • excretion: renal
  • target organ: kidneys
  • pharmacokinetics:
    • 40-50% fixed to cortex (greater than glucoheptonate)
    • maximal cortical uptake within 3 hours
  • miscellaneous facts: 
    • high-resolution imaging with pinhole collimators and SPECT is not possible with DTPA, MAG3 or OIH because of rapid transit times
    • Diseases affecting the proximal convoluted tubules such as renal tubular acidosis, Fanconi syndrome and nephrotoxic drugs such as gentamicin and cisplatin also inhibit the DMSA uptake

Uses, doses and timings

Renal cortical imaging
  • adult dose: 15-20 mCi IV
  • paediatric dose: 200 mCi/kg
  • image at 2 hours
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Article Information

rID: 13609
System: Urogenital
Section: Radiography
Synonyms or Alternate Spellings:
  • DMSA
  • Technetium-99m dimercaptosuccinic acid (DMSA)
  • Technetium-99m dimercaptosuccinic acid
  • Technetium-99m DMSA

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