Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease

Abstract Background 99mTc-labelled Dimercaptosuccinic acid ([99mTc]DMSA) is a radiopharmaceutical commonly used to evaluate renal perfusion, structure, and morphology. However, the renal handling of [99mTc]DMSA in humans remains unclear. Studies in humans with renal tubular dysfunction and animal ex...

Full description

Saved in:
Bibliographic Details
Main Authors: Danny Jensen, Jesper Frank Andersen, Peder Berg, Henrik Birn, Christian Flø, Jørgen Frøkiær
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:EJNMMI Research
Subjects:
Online Access:https://doi.org/10.1186/s13550-025-01272-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850111627575164928
author Danny Jensen
Jesper Frank Andersen
Peder Berg
Henrik Birn
Christian Flø
Jørgen Frøkiær
author_facet Danny Jensen
Jesper Frank Andersen
Peder Berg
Henrik Birn
Christian Flø
Jørgen Frøkiær
author_sort Danny Jensen
collection DOAJ
description Abstract Background 99mTc-labelled Dimercaptosuccinic acid ([99mTc]DMSA) is a radiopharmaceutical commonly used to evaluate renal perfusion, structure, and morphology. However, the renal handling of [99mTc]DMSA in humans remains unclear. Studies in humans with renal tubular dysfunction and animal experiments suggest that renal uptake of [99mTc]DMSA occurs by glomerular filtration and subsequent proximal tubule reabsorption. The main aim of this study was to examine renal handling of [99mTc]DMSA and the pathophysiological implications of [99mTc]DMSA-based imaging in patients with chronic kidney disease (CKD) compared to healthy controls (HC). Results Urinary excretion of [99mTc]DMSA was 1.5-fold higher and more variable in CKD patients compared to HC. While [99mTc]DMSA plasma clearance was only 1.1-fold higher in HC, the [99mTc]DMSA uptake in the kidneys was 2.6-fold higher in HC compared to CKD patients and correlated inversely with the 24-hour urine excretion of [99mTc]DMSA independent of GFR. Conclusion Kidney [99mTc]DMSA accumulation is consistent with tubular uptake following glomerular filtration. The relative DMSA uptake is lower in CKD patients, pointing to defective proximal tubular function in this patient group. Furthermore, the results suggest that [99mTc]DMSA uptake could serve as a marker for tubule-interstitial function.
format Article
id doaj-art-a84c3f224a624ac79a586115e413a9df
institution OA Journals
issn 2191-219X
language English
publishDate 2025-06-01
publisher SpringerOpen
record_format Article
series EJNMMI Research
spelling doaj-art-a84c3f224a624ac79a586115e413a9df2025-08-20T02:37:35ZengSpringerOpenEJNMMI Research2191-219X2025-06-0115111010.1186/s13550-025-01272-0Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney diseaseDanny Jensen0Jesper Frank Andersen1Peder Berg2Henrik Birn3Christian Flø4Jørgen Frøkiær5Department of Emergency Medicine, Goedstrup HospitalDepartment of Biomedicine, Aarhus UniversityDepartment of Biomedicine, Aarhus UniversityDepartment of Renal Medicine, Aarhus University HospitalDepartment of Nuclear Medicine, Aarhus University HospitalDepartment of Nuclear Medicine, Aarhus University HospitalAbstract Background 99mTc-labelled Dimercaptosuccinic acid ([99mTc]DMSA) is a radiopharmaceutical commonly used to evaluate renal perfusion, structure, and morphology. However, the renal handling of [99mTc]DMSA in humans remains unclear. Studies in humans with renal tubular dysfunction and animal experiments suggest that renal uptake of [99mTc]DMSA occurs by glomerular filtration and subsequent proximal tubule reabsorption. The main aim of this study was to examine renal handling of [99mTc]DMSA and the pathophysiological implications of [99mTc]DMSA-based imaging in patients with chronic kidney disease (CKD) compared to healthy controls (HC). Results Urinary excretion of [99mTc]DMSA was 1.5-fold higher and more variable in CKD patients compared to HC. While [99mTc]DMSA plasma clearance was only 1.1-fold higher in HC, the [99mTc]DMSA uptake in the kidneys was 2.6-fold higher in HC compared to CKD patients and correlated inversely with the 24-hour urine excretion of [99mTc]DMSA independent of GFR. Conclusion Kidney [99mTc]DMSA accumulation is consistent with tubular uptake following glomerular filtration. The relative DMSA uptake is lower in CKD patients, pointing to defective proximal tubular function in this patient group. Furthermore, the results suggest that [99mTc]DMSA uptake could serve as a marker for tubule-interstitial function.https://doi.org/10.1186/s13550-025-01272-0DMSA scintigraphyEDTA clearanceChronic kidney diseaseGFRProximal tubular function
spellingShingle Danny Jensen
Jesper Frank Andersen
Peder Berg
Henrik Birn
Christian Flø
Jørgen Frøkiær
Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
EJNMMI Research
DMSA scintigraphy
EDTA clearance
Chronic kidney disease
GFR
Proximal tubular function
title Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
title_full Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
title_fullStr Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
title_full_unstemmed Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
title_short Quantitative renal [99mTc]DMSA imaging predicts urinary [99mTc]DMSA excretion in patients with chronic kidney disease
title_sort quantitative renal 99mtc dmsa imaging predicts urinary 99mtc dmsa excretion in patients with chronic kidney disease
topic DMSA scintigraphy
EDTA clearance
Chronic kidney disease
GFR
Proximal tubular function
url https://doi.org/10.1186/s13550-025-01272-0
work_keys_str_mv AT dannyjensen quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease
AT jesperfrankandersen quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease
AT pederberg quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease
AT henrikbirn quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease
AT christianflø quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease
AT jørgenfrøkiær quantitativerenal99mtcdmsaimagingpredictsurinary99mtcdmsaexcretioninpatientswithchronickidneydisease