Abstract

Conventional Nuclear Medicine offers many investigations for congenital and acquired urinary system diseases in children. Technetium-99m-dimercaptosuccinic acid (DMSA) renal cortical scintigraphy has got a wide spectrum of indications like; determination of differential renal function (DRF), distinguishing acute pyelonephritis from cortical scar, investigation of dysplastic, hypoplastic kidneys, multicyctic kidneys and determination of functional parenchyma, evaluating ectopic kidney and fusion anomalies. The most common indication of DMSA renal cortical scintigraphy is evaluation of urinary tract infections. It is the imaging technique of choice for diagnosing pyelonephritis and effects many clinical conservative or surgical clinical decisions. Recently imaging and processing techniques were standardized and some differences between the guidelines were resolved. Also minimum and maximum imaging doses for DMSA were reduced. Anterior-posterior projection imaging and geometric mean DRF calculation, pinhole and single photon emission computerized tomography (SPECT) imaging were covered by the guidelines. Still, determination of absolute renal function, DRF calculation using SPECT reconstructions, area correction methods for hydronephrotic kidneys with suranormal/normal DRF are the ongoing issues. In this article we assessed the current status of DMSA renal cortical scintigraphy in urinary system diseases of pediatric population.