Review of the Clinical and Technical Aspects of 99mTc-Dimercaptosuccinic Acid Renal Imaging: The Comeback "Kit".

Abstract

^99mTc-labeled dimercaptosuccinic acid (^99mTc-DMSA) imaging is a well-established and highly sensitive method for the diagnosis of several renal cortical disorders affecting children and adults. Beginning in 2014, ^99mTc-DMSA availability was severely impaired when it was added to the Drug Shortages List of the U.S. Food and Drug Administration and was commercially unavailable thereafter. The agent shortage negatively impacted practitioners' ability to evaluate renal cortical defects in children and adults and changed renal imaging practice. A survey among pediatric nuclear medicine clinicians confirmed the clinical need for ^99mTc-DMSA. Finally, in early 2023 the Food and Drug Administration again approved ^99mTc-DMSA in the United States. During the ^99mTc-DMSA shortage, established practitioners may not have had the opportunity of using ^99mTc-DMSA as they were accustomed in their experience. Also, newer imaging specialists and referring physicians and technologists may not have benefited from having ^99mTc-DMSA in their training. Therefore, it is time to bring back ^99mTc-DMSA into the armamentarium of imaging methods available to evaluate regional cortical renal function.