A feasibility study for a new one-day protocol for [99mTc]TcDTPA2- and [99mTc]TcDMSA2- renal scintigraphy on dilated and non-dilated pediatric patients: underlying rationale

Purpose. This work aimed at evaluating the possibility of performing renal exams of dynamic renal (DRS) and static renal (SRS) scintigraphy on the same day (one-day protocol, ODP), exams that are currently performed in two days. Approach. 25 infants (50 kidneys) of both genders, aged 8.4 ± 5.9 years, underwent an F+20 DRS protocol with [99mTc]TcDTPA2- followed by [99mTc]TcDMSA2- administration for the performance of SRS images at 3, 6 and 24 h. Dynamic images (DRS) were classified as dilated (D), undetermined (U), and non-dilated (P). Static images (SRS) were classified as: depressed in accented degree (DA); depressed in moderate degree (DM); depressed in mild degree (DL) and normal (NL). Results. Out of the 25 patients (50 kidneys), 7 (14 kidneys) were excluded by functional exclusion, hence 18 patients (36 kidneys) were clinically compared regarding their static images after 3, 6 and 24 h, resulting in 33.0% of dilated and 66.7% non-dilated. Only two patients of the dilated group were classified as obstructed. At the group with non-dilated and dilated but non-obstructed kidneys, 100% of them had the same clinical classification at 6 and 24 h images. Conclusions. Performance of both DRS and SRS exams in a single day for pediatric patients, when medical requests are carried out jointly, is feasible in a population with or without dilatation, when the difference between dynamic and static images is of at least 6 h. Due to the small number of obstructed kidneys in this study, further evaluation in this population is needed.