title: Can technetium-99m-mercaptoacetyltriglycine replace technetium-99m-dimercaptosuccinic acid in the exclusion of a focal renal defect?
abstract: The presence of focal renal damage dictates different management of a child with urinary tract infection (UTI) compared with children who have normal kidneys. Technetium-99m-dimercaptosuccinic (DMSA) has a high sensitivity in the detection of a focal defect, and allows estimation of differential function. The introduction of 99mTc-MAG3 with high renal extraction suggests that this may be useful in children with UTI but its role remains speculative. Fifty-nine children with previous UTI underwent both 99mTc-DMSA and MAG3 within 4 wk of each other. Differential function and assessment of the images were undertaken. There is close correlation (R2 = 0.97) between the differential function. Analysis of the 99mTc-DMSA and functional MAG3 images showed that the functional image had a specificity of 88% and a sensitivity of 88% in the detection of a focal parenchymal defect. Technetium-99m-MAG3 in the clinical setting of a child with UTl allows accurate assessment of differential function and a high probability of detecting a focal renal abnormality.
authors.affiliation: Department of Radiology, Hospital for Sick Children, London, England.
authors.forename: I
authors.initials: I
authors.lastname: Gordon
authors.forename: P J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: M F
authors.initials: MF
authors.lastname: Lythgoe
authors.forename: M
authors.initials: M
authors.lastname: Orton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D017263:Technetium Tc 99m Mertiatide
chemical_list: D015609:Organotechnetium Compounds; D017263:Technetium Tc 99m Mertiatide; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer