What is a DMSA Scan?

A specialized static nuclear medicine imaging scan using Technetium-99m Dimercaptosuccinic Acid (Tc-99m DMSA) to obtain high-resolution images of functional renal cortex tissue and detect permanent scarring or acute pyelonephritis.

Why is a DMSA Scan Performed?
Pediatric Urinary Tract Infections (UTIs): Evaluating renal parenchymal damage following acute febrile UTIs or recurrent infections.

Vesicoureteral Reflux (VUR): Detecting renal cortical scarring secondary to retrograde urine flow.

Differential / Split Renal Function: Quantifying the relative contribution of each kidney (e.g., Left 52% vs. Right 48%) before reconstructive or ablation surgery.

Congenital Renal Anomalies: Confirming or assessing ectopic kidneys, horseshoe kidney, cross-fused renal ectopia, or small dysplastic kidneys.

DMSA vs. DTPA Scan: What is the Difference?

Primary Focus: DMSA (static imaging)  - Renal Cortex & Scarring (Structure/Tissue); DTPA (dynamic imaging) - Dynamic Filtration & Excretion (Drainage/GFR)
Tracer Behavior: DMSA - Binds to proximal renal tubular cells; DTPA - Filtered rapidly by glomeruli without tubular reabsorption
Timing of Scan: DMSA - Images captured 2 to 4 hours after injection; DTPA - Images captured immediately as tracer is injected
Best Used For: DMSA - Pyelonephritis scars, VUR damage, ectopic tissue; DTPA - PUJ obstruction, hydronephrosis, outflow drainage

Patient Preparation & What to Expect?

Preparation Requirements:

• No Fasting Needed: Normal breakfast/meals and regular fluid intake.

• Pediatric Comfort: Parents may bring a favorite toy, feed bottle, or blanket to help small children lie still during imaging.

The 3-Step Procedure:

1. Radiotracer Administration: A tiny, weight-adjusted dose of Tc-99m DMSA is injected into a small vein.

2. Waiting Period (2 to 3 Hours): The tracer binds to the functional tubular cells in the kidneys. Patients can relax in the waiting lounge or leave and return at the scheduled scan time.

3. Gamma Camera Imaging (15 to 25 Minutes): High-resolution planar and pinhole/SPECT views are acquired from multiple angles (Posterior, Anterior, Left Posterior Oblique, Right Posterior Oblique).

Is the DMSA Scan Safe for Children?

• • Dosing calculated strictly according to European Association of Nuclear Medicine (EANM) pediatric dosage cards.

  • Non-invasive and safe; the tracer emits low diagnostic gamma rays and clears naturally.

  • No allergic reactions or nephrotoxicity, unlike iodinated CT contrast dyes.

Frequently Asked Questions (FAQ)

Q1: How long after a urinary tract infection (UTI) should a follow-up DMSA scan be done?

To distinguish temporary acute inflammation from permanent kidney scarring, clinical guidelines usually recommend performing a follow-up DMSA scan 4 to 6 months after the acute episode of pyelonephritis has resolved.

Q2: Does my child need sedation or anesthesia for a DMSA scan?

In the vast majority of cases, sedation is not necessary. Because imaging is quiet, painless, and does not require going inside an enclosed tunnel, we position infants after feeding or during natural sleep using soft immobilizers and comforting parental presence.

Q3: How long will I be at the center on the day of the scan?

Expect to spend approximately 3 to 4 hours in total. The intravenous injection takes just a few minutes, followed by a 2- to 3-hour waiting window for optimal renal cortex uptake, and a 15- to 25-minute imaging session under the gamma camera.

Q4: When are the DMSA scan reports provided?

Digital reports with calculated differential split renal function percentages and high-definition scintigraphy images are available on the same day or within 24 hours for your treating pediatrician or nephrologist. Please contact at the reception or console at gamma imaging room for the physical report.

Q5: How do I book a DMSA scan at Nepal Center of Nuclear Medicine?

Because radiotracers are freshly formulated on the day of the procedure, prior appointments are required. You can book by calling our Kumaripati desk at 01-5921804 or via WhatsApp at 9851360804.