Scintigraphic imaging in renal infections.

Area of Science:

• Nuclear medicine
• Diagnostic imaging
• Urology

Background:

• Renal infections and subsequent scarring are significant concerns following urinary tract infections (UTIs).
• Accurate imaging is crucial for diagnosis, management, and prognosis.
• Current diagnostic modalities require evaluation for optimal use.

Purpose of the Study:

• To highlight the role of renal cortical scintigraphy using [(99m)Tc]dimercaptosuccinic acid (DMSA) in evaluating renal infections.
• To discuss the utility of DMSA scintigraphy in assessing upper tract involvement and renal scarring post-UTI.
• To review the application of DMSA scintigraphy in guiding further investigations and evaluating treatment regimens for UTIs.

Main Methods:

• Renal cortical scintigraphy utilizing [(99m)Tc]dimercaptosuccinic acid (DMSA).
• Review of recent publications and current clinical applications.
• Comparison with other imaging modalities like Fluorodeoxyglucose (FDG)-PET and leukocyte scanning.

Main Results:

• DMSA scintigraphy is the imaging modality of choice for evaluating renal infections.
• It effectively demonstrates upper tract involvement and assesses renal cortical scarring.
• Its use is expanding to guide further investigations and assess UTI treatment efficacy.

Conclusions:

• [(99m)Tc]DMSA renal scintigraphy is a valuable tool for diagnosing and managing renal infections and their complications.
• It plays a key role in patient management pathways following UTIs.
• Other modalities like FDG-PET and leukocyte scans have limited roles, primarily in specific conditions like infected renal cysts in polycystic disease.