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Clinical application of 99mTc-DTPA dynamic renal scintigraphy with consequent SPECT/CT imaging in patients with different nephrological conditions

Volume 11, Issue 1

Original Article / Published: November 2023


T. Sofiyanski, S. Sergieva, M. Dimcheva, O. Gatsev, I. Saltirov

Department of Nuclear Medicine, Sofia Cancer Center, Sofia, Bulgaria
Clinic of Urology, Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria


Introduction: Dynamic renal scintigraphy with 99mTechnetium diethylenetriaminepentaacetic acid (99mTc-DTPA) is a generally used imaging technique for evaluating renal function of patients with various nephro-urological conditions. Clinical application of SPECT/CT nephroscintigraphy has rarely been discussed.
Objective: The aim of the study was to evaluate the added value of SPECT/CT imaging to dynamic renal scintigraphy with 99mTcDTPA. Materials and Methods: Thirty two patients (66% female and 34% male) who underwent dynamic nephroscintigraphy with subsequent SPECT/CT with mean age 55.9±18.25 years was observed. The CT scan was performed with a low dose protocol. A dose of 185MBq (5mCi) 99mTc-DTPA was administered intravenously.
Results: Our analysis demonstrated impaired relative renal function in various degrees of left kidney in 18 patients (56%) and of right kidney in 14 patients (44%). SPECT/CT imaging revealed the specific cause, responsible for the renal dysfunction in the cases. The hybrid imaging demonstrated urolithiasis in 11 patients, postopertative strictures of ureter in 5 patients, diagnosed urological cancer in 4 patients, external compression of ureter from ovarian cyst in 1 patient and compression of ureter due to nephroptosis in 1 patient as a possible obstructive cause. In 10 patients congenital renal anomalies were the identified causes of impaired renal function – hypoplastic kidney in 4 patients, duplex kidney in 2 patients, multiple cortical cysts in 2 patients, aberrant vessel obstructing the pyeloureteral segment in 1 patient and horseshoe kidney in 1 patient.
Conclusion: The combination of conventional 99mTc-DTPA dynamic renal scintigraphy with subsequent SPECT/CT could provide not only functional but also anatomical information of the urinary tract, especially in the evaluation of obstructive uropathies and congenital renal abnormalities, that can change the clinical management


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99mTc-DTPA dynamic renal scintigraphy, SPECT/CT, uropathies,

How to cite this article:

T. Sofiyanski, S. Sergieva, M. Dimcheva, O. Gatsev, I. Saltirov.
Clinical application of 99mTc-DTPA dynamic renal scintigraphy
with consequent SPECT/CT imaging in patients with different
nephro-urological conditions. Journal of Endourology and
Minimally Invasive Surgery (Bulgaria), 2023; 11(1): 17-28

Corresponding author:

Teodor Sofiyanski, MD
Oncology Clinic Sofia, Department of Nuclear medicine
22„Andrei Saharov“ blvd.
Sofia 1784