Determining Split Renal Function in Children With Ureteropelvic Junction Stenosis: Technetium-99m Mercaptoacetyltriglycine (Tc99m MAG-3) or Technetium-99m Dimercaptosuccinic Acid (Tc-99m DMSA)?

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dc.contributor.authorOzdemir, Hale
dc.contributor.authorGirisgen, Ilknur
dc.contributor.authorYaylali, Olga
dc.contributor.authorBecerir, Tuelay
dc.contributor.authorHerek, Oezkan
dc.contributor.authorSenol, Hande
dc.contributor.authorYuksel, Selcuk
dc.date.accessioned2025-01-27T20:22:38Z
dc.date.available2025-01-27T20:22:38Z
dc.date.issued2024
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractBackground Ureteropelvic junction stenosis (UPJS) is the most common cause of clinically significant antenatal hydronephrosis. We compared separate renal function results obtained using technetium-99mmercaptoacetyltriglycine (Tc-99m MAG-3) and technetium-99m-dimercaptosuccinic acid (Tc-99m DMSA) in pediatric patients with UPJS to evaluate the adequacy of Tc-99m MAG-3 scintigraphy and the necessity of additional Tc-99m DMSA scintigraphy during follow-up. Methodology Patients diagnosed with hydronephrosis in the Pediatric Nephrology Department of Pamukkale University Faculty of Medicine over a period of 10 years (2012-2022) were evaluated retrospectively. Patients who had been diagnosed with UPJS and underwent both Tc-99m MAG-3 and Tc-99m DMSA scintigraphy during follow-up were included in the study. Technetium-99m-labeled MAG-3 and DMSA scans were re-evaluated for all patients by the Department of Nuclear Medicine. Results The study included 52 children with unilateral UPJS (12 girls and 40 boys) with a mean age of 6.34 +/- 4.81 years (range: 2.97-9.79 years). Thirty-six patients (69.2%) were diagnosed antenatally. Differential renal function in Tc-99m DMSA was 46.94 +/- 10.64 and in Tc-99m MAG-3 was 43.08 +/- 11.18; the functions were lower in Tc-99m MAG-3, but the values were within normal limits for both groups (p=0.0001, z=-3.893). When differential renal functions were compared between Tc-99m DMSA and Tc-99m MAG-3 results, a statistically significant positive and strong correlation was found in the kidney with ureteropelvic junction obstruction (UPJO) (p=0.0001, r=0.752). When classifying the Tc-99m MAG-3 and Tc-99m DMSA results in the kidney with UPJO (supranormal, normal, low function) for the determination of differential renal functions, there was a consistency of 76%, and it was correlated (p=0.0001, k=0.456). While two patients had supranormal function and 13 patients had low function in Tc-99m MAG-3, five patients had supranormal function, and eight patients had low function in Tc-99m DMSA. Conclusions Some studies in the literature have reported that Tc-99m MAG-3 causes supranormal function measurements in patients with UPJS; our results showed that Tc-99m DMSA resulted in a higher rate of supranormal values for affected kidneys. We believe that Tc-99m DMSA should not be performed in addition to Tc-99m MAG-3 scintigraphy in the follow-up of every patient with UPJS but can be utilized in select cases, such as patients with surgical indications and those suspected before surgery.
dc.description.sponsorshipHale ozdemir and lknur Girigen contributed equally to this work and should be considered co-first authors.
dc.identifier.doi10.7759/cureus.65075
dc.identifier.issn2168-8184
dc.identifier.issue7
dc.identifier.pmid39171026
dc.identifier.urihttps://doi.org/10.7759/cureus.65075
dc.identifier.urihttps://hdl.handle.net/20.500.12428/21976
dc.identifier.volume16
dc.identifier.wosWOS:001278577200006
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringernature
dc.relation.ispartofCureus Journal of Medical Science
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20250125
dc.subjecttc-99m dmsa
dc.subjecttc-99m mag-3 scintigraphy
dc.subjectchildren
dc.subjecthydronephrosis
dc.subjectureteropelvic junction stenosis
dc.titleDetermining Split Renal Function in Children With Ureteropelvic Junction Stenosis: Technetium-99m Mercaptoacetyltriglycine (Tc99m MAG-3) or Technetium-99m Dimercaptosuccinic Acid (Tc-99m DMSA)?
dc.typeArticle

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