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Comparison of the renal dynamic scan performed with 99mTc-L,L-EC and 99mTc-MAG3 in children with pelviureteric junction obstruction

Jain, Vishesha; Arora, Saurabhb; Passah, Averiliciab; Mani, Kalaivanic; Yadav, Devendra K.a; Goel, Prabudha; Gupta, Devendra K.a

doi: 10.1097/MNM.0000000000000902

The aim was to compare the renal dynamic scan (RDS) performed with technetium-99-L,L-ethylene dicysteine (99mTc-L,L-EC) and technetium-99-mercaptoacetyltriglycine (99mTc-MAG3) in children with pelviureteric junction (PUJ) obstruction. A retrospective study was carried out and children with PUJ obstruction who had RDS performed with both 99mTc-L,L-EC and 99mTc-MAG3. Children with any intervention in between the two scans or a gap of more than 2 months in between renal scans were excluded. The dose of each radiotracer used was 0.1 mCi/kg (3.7 MBq/kg), with a minimum dose of 1 mCi (37 MBq). RDS was performed using the F+0 protocol. The differential renal function, Tmax, T1/2, drainage pattern, and hepatic uptake of the radiotracer were recorded and compared. A Bland–Altman plot was used to assess agreement between the two radiotracers. Sixteen children were included in the study. A total of 18 obstructed and 14 normal renal units were available to us for study. The values of differential renal function as well as Tmax and T1/2 of the two radiotracers were in agreement. In three obstructed kidneys in which T1/2 on 99mTc-MAG3 was greater than 20 min, 99mTc-L,L-EC showed T1/2 values of 13.3 min or less. 99mTc-L,L-EC showed nonobstructive drainage in three patients who had shown partial obstruction on 99mTc-MAG3 scan. The hepatic uptake of 99mTc-L,L-EC was also lower compared with 99mTc-MAG3. To conclude 99mTc-L,L-EC is a useful radiotracer for the evaluation of children with PUJ obstruction, with better assessment of drainage and lower hepatic uptake compared with 99mTc-MAG3.

Departments of aPediatric Surgery

bNuclear Medicine

cBiostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Correspondence to Vishesh Jain, MCh, Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India Tel: +91 886 008 0432; fax: +91 112 658 8641; e-mail:

Received July 30, 2018

Accepted August 11, 2018

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