Comparison of the relative renal function evaluated by 99Tcm-DMSA and 99Tcm-DTPA imaging in children with acute urinary tract infection

Abstract

Objective To compare the relative renal function (RRF) evaluated by 99Tcm-dimercaptosuccinic acid (DMSA) and 99Tcm-diethylene triamine pentaacetic acid (DTPA) imaging in children with acute urinary tract infection (UTI). Methods A total of 69 children (29 males, 40 females, age: (45±38) months; duration of disease: <6 months) with acute UTI diagnosed clinically in Wuxi People′s Hospital from January 2017 to June 2019 were enrolled retrospectively. All children underwent 99Tcm-DMSA renal static imaging and 99Tcm-DTPA renal dynamic imaging, and the regions of interest (ROI) were drawn manually to calculate the RRF of the right and left kidneys. The consistency of RRF evaluated by the two imaging methods was analyzed by Bland-Altman analysis, the correlation was analyzed by Pearson correlation analysis, and the difference was compared by the independent-sample t test. Results The values of RRF measured with 99Tcm-DMSA and 99Tcm-DTPA were (52.27±14.53)% and (52.22±14.14)% for the left kidney (t=0.913, P>0.05), those for the right kidney were (47.73±14.53)% and (47.78±14.14)% (t=0.913, P>0.05), respectively. A significant positive correlation was found between the RRF measured with the two imaging methods both for left and right kidneys (r values: 0.959, 0.959; both P<0.01). Bland-Altman analysis showed that the average difference of RRF measured with the two imaging methods for left kidney was 0.1% and the 95% limits of agreement (LoA) was from -8.0% to 8.1%, those for right kidney were -0.1% and from -8.1% to 8.0%. Conclusions There is a good correlation between RRF measured with 99Tcm-DMSA renal static imaging and that measured with 99Tcm-DTPA renal dynamic imaging in children with acute UTI. Both imaging methods can be used to evaluate the RRF in children with acute UTI. Key words: Urinary tract infections; Infant; Child; Radionuclide imaging; Technetium Tc 99m dimercaptosuccinic acid; Technetium Tc 99m pentetate