Nuclear Medicine DMSA Scan

Authors: Mrs Lynne Bowlen*
                            Dr Timothy Cain *

What are the prerequisites for having a DMSA scan done?

No prerequisites.

A recent or current UTI may demonstrate a lack of radiopharmaceutical accumulation due to pyelonephritis. This may resolve on further imaging or reflect permanent scarring. It is usual to wait 8-12 weeks following a recent infection before performing a DMSA scan, unless you are looking for evidence of acute pyelonephritis or assessing an acute renal condition.

What are the absolute contraindications for a DMSA scan?

The justification for the procedure (harm versus expected benefit) needs to be seriously considered.
If your patient is breast feeding, please discuss your patient with the nuclear medicine specialist to optimise dose minimisation and appropriate withdrawal times for breast feeding and reduced contact with the infant.

What are the relative contraindications for a DMSA scan?

Pregnancy is almost an absolute contraindication for DMSA scanning and a serious medical condition would be required to warrant performing a DMSA scan in a patient with an ongoing pregnancy.

Lactation – technetium based radiopharmaceuticals are actively excreted into breast milk. Procedure would be considered after full consultation between the referring doctor and the nuclear medicine specialist. The specialist would provide protocols to reduce the dose to the patient (e.g. lower the administered dose) and, depending on the administered dose, what instructions need to be provided to the patient.

Weight limits – this depends on the equipment available at your local practice and the area needing to be examined. Most scanning beds have weight limits ranging from 160kg to 220kg. Some imaging can be done with the patient sitting or standing, or on a hospital bed or trolley. Please discuss with your local practice if necessary.

Recent nuclear medicine scan or treatment – patients requiring multiple nuclear medicine scans need to have their procedures co-ordinated for the most effective program. Most scans are technetium based.

What are the adverse effects of a DMSA scan?

There are no risks involved in the DMSA Scan procedure itself.

There is a small dose of ionising radiation that is similar to other routine medical imaging tests (see radiation risk of medical imaging for adults and children).

The IV injection and the use of restraints can be stressful for small children and their parents (see how can I make my child’s examination less stressful?).

Are there alternative imaging tests, interventions or surgical procedures to a DMSA scan?

An ultrasound examination of the kidneys can also provide information on renal size, and areas of cortical thinning can indicate scarring. The DMSA gives additional information on relative function. Please discuss individual patients with your nuclear medicine specialist.

*The author has no conflict of interest with this topic.

Page last modified on 26/7/2017.

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