Renal Transplant Evaluation - Role of 99mTc- L, L-EC

Introduction: Renal Dynamic Scintigraphy (RDS) is a Nuclear Medicine imaging technique for evaluating the renal physiology and function. The three commonly used radiotracers for RDS include ^99mTc-Diethylene Triamine Penta-acetic Acid (^99mTc-DTPA), ^99mTc-Mercapto-acetyl Triglycine (^99mTc-MAG3) and ^99mTc-L,L,ethylenedicysteine (^99mTc-L, L-EC). Amongst these, L,L-EC is the agent preferred in the developing nations due to its lower cost and better availability and at least non-inferior tracer kinetics to MAG3. Timely diagnosis of renal transplant related complications is of paramount importance as its management decision can drastically impact the patient outcome.

Methods: Renal transplant has become the preferred treatment for end stage renal disease. The main indications for renal transplant scintigraphy include: Evaluation of vascular perfusion, graft dysfunction, peri-transplant fluid collection, urological complications and prognostication. In this exhibit, we wish to discuss interesting case findings of ^99mTc- L, L-EC Renal Dynamic Scintigraphy in renal transplant cases.

Results: Pictorial demonstration of concepts of the radiochemistry of ^99mTc-L, L-EC and imaging protocol of Renal Dynamic Scan would be provided along with a series of functional imaging of cases of renal transplant complications. The key headings would include: Overview of Renal Dynamic Scan, Key difference in the 3 commonly used tracers, Clinical cases utilizing ^99mTc-L, L-EC scan in patients with renal transplant evaluation and discussion of pertinent findings and pitfalls.

Conclusions: In this exhibit, we present the case based examples of the role of imaging with ^99mTc-L, L-EC Renal Dynamic Scan in cases of renal transplant evaluation.