^99mTc‑DMSA renal cortical quantitative SPECT/CT imaging in diabetic patients: feasibility and initial results

Introduction Diabetes mellitus is a common cause of chronic kidney disease. Radionuclide imaging of the kidneys using technetium‑^99m‑labeled dimercaptosuccinic acid (^99mTc‑DMSA) is a well‑established method for the evaluation of kidney parenchyma. We hypothesize that early preclinical detection of renal affection in diabetic patients can be done by quantitative single‑photon emission computed tomography (SPECT) imaging using ^99mTc‑DMSA. Patients and methods In this study we included 29 patients: 13 diabetic and 16 volunteers as control. All must have within normal renal function. We excluded patients with known history of renal disease or abnormal renal function, patients with systemic diseases directly affect kidney function rather than diabetes. All patients included in our study were subjected to detailed clinical history, renal function, and quantitative ^99mTc‑DMSA renal imaging using SPECT/computed tomography techniques. About 5 mCi of ^99mTc‑DMSA were injected intravenously. Then imaging was acquired after 2–4 h in the supine position using a dual‑head gamma camera with a low‑energy all‑purpose collimator. SPECT/computed tomography images are then taken. Data were reconstructed; then a 3D ball region of interest is drawn over each kidney to assess the counts of the kidney. Results There was a significant difference in the mean of the BMI‑corrected counts divided by the injected dose (P = 0.024). The same results were obtained when the counts were summed and corrected according to the injected dose between the two groups (P = 0.034). Conclusion Quantitative SPECT ^99mTc‑DMSA imaging may have a role in the evaluation of renal functions in diabetics with no clinical evidence of renal affection.