Clinically Silent Renal Asymmetry: Marked Disparity on Tc-99m DTPA Scintigraphy

Clinically Silent Renal Asymmetry: Marked Disparity on Tc-99m DTPA Scintigraphy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinically Silent Renal Asymmetry: Marked Disparity on Tc-99m DTPA Scintigraphy Chen zhaoxi, Fang rongrong, Wang Genli, Ye xiuying, Cai Shumei, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9070012/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract A reliable, non-invasive method for quantitatively evaluating each person's kidney function is Tc-99m diethylenetriamine pentaacetate (DTPA) dynamic renal scintigraphy. Split renal perfusion, uptake, time-to-peak activity, and glomerular filtration rate (GFR) were assessed in 33 consecutive patients (January 2015–July 2024) who received medical treatment for suspected or confirmed renal failure. Kidney stones (n = 14), urinary tract infections (n = 5), acute kidney injury (n = 2), renal transplantation (n = 1), and obstructive uropathy (n = 1) were associated with the underlying conditions. The validated Gates method was used to calculate GFR in accordance with standardized European Association of Nuclear Medicine (EANM) protocols. Individual kidney parameters were correlated with clinical variables and compared using paired t-tests. The average GFR was 65.4 ± 24.1 mL/min. Significant inter-kidney asymmetry was frequently observed in the 32 patients with two functioning kidneys: in 56% of cases, one kidney contributed ≥ 70% of total function, and in 28% of cases, ≥ 80%. In 72% of patients, there was additionally a difference of more than 20% between perfusion and uptake. Lower total GFR was substantially correlated with older age and comorbidities. Clinically silent, but significant functional differences between the kidneys that are not visible from serum creatinine or estimated GFR alone can be reliably detected by Tc-99m DTPA scintigraphy. These results support the use of quantitative renal scintigraphy for more accurate diagnosis, risk assessment, and tailored treatment of patients with renal disease. They also emphasize the significance of regular split-function reporting in nuclear medicine practice. Renal scintigraphy nuclear medicine functional asymmetry Tc-99m DTPA Glomerular filtration rate (GFR) Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers invited by journal 08 Apr, 2026 Editor invited by journal 18 Mar, 2026 Editor assigned by journal 16 Mar, 2026 Submission checks completed at journal 16 Mar, 2026 First submitted to journal 09 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9070012","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":623084935,"identity":"36541d30-b476-463b-83a0-b07d69974186","order_by":0,"name":"Chen zhaoxi","email":"","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"zhaoxi","suffix":""},{"id":623084937,"identity":"2422e680-8783-4565-b246-51eb3650567e","order_by":1,"name":"Fang rongrong","email":"","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Fang","middleName":"","lastName":"rongrong","suffix":""},{"id":623084944,"identity":"0c295b11-7523-481c-815a-00383743a2f4","order_by":2,"name":"Wang Genli","email":"","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Wang","middleName":"","lastName":"Genli","suffix":""},{"id":623084946,"identity":"36eedf1a-88ed-424d-91ca-2e5b106aa3ce","order_by":3,"name":"Ye xiuying","email":"","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ye","middleName":"","lastName":"xiuying","suffix":""},{"id":623084947,"identity":"279636fd-6689-4bb4-bb1d-be247ddc8003","order_by":4,"name":"Cai Shumei","email":"","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Cai","middleName":"","lastName":"Shumei","suffix":""},{"id":623084948,"identity":"fd9bef57-c741-43a0-a3e5-9b1c92ea124a","order_by":5,"name":"Cui Xiangjun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYBAC/gbGBgYGAxDzAAPDByDFx8DAjFeLxAEkLYwzgAJshLQYOCBxmHmI0iKR3MDMU2CXJ+94xuyxTcXhOjb25sMGDDU20bi1JDYwzjBILjY8cMbcOOfMYQk2nmPJCQzH0nIb8Ghh+GDAnLix4YyZdG4bUItEjjHQg4fxa0kwqIdosSRKSwTYlsOJ8xmAWhihWhLwaZE487Dh4AyD44kbGI6VSfacSZdsA/rFIAGPX/jb0x8+5vlTnTh/xuFtEj8qrPn5gSEm8aHGBqcWEDgAduGNA0hCCXiUw4F8Pz5TR8EoGAWjYEQDABluV73OYJ+3AAAAAElFTkSuQmCC","orcid":"","institution":"Fuding City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Cui","middleName":"","lastName":"Xiangjun","suffix":""}],"badges":[],"createdAt":"2026-03-09 07:56:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9070012/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9070012/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107077264,"identity":"9f07c97b-bfbb-4b36-b452-38e4dda47ead","added_by":"auto","created_at":"2026-04-16 13:28:25","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1757280,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript13.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9070012/v1_covered_0a175928-847e-4c1c-bb5c-a1b0bd46fa41.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinically Silent Renal Asymmetry: Marked Disparity on Tc-99m DTPA Scintigraphy","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-imaging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmim","sideBox":"Learn more about [BMC Medical Imaging](http://bmcmedimaging.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmim/default.aspx","title":"BMC Medical Imaging","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Renal scintigraphy, nuclear medicine, functional asymmetry, Tc-99m DTPA, Glomerular filtration rate (GFR)","lastPublishedDoi":"10.21203/rs.3.rs-9070012/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9070012/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eA reliable, non-invasive method for quantitatively evaluating each person's kidney function is Tc-99m diethylenetriamine pentaacetate (DTPA) dynamic renal scintigraphy. Split renal perfusion, uptake, time-to-peak activity, and glomerular filtration rate (GFR) were assessed in 33 consecutive patients (January 2015\u0026ndash;July 2024) who received medical treatment for suspected or confirmed renal failure. Kidney stones (n\u0026thinsp;=\u0026thinsp;14), urinary tract infections (n\u0026thinsp;=\u0026thinsp;5), acute kidney injury (n\u0026thinsp;=\u0026thinsp;2), renal transplantation (n\u0026thinsp;=\u0026thinsp;1), and obstructive uropathy (n\u0026thinsp;=\u0026thinsp;1) were associated with the underlying conditions. The validated Gates method was used to calculate GFR in accordance with standardized European Association of Nuclear Medicine (EANM) protocols. Individual kidney parameters were correlated with clinical variables and compared using paired t-tests. The average GFR was 65.4\u0026thinsp;\u0026plusmn;\u0026thinsp;24.1 mL/min. Significant inter-kidney asymmetry was frequently observed in the 32 patients with two functioning kidneys: in 56% of cases, one kidney contributed\u0026thinsp;\u0026ge;\u0026thinsp;70% of total function, and in 28% of cases, \u0026ge;\u0026thinsp;80%. In 72% of patients, there was additionally a difference of more than 20% between perfusion and uptake. Lower total GFR was substantially correlated with older age and comorbidities. Clinically silent, but significant functional differences between the kidneys that are not visible from serum creatinine or estimated GFR alone can be reliably detected by Tc-99m DTPA scintigraphy. These results support the use of quantitative renal scintigraphy for more accurate diagnosis, risk assessment, and tailored treatment of patients with renal disease. 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