Background Urinary tract infection (UTI) is one of the commonly encountered conditions in children. Dimercaptosuccinic acid (DMSA) scintigraphy is widely advocated for functional and morphological evaluation of the renal cortex including parenchymal defect. Moreover, only a small percentage of renal defects are detected by ultrasound. We aimed to examine DMSA scintigraphy of children and identify factors associated with cortical defect. Methods Patients aged ≤ 18 years old who underwent DMSA scintigraphy (November 18, 2019–February 2, 2023, 30 children) were included. All children received intravenous injections of 99mTc-DMSA followed by static planar and single-photon-emission computed tomography imaging at 3 hours. Cortical findings and differential functions of the worst affected kidney were graded accordingly. Grade I has no more than two cortical defects, grade II has more than two cortical defects with normal parenchyma between the defects, while grade III is when generalized damage is noted, and grade IV is when a shrunken kidney is seen with no DMSA uptake. Normal functioning kidney is when the relative function at 45 to 55%, mildly reduced function at 40 to 44%, and substantially impaired function at 10 to 39%, while nonfunctioning is when the differential split renal function < 10%. All data were then statistically analyzed. Results Majority was female (53%). The mean age was 5.85 years. UTI episodes were 73%. Twenty-two children had congenital urinary tract anomalies. All patients with vesicoureteric refluxes (VURs) had positive defects. Scintigraphy showed abnormalities in 17 children affecting unilateral (64%) or both kidneys (36%). There were 17 children (57%) respectively in the abnormal DMSA scan findings category with normal until significant impairment of the functioning kidney category. VURs were significantly associated with abnormal scintigraphy (p < 0.05). A significant association was found between abnormal DMSA scan findings and differential renal function (p < 0.05). Conclusion Significant association was noted between VURs and abnormal DMSA scintigraphy, abnormal DMSA scan findings, and impaired differential renal function. Special consideration should be given to these cases.

22 Jul 2024·Cureus Journal of Medical Science

Determining Split Renal Function in Children With Ureteropelvic Junction Stenosis: Technetium-99m Mercaptoacetyltriglycine (Tc-99m MAG-3) or Technetium-99m Dimercaptosuccinic Acid (Tc-99m DMSA)?

Article

Author: Girişgen, İlknur ; Yaylalı, Olga ; Becerir, Tülay ; Yüksel, Selçuk ; Herek, Özkan ; Özdemir, Hale ; Şenol, Hande

Background Ureteropelvic junction stenosis (UPJS) is the most common cause of clinically significant antenatal hydronephrosis. We compared separate renal function results obtained using technetium-99m-mercaptoacetyltriglycine (Tc-99m MAG-3) and technetium-99m-dimercaptosuccinic acid (Tc-99m DMSA) in pediatric patients with UPJS to evaluate the adequacy of Tc-99m MAG-3 scintigraphy and the necessity of additional Tc-99m DMSA scintigraphy during follow-up. Methodology Patients diagnosed with hydronephrosis in the Pediatric Nephrology Department of Pamukkale University Faculty of Medicine over a period of 10 years (2012-2022) were evaluated retrospectively. Patients who had been diagnosed with UPJS and underwent both Tc-99m MAG-3 and Tc-99m DMSA scintigraphy during follow-up were included in the study. Technetium-99m-labeled MAG-3 and DMSA scans were re-evaluated for all patients by the Department of Nuclear Medicine. Results The study included 52 children with unilateral UPJS (12 girls and 40 boys) with a mean age of 6.34 ± 4.81 years (range: 2.97-9.79 years). Thirty-six patients (69.2%) were diagnosed antenatally. Differential renal function in Tc-99m DMSA was 46.94 ± 10.64 and in Tc-99m MAG-3 was 43.08 ± 11.18; the functions were lower in Tc-99m MAG-3, but the values were within normal limits for both groups (p=0.0001, z=-3.893). When differential renal functions were compared between Tc-99m DMSA and Tc-99m MAG-3 results, a statistically significant positive and strong correlation was found in the kidney with ureteropelvic junction obstruction (UPJO) (p=0.0001, r=0.752). When classifying the Tc-99m MAG-3 and Tc-99m DMSA results in the kidney with UPJO (supranormal, normal, low function) for the determination of differential renal functions, there was a consistency of 76%, and it was correlated (p=0.0001, k=0.456). While two patients had supranormal function and 13 patients had low function in Tc-99m MAG-3, five patients had supranormal function, and eight patients had low function in Tc-99m DMSA. Conclusions Some studies in the literature have reported that Tc-99m MAG-3 causes supranormal function measurements in patients with UPJS; our results showed that Tc-99m DMSA resulted in a higher rate of supranormal values for affected kidneys. We believe that Tc-99m DMSA should not be performed in addition to Tc-99m MAG-3 scintigraphy in the follow-up of every patient with UPJS but can be utilized in select cases, such as patients with surgical indications and those suspected before surgery.

01 Jun 2024·Nuclear medicine communications

Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA

Article

Author: Dilawar, Hasnain ; Fatima, Shazia ; Rana, Razia ; Ahmed, Akhtar ; Habib, Salman ; Hadi, Imran ; Iqbal, Javaid ; Abdul Rehman, Talal

Purpose:

The purpose of this study is to compare the value of absolute renal uptake (ARU %) in patients by using Tc-99m MAG-3 and Tc-99m DMSA scan.

Material and methods:

Absolute renal uptake is calculated using Tc-99m MAG-3 and Tc-99m DMSA in renal scintigraphy, Itoh and Tauex kidney depth methods used, respectively. n = 40 adult patients of both genders were included. All patients underwent Tc-99m MAG-3 and Tc-99m DMSA, respectively.

Results:

The values of ARU (%) were calculated separately in selected patients n = 40, (left = 17, right = 23 normal functioning kidneys) by MAG-3 and DMSA. Absolute renal uptake (%) of Tc-99m MAG-3 in left kidneys was found to be 15.2 ± 3.4, with spilt renal function 79.2 ± 14.7 and ARU (%) in right kidneys 16.2 ± 3.4 with spilt renal function 77.5 ± 19. Absolute renal uptake of Tc-99m DMSA in left kidneys was 17.5 ± 3.2 and in right kidneys 17.9 ± 4.5 with spilt renal function 81.8 ± 10.7 and 79.3 ± 13.8 for left and right kidney, respectively. Statistical analysis showed strong Pearson correlation.

Conclusion:

Absolute renal uptake % was found to be more reliable in cases of bilateral compromised kidneys. ARU (%) calculated by Tc-99m MAG-3 solely can be used as predictor of renal function. The use of Tc-99m MAG-3 has more advantages than Tc-99m DMSA alone in renal scintigraphy as dynamic scintigraphy gives less radiation burden to patient, more information regarding renal function, and shorter stay time at hospital in comparison to static renal imaging. SRF % is less reliable than ARU (%).

News (Medical) associated with Technetium Tc99M Succimer

01 Jun 2023

·www.fiercebiotech.com

Ariceum snaps up fellow European biotech Theragnostics to bolster radiopharma efforts

Ariceum Therapeutics raised 25 million euros a year ago to advance its lead asset acquired from Ipsen. Radiopharmaceuticals are all the rage in cancer drug development these days, and Germany-based Ariceum Therapeutics doesn’t want to lose any ground. The company is paying $2.5 million in cash for British biotech Theragnostics. The acquisition brings with it a couple of assets, according to an announcement Thursday, for which Ariceum could end up handing out an additonal $41.5 million in milestone payments. One of the newly acquired assets, THG-008, is a radiolabeled, cancer-imaging PARP inhibitor currently in a phase 1 trial at Memorial Sloan Kettering Hospital in New York. Ariceum also takes possession of THG-009, a radiopharmaceutical therapeutic aimed at PARP that’s being developed to treat patients with glioblastoma. As well as taking on THG-008, the acquisition shores up Ariceum’s diagnostics efforts in other ways, with the biotech now owning the FDA-approved Nephroscan, which is used to identify kidney disorders. The test will help bolster the company’s presence in the U.S., Ariceum CEO Manfred Rüdiger, Ph.D., said in the release. Last but not least, Ariceum’s purchase includes Theragnostics’ Ga-68 kit technology IP that’s currently licensed to Novartis, one of the Big Pharma leaders in radiopharmaceutical development. The deal adds depth to Ariceum’s already established—albeit small—radiopharma pipeline, led by satoreotide, a potential diagnostic and treatment for neuroendocrine cancers. The company closed a 25 million euro series A round a year ago after snapping up rights to satoreotide from Ipsen. The purchase of Theragnostics is just the latest dealmaking on the radiopharmaceutical front, which has dominated headlines so far this year. Bicycle Therapeutics has been riding out front, inking two deals with Bayer and Novartis potentially worth up to $1.7 billion each. Newly launched biotechs focusing on the modality have also raked in cash. Convergent Therapeutics raised $90 million on the promise of its radiopharma pipeline in May, and, a few weeks earlier, Abdera took flight with $142 million in financing.

Phase 1AcquisitionOligonucleotideDrug Approval

01 Jun 2023

·www.prnewswire.com

Ariceum Therapeutics Expands Pipeline with Acquisition of Theragnostics Ltd

Acquisition of next generation radiopharmaceutical clinical pipeline to include Auger-based systemic targeted PARP inhibitor radiation therapies Expansion of operations in the US Acquisition of commercial FDA-approved, diagnostic product NEPHROSCANTM in partnership with GE Healthcare and Ga-68 kit technology IP currently licensed to Novartis Theragnostics' and Ariceum's leadership teams to join forces creating a specialist team of experts in the field of Radiopharmaceuticals BERLIN, June 1, 2023 /PRNewswire/ -- Ariceum Therapeutics (Ariceum), a private biotech company developing radiopharmaceutical products for the diagnosis and treatment of certain hard-to-treat cancers, is pleased to announce the acquisition of Theragnostics Ltd., a UK-based private biopharmaceutical company engaged in the development of radio-labelled PARP inhibitors for the diagnosis and treatment of tumours. The acquisition provides Ariceum with an expanded portfolio of therapeutic and diagnostic assets in late preclinical and early clinical development. It also comprises NEPHROSCANTM, a diagnostic product in partnership with GE Healthcare which is approved by the US Food and Drug Administration (FDA) and affords Ariceum expanded operations in the US. Under the terms of the acquisition, Ariceum will acquire 100% of the shares of Theragnostics in exchange for an upfront payment of $2.5 million in cash and milestone payments totalling up to $41.5 million. Manfred Rüdiger, PhD, Chief Executive Officer of Ariceum Therapeutics, said: "We are delighted to welcome Theragnostics' expert radiopharmaceutical team to Ariceum and to integrate its innovative products into our proprietary pipeline through this acquisition. In full alignment with our strategy, Ariceum continues to create value for its shareholders by building and advancing a well-balanced portfolio from early discovery to mid-clinical stage projects up to FDA approved NEPHROSCANTM which advances our presence in the US." Greg Mullen, Former Chief Executive Officer of Theragnostics and Newly Appointed Chief Operating Officer of Ariceum Therapeutics, commented: "The acquisition by Ariceum Therapeutics is an exciting opportunity for Theragnostics and we are delighted to be part of a world-leading and innovative radiopharmaceutical company, ensuring the rapid clinical development of PARP inhibitor Auger therapy." Theragnostics' assets obtained by Ariceum include ATD 001 (formerly THG 008), a novel fluorine-18 radiolabelled PARP inhibitor for the imaging cancer, and AT-001 (formerly THG 009), a I-123-labelled PARP inhibitor which is in development for the treatment of aggressively growing cancers and already having UK ILAP approval for primary and recurrent glioblastoma. Theragnostics' early non-clinical data have demonstrated promising results which support progression of AT-001 into a Phase 1 clinical study in recurrent glioblastoma. Auger emitters such as I-123 combined with a PARP inhibitor enable delivery of radionuclides to the DNA to selectively kill cancer cells whilst sparing healthy tissue, thereby offering a potentially powerful treatment option in several cancer indications. In addition, Ariceum will gain access to the US FDA-approved product, NEPHROSCANTM (partnered with GE Healthcare), a radioactive diagnostic agent indicated for use as an aid in the scintigraphic evaluation of renal parenchymal disorders in adults and paediatric patients. Ariceum will also acquire Theragnostics Ga-68 kit technology IP which is licensed by Theragnostics to Novartis for their approved Ga-68 PSMA kit, LOCAMETZ®, a diagnostic medicine used in adults with prostate cancer. Notes to Editors About Ariceum Therapeutics Ariceum Therapeutics (Ariceum) is a private, clinical stage radiopharmaceutical company focused on the diagnosis and precision treatment of certain neuroendocrine and other aggressive, hard-to-treat cancers. The name Ariceum is an anagram of 'Marie Curie' whose discovery of radium and polonium has made huge contributions to finding treatments for cancer. Ariceum's lead targeted systemic radiopharmaceutical product, 177Lu-satoreotide tetraxetan ("satoreotide") is an antagonist of the somatostatin type 2 (SST2) receptor which is overexpressed in neuroendocrine tumours (NETs) and some aggressive cancers such as small cell lung cancer (SCLC), all of which have few treatment options and poor prognosis. Satoreotide is being developed as a 'theranostic' pair for the combined diagnosis and targeted radionuclide treatment of these tumours. Following the acquisition of Theragnostics Ltd, Ariceum Therapeutics obtained all assets, including FDA-approved product, NEPHROSCANTM in partnership with GE Healthcare. Ariceum Therapeutics, launched in 2021, acquired all rights to satoreotide from Ipsen. Ipsen remains a shareholder in the Company. Ariceum is headquartered in Berlin, with operations in Germany, Australia and Switzerland and activities currently across Europe, North America and Australia. Ariceum is led by a highly experienced management team and supported by specialist investors including EQT Life Sciences (formerly LSP), HealthCap, Pureos Bioventures, Andera Partners and Earlybird Venture Capital. For further information, please visit SOURCE Ariceum Therapeutics

Acquisition

100 Deals associated with Technetium Tc99M Succimer

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Kidney Diseases	United States	Theragnostics Ltd.	18 Feb 2022

Clinical Result

Indication

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


SNMMI2022	Not Applicable	Urinary Tract Infections	-	Tc-99m DMSA (Presence of VUR)	uofgynclud(zpzwgvijgk) = nrjucdynyd nezafixtnb (akzsbjtkzv ) View more	-	08 Aug 2022
SNMMI2022	Not Applicable	Urinary Tract Infections	-	Tc-99m DMSA (Presence of cortical defect)	uofgynclud(zpzwgvijgk) = nqefupkevl nezafixtnb (akzsbjtkzv ) View more	-	08 Aug 2022
EANM2017	Not Applicable	99m-Tc-Dimercaptosuccinic acid(DMSA)	-	99m-DMSA (Geometric Mean Analysis)	rutqhdnzii(ixhtiriqub) = muqbkrnbnd nfkmeaacpz (ypunjwofzp, 0.20)	-	11 Sep 2017
EANM2016	Not Applicable	-	200	Tc-DMSA (Normal 99m Tc-EC renogram)	xntozsgrni(xcxkqwphgl) = wllspzzqrr jrtyuyqcnw (rnvepntibb )	-	21 Sep 2016
EANM2016	Not Applicable	-	200	Tc-DMSA (Abnormal 99m Tc-EC renogram)	xntozsgrni(xcxkqwphgl) = jlxwnxiuoo jrtyuyqcnw (rnvepntibb )	-	21 Sep 2016
EANM2007	Not Applicable	Thyroid Cancer, Medullary serum calcitonin	-	Tc-99m DMSA (V) (Patients with medullary thyroid carcinoma)	uoktnldtdl(mforlcehik) = qobckvkcnc dqtgbmxikf (coupdtedxe ) View more	-	15 Oct 2007

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