This is the case of a male, 69 years of age, who presented with hematuria. The test was requested before surgery to assess renal function. Note large mass occupying the lower right organ (arrows). Left kidney is normal. Relative function was 47% in the right side and 53% in the left organ. Mild amount of soft tissue activity which might be explained by some degree of global insufficiency.
Usually the diagnosis of space occupying lesions is made based on anatomic imaging modalities, due to lack of specificity of nuclear medicine procedures. Nonetheless, in these conditions the DMSA renal scan is valuable to estimate the function either preoperatively or after surgery for follow up, like in the work of Dente D. et al., who at 6 months following surgery, found only 7% less relative function in the kidney with resected tumors up to 4 cm, using partial nephrectomy.
References:
1 Dente D, Paniccia T, Petrone D, Gaspari G, Tucci C, Rossetti R, Pompa P. Open partial nephrectomy with no clamping of the pedicule: a good surgical option in treatment of renal cancer. Minerva Urol Nefrol. 2010 Dec;62(4):341-6.