technetium tc 99m mertiatide


Summary: A technetium diagnostic aid used in renal function determination.

Top Publications

  1. Ozker K, Onsel C, Kabasakal L, Sayman H, Uslu I, Bozluolçay S, et al. Technetium-99m-N,N-ethylenedicysteine--a comparative study of renal scintigraphy with technetium-99m-MAG3 and iodine-131-OIH in patients with obstructive renal disease. J Nucl Med. 1994;35:840-5 pubmed
    ..85 min, respectively. It is concluded that 99mTc-EC has excellent imaging characteristics and similar excretion properties to OIH. The advantages of 99mTc-EC over 99mTc-MAG3 are lower hepatobiliary uptake and simplicity of preparation. ..
  2. Itoh K. 99mTc-MAG3: review of pharmacokinetics, clinical application to renal diseases and quantification of renal function. Ann Nucl Med. 2001;15:179-90 pubmed
    ..In this review, I focused on its pharmacokinetics, simplified quantitative methods and clinical application in renal diseases. ..
  3. Herrler T, Tischer A, Meyer A, Feiler S, Guba M, Nowak S, et al. The intrinsic renal compartment syndrome: new perspectives in kidney transplantation. Transplantation. 2010;89:40-6 pubmed publisher
    ..Surgical pressure relief effectively prevented functional and structural renal impairment, and we speculate that this approach might be of value for improving graft function after renal transplantation. ..
  4. Esteves F, Taylor A, Manatunga A, Folks R, Krishnan M, Garcia E. 99mTc-MAG3 renography: normal values for MAG3 clearance and curve parameters, excretory parameters, and residual urine volume. AJR Am J Roentgenol. 2006;187:W610-7 pubmed
    ..Normal limits adjusted for age and sex have been established. Applying normal ranges to quantitative MAG3 parameters may assist in the interpretation of MAG3 scintigraphy and facilitate appropriate patient management. ..
  5. Gates G. Filtration fraction and its implications for radionuclide renography using diethylenetriaminepentaacetic acid and mercaptoacetyltriglycine. Clin Nucl Med. 2004;29:231-7 pubmed
    ..Accordingly, a renogram protocol is presented for the combined use of DTPA and MAG3 resulting in GFR estimation (from DTPA) while yielding superior renal images and renogram curves from MAG3. ..
  6. Roberts J, Chen B, Curtis L, Agarwal A, Sanders P, Zinn K. Detection of early changes in renal function using 99mTc-MAG3 imaging in a murine model of ischemia-reperfusion injury. Am J Physiol Renal Physiol. 2007;293:F1408-12 pubmed
    ..Our study shows that using dynamic imaging, renal dysfunction can be detected and quantified reliably as early as 5 h after I/R insult, allowing for evaluation of early treatment interventions. ..
  7. Schlotmann A, Clorius J, Rohrschneider W, Clorius S, Amelung F, Becker K. Diuretic renography in hydronephrosis: delayed tissue tracer transit accompanies both functional decline and tissue reorganization. J Nucl Med. 2008;49:1196-203 pubmed publisher
    ..According to the literature, a delayed TTT is determined by the filtration fraction of the kidneys and appears to identify an obstruction-mediated upregulated renin-angiotensin system. ..
  8. Park U, Kim H, Cho W, Kim M, Hwang E, Han S, et al. Use of early postoperative MAG3 renal scan to predict long-term outcomes of renal transplants. Exp Clin Transplant. 2013;11:118-21 pubmed publisher
    ..A grade 2 renography pattern, with normal uptake and flat excretion, indicates a dismal prognosis for the long-term allograft survival. ..
  9. O ROURKE E, Hussain R, Buscombe J, Hilson A. Overlying urostomy bag simulating urinary leak in a postrenal transplant MAG3 study. Clin Nucl Med. 2006;31:578-80 pubmed

More Information


  1. Binongo J, Taylor A, Hill A, Schmotzer B, Halkar R, Folks R, et al. Use of classification and regression trees in diuresis renography. Acad Radiol. 2007;14:306-11 pubmed
  2. Morel O, Metrard G, Jeanguillaume C, Rakotonirina H, Blaire T, Le Jeune J, et al. Renovascular hypertension and double renal arterial supply diagnosed by Tc-99m MAG3 captopril renography. Clin Nucl Med. 2006;31:298-300 pubmed
  3. Keir M, Lambert H, Coulthard M. Maximizing the sensitivity of the indirect radionuclide cystogram: a retrospective audit. Pediatr Nephrol. 2013;28:2137-41 pubmed publisher
    ..Additional imaging and mathematical assessment can significantly increase the sensitivity of the IRC for detecting VUR, possibly to equal that of the MCUG. ..
  4. Taylor A, Ziffer J, Steves A, Eshima D, Delaney V, Welchel J. Clinical comparison of I-131 orthoiodohippurate and the kit formulation of Tc-99m mercaptoacetyltriglycine. Radiology. 1989;170:721-5 pubmed
    ..96 L +/- 1.94) was less than that of I-131 OIH (9.41 L +/- 3.73) (P less than .001). These characteristics and the advantages of a simple kit formulation should lead to widespread clinical use. ..
  5. Phisitkul S, Brian S, Rakvit A, Jenkins L, Bohannon W, Harris J, et al. Abdominal aortic aneurysm demonstrated on renal scintigraphy. Clin Nucl Med. 2003;28:711-4 pubmed
    ..0 cm on abdominal computed tomography. This study demonstrates that a suspected abdominal aortic aneurysm can be confirmed using the addition of anterior abdominal imaging with normal posterior imaging at the time of renal scintigraphy. ..
  6. Ramos Font C, Varo M, Ortega E, Casas J, Avisbal M, Romero J. Tc-99 HMPAO labeled leukocyte imaging in a renal transplant in a patient with ulcerative colitis. Clin Nucl Med. 2005;30:827-8 pubmed
  7. Tondeur M, Sand A, Ham H. Interobserver reproducibility in the interpretation of captopril renograms from patients suspected of having renovascular hypertension. Clin Nucl Med. 2004;29:479-84 pubmed
    ..This study shows that the analysis by the Internet of interobserver agreement is an easy and rapid method allowing one to identify difficult to interpret pre- and postcaptopril renographic data. ..
  8. Cascio S, Siddiqui M, Barrett A. Is screening ultrasound of the urinary tract indicated in infants with hypertrophic pyloric stenosis?. Acta Paediatr. 2005;94:23-5 pubmed
    ..The abnormalities detected were not clinically relevant and did not require surgical intervention. We do not recommend screening of the urinary tract in infants with HPS. ..
  9. Hoh I, Bomanji J, Nagabhushan N, Chu A, Ell P, Neild G, et al. Effect of the abnormal bladder when full on upper tract drainage using a combined cystometrogram-(99m)Tc-mercapto-acetyltriglycine renogram: a prospective study. BJU Int. 2007;100:1131-6 pubmed
    ..It remains to be seen whether bladder emptying designed to keep the urine volume below the obstructing threshold volume will prevent further loss of renal function. ..
  10. Schlotmann A, Clorius J, Clorius S. Diuretic renography in hydronephrosis: renal tissue tracer transit predicts functional course and thereby need for surgery. Eur J Nucl Med Mol Imaging. 2009;36:1665-73 pubmed publisher
    ..Delayed TTT appears to identify the need for therapy to preserve function of hydronephrotic kidneys, while timely TTT may exclude risk even in the presence of an obstructive RFS or SKF < 40%. ..
  11. Tartaglione G, D Addessi A, de Waure C, Pagan M, Raccioppi M, Sacco E, et al. (99m)Tc-MAG3 diuretic renography in diagnosis of obstructive nephropathy in adults: a comparison between F-15 and a new procedure F+10(sp) in seated position. Clin Nucl Med. 2013;38:432-6 pubmed publisher
    ..This study shows that the F+10(sp) procedure reduces the equivocal findings of F-15 procedure in 36 patients. It can improve the accuracy and compliance, avoiding adverse effects and reducing bladder filling-related problems. ..
  12. Takahara N, Saga T, Inubushi M, Kusuhara H, Seki C, Ito S, et al. Drugs interacting with organic anion transporter-1 affect uptake of Tc-99m-mercaptoacetyl-triglycine (MAG3) in the human kidney: therapeutic drug interaction in Tc-99m-MAG3 diagnosis of renal function and possible application of Tc-99m-MAG3 for drug . Nucl Med Biol. 2013;40:643-50 pubmed publisher
    ..Drugs with OAT1 affinity affect the renal uptake of Tc-99m-MAG3 and blood clearance. This might cause misinterpretation of functional diagnosis of the kidney using Tc-99m-MAG3. ..
  13. Wesolowski M, Conrad G, Šámal M, Watson G, Wanasundara S, Babyn P, et al. A simple method for determining split renal function from dynamic (99m)Tc-MAG3 scintigraphic data. Eur J Nucl Med Mol Imaging. 2016;43:550-8 pubmed publisher
    ..As such, it adds a new reliable method for quality control of monitoring relative kidney function. ..
  14. Inoue Y, Itoh H, Tagami H, Miyatake H, Asano Y. Measurement of Renal Depth in Dynamic Renal Scintigraphy Using Ultralow-Dose CT. Clin Nucl Med. 2016;41:434-41 pubmed publisher
    ..Substantial differences in renal depth between prediction and CT measurement indicated potential usefulness of CT measurement, although no actual improvement in the accuracy of clearance estimation was demonstrated in this study. ..
  15. Rutland M, Que L. A comparison of the renal handling of 99Tcm-DTPA and 99Tcm-MAG3 in hypertensive patients using an uptake technique. Nucl Med Commun. 1999;20:823-8 pubmed
    ..min(-1).1.73 m-2 for MAG3, in hypertensive patients aged 20-40 years. These values showed a good correlation with other published GFR and MAG3 clearance rates (obtained using blood sampling methods) in normal patients of similar ages. ..
  16. Kanazawa T, Shimizu M, Seto H, Kageyama M, Kameda K, Toyoshima S, et al. Reproducibility of 99Tcm-MAG3 clearance in normal volunteers with the two-sample method: comparison with 131I-OIH. Nucl Med Commun. 1998;19:899-903 pubmed
    ..There were no significant differences between the first and the second measurements of 99Tcm-MAG3 and 131I-OIH clearance, respectively. 99Tcm-MAG3 clearance was shown to be very similar to that of 131I-OIH in healthy volunteers. ..
  17. Cohn D, Gruenewald S. Postural renal transplant obstruction: a case report and review of the literature. Clin Nucl Med. 2001;26:673-6 pubmed
    ..This case indicates that posture may affect ureteric patency and highlights this potential pitfall in the evaluation of intermittent graft dysfunction by diuretic renography. ..
  18. Itoh K, Tsukamoto E, Kakizaki H, Nonomura K, Furudate M. Comparative study of renal scintigraphy with 99Tcm-mercaptoacetyltriglycine and 123I-orthoiodohippurate. Nucl Med Commun. 1993;14:644-52 pubmed
    ..However, 99Tcm-MAG3 has the clinical advantages of superior image quality, the feasibility of gamma camera measurement of quantitative renal uptake, and ready availability for routine clinical use. ..
  19. Brandau W, Bubeck B, Eisenhut M, Taylor D. Technetium-99m labeled renal function and imaging agents: III. Synthesis of 99mTc-MAG3 and biodistribution of by-products. Int J Rad Appl Instrum A. 1988;39:121-9 pubmed
    ..The results suggest that the radiochemical purity of 99mTc-MAG3-preparations should be not less than 95%. ..
  20. Rengel M, Gomes Da Silva G, Incháustegui L, Lampreave J, Robledo R, Echenagusia A, et al. Renal artery stenosis after kidney transplantation: diagnostic and therapeutic approach. Kidney Int Suppl. 1998;68:S99-106 pubmed
  21. Nimmon C, Fleming J, Samal M. Probable range for whole kidney mean transit time values determined by reexamination of UK audit studies. Nucl Med Commun. 2008;29:1006-14 pubmed publisher
    ..Visual display of both the renal retention function and the reconvolution curve are suggested as simple quality control measures for analysis software. ..
  22. Kanamaru H, Yamamoto M, Nagahama K, Yagihashi Y, Kato K, Oida T, et al. Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy. Int J Urol. 2011;18:570-4 pubmed publisher
    ..Preoperative MAG3 renogram is not superior to eGFR measurement as a prognostic indicator of long-term renal function after unilateral nephrectomy. ..
  23. Tondeur M, De Palma D, Roca I, Piepsz A, Ham H. Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study. Eur J Nucl Med Mol Imaging. 2008;35:644-54 pubmed
    ..There is an urgent need for better standardisation in estimating the quality of drainage. ..
  24. O Malley J, Ziessman H, Chantarapitak N. Tc-99m MAG3 as an alternative to Tc-99m DTPA and I-131 Hippuran for renal transplant evaluation. Clin Nucl Med. 1993;18:22-9 pubmed
    ..In conclusion, Tc-99m MAG3 is superior to I-131 Hippuran for evaluation of renal transplant function. Tc-99m is the agent of choice for evaluation of renal transplant blood flow and function. ..
  25. Harper L, Bourquard D, Grosos C, Abbo O, Ferdynus C, Michel J, et al. Cortical transit time as a predictive marker of the need for surgery in children with pelvi-ureteric junction stenosis: preliminary study. J Pediatr Urol. 2013;9:1054-8 pubmed publisher
    ..CTT is easy to determine on diuretic renal scan. A prospective trial is being devised to confirm what role it could have in the management of children with hydronephrosis. ..
  26. Nielsen M, Granerus G, Ohlsson M, Holst H, Thorsson O, Edenbrandt L. Interpretation of captopril renography using artificial neural networks. Clin Physiol Funct Imaging. 2005;25:293-6 pubmed
    ..Artificial neural networks can be trained to interpret captopril renography tests for detection of renovascular hypertension caused by renal artery stenosis. The result almost equals that of human experts shown in previous studies. ..
  27. Dubovsky E, Diethelm A, Keller F, Russell C. Renal transplant hypertension caused by iliac artery stenosis. J Nucl Med. 1992;33:1178-80 pubmed
    ..Arteriography demonstrated high grade stenosis not of the renal artery but of the iliac artery. After successful angioplasty, the patient's hypertension resolved. ..
  28. Jung H, Chung Y, Kim E, Kim S, Lee S, Sohn H, et al. Influence of hydration status in normal subjects: fractional analysis of parameters of Tc-99m DTPA and Tc-99m MAG3 renography. Ann Nucl Med. 2005;19:1-7 pubmed
    ..Dehydration may bring about a false positive curve pattern on renograms which can be prevented or minimized by using the cortical ROI. There were insignificant differences between most parameters of Tc-99m DTPA and Tc-99m MAG3. ..
  29. Horita Y, Hayashida K, Fukuchi K, Takishita S, Tadokoro M, Taura K, et al. Acetazolamide assisted Tc-99m MAG3 renography to assess renal blood flow reserve. Ann Nucl Med. 2003;17:139-44 pubmed
    ..We suggested that the deltaERPF determined by baseline and ACZ Tc-99m MAG3 renography is a useful parameter for assessing renal blood flow reserve. ..
  30. Keske U, Cordes M, Wilfling M, Hunger J, Hosten N, Gahl G. [99mTc-MAG3 and 131I-OIH in patients with kidney insufficiency and with normal kidneys]. Rofo. 1990;152:287-92 pubmed
    ..It is concluded that MAG3 may be used as substitute for OIH in patients with normal and impaired renal function. ..
  31. Beetz R, Bartenstein P, Stein R. [Age-dependency of isotope drainage in diuretic renograms]. Klin Padiatr. 2002;214:104-8 pubmed
    ..In urinary tract dilatation, mistakes regarding the interpretation of isotope drainage may be minimized by taking the measurements in the normal contralateral RU in account and by comparing them with age-referred normal values. ..
  32. Vanderheyden J, Liu G, He J, Patel B, Tait J, Hnatowich D. Evaluation of 99mTc-MAG3-annexin V: influence of the chelate on in vitro and in vivo properties in mice. Nucl Med Biol. 2006;33:135-44 pubmed
    ..Nevertheless, (99m)Tc MAG(3)-annexin may be an attractive alternative to (99m)Tc Hynic-annexin for the in vivo imaging of phosphatidylserine receptors. ..
  33. Lusch A, Koen M, Becker T, Engelhardt P, Riccabona M. [Pelvic kidney in childhood. Specific features, concomitant pathologies and useful diagnostic investigations]. Urologe A. 2007;46:132-6 pubmed
    ..For asymptomatic cases we recommend regular ultrasound monitoring of the kidney -- at first every 6 months and later once a year. In cases with complex anatomy MRI is a suitable method for further diagnostic work-up. ..
  34. Tatsugami K, Tanaka S, Ohtsubo S, Inokuchi J, Yokomizo A, Kuroiwa K, et al. Causes of diminished renal function in the affected kidney after partial nephrectomy. BJU Int. 2012;110:E357-61 pubmed publisher
    ..008). Successful preservation of renal function after PN depends on renal cooling during renal hilar clamping. Cold ischaemia for avoiding renal damage is recommended if renal hilar clamping is necessary for tumour extraction. ..
  35. Szabo Z, Kutkuhn B, Georgescu G, Mecklenbeck W, Suatmadji A, Vosberg H. [Parametric representation of kidney function using 99mTc-mercaptoacetyltriglycine (MAG3)]. Nuklearmedizin. 1989;28:73-83 pubmed
  36. Russell C, Yang H, Gaston R, Hudson S, Diethelm A, Dubovsky E. Prediction of renal transplant survival from early postoperative radioisotope studies. J Nucl Med. 2000;41:1332-6 pubmed
    ..We present here the correlation between baseline measurements and the 1-y graft survival...
  37. Hackländer T, Mertens H, Stattaus J, Lürken M, Lerch H, Altenburg A, et al. Evaluation of renovascular hypertension: comparison of functional MRI and contrast-enhanced MRA with a routinely performed renal scintigraphy and DSA. J Comput Assist Tomogr. 2004;28:823-31 pubmed
    ..The noninvasive MRA can replace DSA in the diagnosis of renal artery stenosis. However, fMRI can not replace renal scintigraphy. ..
  38. De Sadeleer C, Piepsz A, Tondeur M, Ham H. Simplified algorithms for the estimation of 99Tcm-MAG3 clearance. Nucl Med Commun. 2000;21:65-9 pubmed
    ..min-1, with no systematic bias; with Bubeck's algorithm there was a marked underestimation, both in the low and high clearance ranges. We suggest Russell's single-sample method is the method of choice. ..
  39. Sadic M, Demirel K, Koca G, Atilgan H, Korkmaz M. An incidental detection of aortic aneurysm on Tc-99m MAG3 renal scintigraphy. Nucl Med Rev Cent East Eur. 2013;16:97-9 pubmed publisher
  40. Cosgriff P, Gordon I. Diuretic renogram clearance half-times in the diagnosis of obstructive uropathy: effect at age and previous surgery. Nucl Med Commun. 2003;24:1255-6; author reply 1256-7 pubmed
  41. Drost W, McLoughlin M, Mattoon J, Lerche P, Samii V, DiBartola S, et al. Determination of extrarenal plasma clearance and hepatic uptake of technetium-99m-mercaptoacetyltriglycine in cats. Am J Vet Res. 2003;64:1076-80 pubmed
    ..Evaluation of renal function in cats may be more accurate via camera-based versus plasma clearance-based methods because camera-based studies can discriminate specific organs. ..
  42. Johnston P, Kennedy P, Blair P. Periaortitis complicating chronic aortic dissection. Eur Heart J. 2007;28:442 pubmed
  43. Blaustein D, Myint M, Babu K, Avram M, Chandramouli B. The role of technetium-99m MAG3 renal imaging in the diagnosis of acute tubular necrosis of native kidneys. Clin Nucl Med. 2002;27:165-8 pubmed
    ..For patients with acute renal failure, a renal scan can facilitate decision-making regarding the initiation of therapy. ..
  44. Fine E. Interventions in renal scintirenography. Semin Nucl Med. 1999;29:128-45 pubmed
    ..Finally, further investigations of exercise renography in essential hypertension have deepened the plausibility of a renal role in the etiology of perhaps 50% of affected individuals...
  45. Rehling M, Nielsen L. Plasma clearance of 99Tcm-MAG3: accuracy of five single-sample methods. Nucl Med Commun. 2000;21:193-7 pubmed
    ..and Piera et al. The smallest standard deviation was obtained using the method of Bubeck et al. This method is recommended for use in patients with a plasma clearance greater than 75 ml.min-1. ..
  46. Ponto J. Effect of solvent flow rate in mini-column testing of 99mTc-mertiatide. J Nucl Med Technol. 2005;33:232-3 pubmed
    ..Faster flow rates for mini-column testing of 99mTc-mertiatide save time (and correspondingly reduce radiation exposure to the worker) without adversely affecting the results of radiochemical purity determinations. ..
  47. Sfakianakis G, Sfakianaki E, Georgiou M, Serafini A, Ezuddin S, Kuker R, et al. A renal protocol for all ages and all indications: mercapto-acetyl-triglycine (MAG3) with simultaneous injection of furosemide (MAG3-F0): a 17-year experience. Semin Nucl Med. 2009;39:156-73 pubmed publisher
    ..The clinical usefulness of the MAG(3)-F(0) protocol in most congenital or acquired renal problems is proven through long-term clinical experience and has resulted in a substantial utilization of the test at our Center. ..
  48. Beattie L, O Brien L, Waight C, Homer N, Andrew R, Millar A. Preparation of 99m Tc-MAG3: the effect on radiochemical purity of using sodium chloride injection from plastic ampoules that have been exposed to light. Nucl Med Commun. 2008;29:649-53 pubmed publisher
    ..Exposure of plastic ampoules to light causes leaching of many compounds into the solution. An unknown leached compound destabilizes the 99m Tc-tartrate intermediate complex. ..
  49. Abdel Dayem H, Sadek S, al Bahar R, Sabha M, el Sayed M. Comparison of 99Tcm-mercaptoacetyltriglycine and 131I-orthoiodohippurate in determination of effective renal plasma flow (ERPF). Nucl Med Commun. 1989;10:99-107 pubmed
    ..96 + 0.995X, where Y = ERPF determined by 131I-OIH and X = ERPF determined by 99Tcm-MAG3. This study indicates that 99Tcm-MAG3 is a useful 99Tcm replacement for 131I-OIH in the determination of ERPF and generation of renogram curves. ..
  50. Halkar R, Taylor A, Manatunga A, Issa M, Myrick S, Grant S, et al. Monitoring renal function: a prospective study comparing camera-based technetium-99m mercaptoacetyltriglycine clearance and creatinine clearance. Urology. 2007;69:426-30 pubmed
  51. Horita Y, Nakamura S, Hirashima S, Tadokoro M, Taura K, Suyama N, et al. Evaluation of Tc-99m MAG3 dynamic renal scintigraphy with an aneurysmal type renal arteriovenous fistula. Clin Nucl Med. 2003;28:429-31 pubmed
  52. Cheung W, Wong K, Wong Y, Ma K. Segmental renal artery stenosis diagnosed with captopril renography in a child. Pediatr Radiol. 2004;34:636-9 pubmed
    ..This showed a segmental abnormality when the left kidney was analyzed as two separate cortical regions of interest. Subsequent angiography confirmed stenosis in the distal mid and lower pole branches of the left renal artery. ..
  53. Teh H, Ang E, Wong W, Tan S, Tan A, Chng S, et al. MR renography using a dynamic gradient-echo sequence and low-dose gadopentetate dimeglumine as an alternative to radionuclide renography. AJR Am J Roentgenol. 2003;181:441-50 pubmed
    ..This technique allows assessment of split renal function and urinary excretory status and is a feasible alternative to radionuclide renography. ..