Nuclear medicine · Renal imaging
DMSA scan, nuclear medicine imaging of the kidneys for scarring, split function and reflux nephropathy.
A Tc-99m DMSA scan is a nuclear-medicine test that shows renal cortical function — differential (split) function between the two kidneys and areas of renal scarring or reflux nephropathy. Widely used in paediatric nephrology and adult renal work-up.
Why patients choose us
- 01
The right hands
We route you to a consultant nuclear-medicine physician — with paediatric and adult nephrology experience, who reports what they see.
- 02
A rounded renal picture
Findings are placed alongside ultrasound, bloods and MAG3 where relevant, not read in isolation.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What a DMSA scan is, in six lines.
The short-form summary — tracer, what it measures, and where it sits alongside ultrasound and MAG3.
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Definition
Tc-99m DMSA renal cortical scintigraphy.
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Split function
Quantifies differential (%) renal function between the two kidneys.
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Scarring
Detects renal cortical scarring and reflux nephropathy.
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Radiation
Low radiation dose compared with older isotopes.
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Complementary
Complements ultrasound and MAG3 renography.
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MDT use
Multi-disciplinary paediatric and adult nephrology use.
The problem
A DMSA is only as useful as the question it answers.
DMSA is powerful for cortical function and scarring — and the wrong test for drainage or structure. We help you check the question first, then route you to the right department.
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Child after recurrent UTIs?
DMSA is the standard renal-scarring test — we arrange it with a paediatric-tuned protocol.
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Adult with reflux or hypertension?
DMSA quantifies split function and scarring alongside your nephrology work-up.
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Pre-partial-nephrectomy baseline?
A baseline DMSA gives your urologist a clear picture of function before renal-sparing surgery.
Diagnosis and preparation
From referral to report — what happens, in order.
A nuclear-medicine appointment is different from a plain scan — injection, wait, then imaging.
Phase 1 · Before your scan
Referral, hydration, injection
Phase 2 · On the day
Wait, image, sedate if needed
Phase 3 · After
Consultant report
- 01
Before
Referral from nephrology or urology
A short, confidential form. Symptoms, reflux history, prior scans, referral or insurer if you have them.
- 02
Before
Good hydration before the scan
Drink water in the hours before your appointment — this improves image quality and tracer clearance.
- 03
Before
IV Tc-99m DMSA injection
A small intravenous injection of the Tc-99m DMSA tracer in the nuclear-medicine department.
- 04
On the day
Wait 2–4 hours for cortical uptake
You can leave the department and return — the tracer needs time to concentrate in the renal cortex.
- 05
On the day
Gamma-camera imaging (30–45 min)
You lie still on the couch while the gamma camera acquires posterior and oblique views of the kidneys.
- 06
On the day
Sedation for young children if needed
Play specialists and, occasionally, light sedation help younger children lie still for the acquisition.
- 07
After
Nuclear-medicine consultant report
A written report from the reporting consultant, with onward nephrology, urology or paediatric MDT pathway as needed.
Typical end-to-end: 1–2 weeks from referral to written report.
What it shows
When a DMSA scan is the right test.
DMSA answers a specific set of questions — split function, cortical scarring and reflux nephropathy. These are the presentations we see most.
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Split renal function (%)
Quantifies the percentage contribution of each kidney to overall renal function.
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Renal cortical scarring
Detects focal cortical defects that indicate previous parenchymal injury.
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Reflux nephropathy
Characterises the scarring pattern typical of vesicoureteric reflux.
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Pyelonephritis-related scars
Identifies scarring after acute or recurrent pyelonephritis.
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Duplex or ectopic kidneys
Delineates functioning tissue in duplex systems or ectopic kidneys.
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Post-transplant graft function
Assesses cortical function in a transplanted kidney.
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Baseline for renal-preserving surgery
A pre-operative baseline before partial nephrectomy or other renal-sparing procedures.
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Red flag: severe unilateral scarring with hypertension — renal MDT for possible nephrectomy
A poorly functioning, scarred kidney driving hypertension is a nephrectomy discussion, not a watch-and-wait.
Scan types
Not all DMSA studies are the same.
What each option on your referral is actually for.
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Split function (%) analysis
Quantitative differential function between the two kidneys — the core DMSA output.
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Cortical scar mapping
Focal cortical defects mapped onto posterior and oblique views.
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Reflux-nephropathy pattern
Characteristic wedge-shaped scarring in children investigated for VUR.
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Pre-partial-nephrectomy baseline
Baseline cortical function before renal-sparing surgery in adult urology.
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Duplex-kidney assessment
Contribution of each moiety in a duplex collecting system.
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Post-transplant DMSA
Cortical assessment of a transplant graft where scarring or infarction is suspected.
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Paediatric DMSA with play prep
Paediatric-tuned protocol with play-specialist support, and light sedation when needed.
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Adult DMSA for hypertension work-up
Adult DMSA in the work-up of renovascular or reflux-related hypertension.
Our vetted London network
A small panel of departments, we picked them.
ARSAC-licensed nuclear-medicine departments across central London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every department in our network.
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Consultant nuclear-medicine physicians reporting DMSA studies routinely
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Paediatric-tuned protocols with play-specialist support
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ARSAC-licensed departments with modern gamma cameras
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Onward paediatric or adult nephrology MDT pathway if significant findings
Safety and eligibility
One of the lower-dose tests in nuclear medicine.
DMSA is well tolerated — the practical points are hydration, lying still, and the question of pregnancy or breastfeeding.
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Low radiation dose
DMSA delivers a low radiation dose — comparable to a small number of chest X-rays and lower than older renal isotopes.
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IV injection, then a wait
A small IV cannula for the tracer injection, then a 2–4 hour wait outside the department.
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Lie still for imaging
The 30–45 minute acquisition requires lying still — play specialists and sedation help younger children.
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Hydration before and after
Drink water before and after the scan to help clear the tracer.
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Pregnancy and breastfeeding
Not used in pregnancy without careful discussion. Brief interruption of breastfeeding is usually advised — the department will confirm.
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ARSAC-licensed department
DMSA is delivered only in ARSAC-licensed nuclear-medicine departments with appropriate governance.
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DMSA is not a structural scan
DMSA answers cortical function and scarring — ultrasound or cross-sectional imaging is needed for structural questions.
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MAG3 for drainage questions
If the question is obstruction or drainage, MAG3 renography is usually the right test, not DMSA.
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Bring prior imaging and bloods
Prior ultrasound, MCUG and renal-function bloods materially sharpen interpretation.
Reading your report
A DMSA report can look technical. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and clinical context
Your details, the reason for the DMSA, and the nephrology or urology question being asked.
- 02 Technique
Tracer, dose and acquisition
Tc-99m DMSA activity administered, uptake interval, and the gamma-camera views acquired.
- 03 Findings
Split function (%) and cortical defects
Differential function for each kidney and a description of any focal cortical scarring or defects.
- 04 Impression
The conclusion: read this first
Normal, focal scarring, reflux-nephropathy pattern or reduced split function — and the concrete next step.
Treatment options and next steps
What tends to happen after a DMSA scan.
The scan itself is one data point — the pathway that follows is where it earns its keep.
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Antibiotic prophylaxis for reflux
Low-dose prophylactic antibiotics for children with vesicoureteric reflux.
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Surgical correction of VUR (STING / reimplantation)
Endoscopic STING injection or ureteric reimplantation where indicated.
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Renal-sparing surgery
Partial nephrectomy planned around the split-function baseline.
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Antihypertensive optimisation
Blood-pressure control tuned to renal function and scarring pattern.
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Serial renal function monitoring
Regular renal-function bloods and blood pressure to track trajectory.
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Nephrology follow-up
Ongoing outpatient nephrology review with the DMSA in the notes.
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Multi-disciplinary team review
Paediatric or adult renal MDT for complex or borderline cases.
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Transplant or dialysis pathway
Referral into the transplant or dialysis pathway where end-stage disease is developing.
Red flags
When the DMSA finding needs an urgent conversation.
Any of these should trigger prompt nephrology, urology or transplant input — not a routine follow-up.
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Severe unilateral scarring with hypertension
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Bilateral reflux nephropathy
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Post-transplant graft failure
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Duplex system with obstruction
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Ectopic kidney with obstruction
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Suspected renal malignancy on cross-sectional imaging
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Chronic pyelonephritis
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Post-cystectomy renal decline
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Congenital hypoplastic kidney
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about DMSA scans.
Quick answers on what a DMSA shows, paediatric referrals, safety, how long it takes, DMSA vs MAG3, and when to see a specialist urgently.
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What does a DMSA scan show?
A DMSA scan shows renal cortical function — how well the working tissue of each kidney takes up the Tc-99m DMSA tracer. It quantifies the percentage split of function between the two kidneys and highlights areas of cortical scarring or reflux nephropathy.
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Why has my child been referred for a DMSA scan?
DMSA is the standard test after urinary-tract infections in children when there is concern about renal scarring, or as part of the work-up for vesicoureteric reflux. It answers whether the kidneys have been damaged and how each is functioning.
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Is a DMSA scan safe?
Yes. DMSA uses a small, standardised dose of Tc-99m tracer and delivers a low radiation dose — one of the lower doses in nuclear medicine. It is delivered in ARSAC-licensed departments with paediatric-tuned protocols.
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How long does a DMSA scan take?
You receive an IV injection, then wait 2–4 hours for the tracer to concentrate in the renal cortex. Imaging itself takes 30–45 minutes on the gamma camera.
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What is the difference between a DMSA and a MAG3 scan?
DMSA measures renal cortical function and detects scarring — it answers "how much working tissue does each kidney have?" MAG3 measures drainage and is used to investigate obstruction. They answer different questions and are sometimes both requested.
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When should I see a specialist urgently instead?
Severe unilateral scarring with new hypertension, suspected renal malignancy or a failing transplant graft need urgent nephrology or urology input — not a routine outpatient wait.
Sources
What informed this guide.
- British Association of Paediatric Nephrology. Clinical guidelines.
- Renal Association (UK Kidney Association). Clinical practice guidelines.
- European Association of Nuclear Medicine. Paediatric and renal imaging guidelines.
- Royal College of Radiologists. iRefer imaging guidelines.
Reviewed by Pulse Atlas Editorial Board, . Published 2026-07-30. Next review 2027-07-30.
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In practice, in London
Getting dmsa scan sorted in London, without the guesswork
With dmsa scan, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for dmsa scan is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
A private dmsa scan pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For dmsa scan specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for dmsa scan can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.
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