Review of the Clinical and Technical Aspects of 99m Tc-Dimercaptosuccinic Acid Renal Imaging: The Comeback " Kit "

99m Tc-labeled dimercaptosuccinic acid (99mTc-DMSA) 99m Tc-DMSA) imaging is a well-established and highly sensitive method for the diagnosis of several renal cortical disorders affecting children and adults. Beginning in 2014, 99m Tc-DMSA availability was severely impaired when it was added to the Drug Shortages List of the U.S. Food and Drug Administration and was commercially unavailable thereafter. The agent shortage negatively impacted practitioners' ability to evaluate renal cortical defects in children and adults and changed renal imaging practice. A survey among pediatric nuclear medicine clinicians confirmed the clinical need for 99m Tc-DMSA. Finally, in early 2023 the Food and Drug Administration again approved 99m Tc-DMSA in the United States. During the 99m Tc-DMSA shortage, established practitioners may not have had the opportunity of using 99m Tc-DMSA as they were accustomed in their experience. Also, newer imaging specialists and referring physicians and technologists may not have benefited from having 99m Tc-DMSA in their training. Therefore, it is time to bring back 99m Tc-DMSA into the armamentarium of imaging methods available to evaluate regional cortical renal function.