MAG3 scan

A MAG3 scan is a diagnostic imaging procedure that allows a nuclear medicine technologist to visualize the kidneys and learn more about how they are functioning. MAG3 is an acronym for Mercapto Acetyl Tri Glycine, a compound that is chelated with a radioactive element - Technetium-99m.

Scan procedure
After injection into the venous system, the compound is excreted by the kidneys and its progress through the renal system can be tracked with a gamma camera. If the kidney is not getting blood for example, it will not be viewed at all, even it looks structurally normal in medical ultrasonography or magnetic resonance imaging. If the kidney is getting blood, but there is an obstruction lower down, the contrast will not pass beyond the level of the obstruction, whereas if there is a partial obstruction then there is a delayed transit time for the MAG3 to pass. More information can be gathered by calculating time activity curves; with normal kidney perfusion, peak activity should be observed after 3-5 minutes. The relative quantitative information gives the differential fuction between each kidney's filtration activity.

Clinical use
The technique is very useful in evaluating the functioning of kidneys. It is widely used before renal transplantation to assess the vascularity of the kidney to be transplanted and with a test dose of captopril to highlight possible renal artery stenosis in the donor's other kidney, and later the performance of the transplant.

The use of the test to identify reduced renal function after test doses of captopril (an angiotensin converting enzyme inhibitor drug) has also been used to identify the cause of hypertension in patients with renal failure. Initially there was uncertainty as to the usefulness, or best test parameter to identify renal artery stenosis, the eventual consensus was that the distinctive finding is of alteration in the differential function.

History
It was developed in 1986, first trialled clinically the following year, and passed phase III testing in 1988.

99mTc-MAG3 has replaced the older Iodine-131 orthoiodohippurate or I131-Hippuran because of better quality imaging regardless of the level of renal function, and with the benefit of being able to administer lower radiation dosages.