Table 1

Summary of tests used for different clinical applications

Aim
Current Reference standard
Tests
Advantage over the reference standard

Localisation of infection
Tc-99 m-DMSA renal scintigraphy
Clinical features
Laboratory-based tests
Ultrasound
All less invasive, no exposure to ionising radiation
Detection of reflux
Micturating cystourethrography (MCUG)
Ultrasound
Less invasive, no exposure to ionising radiation


Indirect radionuclide cystography
Single procedure test for reflux and scarring
Prediction of renal scarring
Follow-up Tc-99 m-DMSA renal scintigraphy
Clinical features
Would allow earlier prediction of children at risk of renal scarring


Ultrasound



MCUG



Acute DMSA renal scintigraphy

Detection of renal scarring
Tc-99 m-DMSA renal scintigraphy
Ultrasound
Less invasive, no exposure to ionising radiation


Intravenous pyelography (IVP)
Provides a detailed anatomic map, considered essential where surgery is planned.


Radionuclide cystography
Advocated as a single procedure test for reflux and scarring

Westwood et al. BMC Pediatrics 2005 5:2   doi:10.1186/1471-2431-5-2