Assessing the kidney function parameters glomerular filtration rate and effective renal plasma flow with dynamic FDG-PET/MRI in healthy subjects

Geist, Barbara; Baltzer, Pascal; Fueger, Barbara J.; Hamboeck, Martina; Nakuz, Thomas; Papp, László; Rasul, Sazan; Sundar, Lalith Kumar Shiyam; Hacker, Marcus; Staudenherz, Anton

doi:10.1186/s13550-018-0389-1

Cited by 28 publications

(31 citation statements)

References 23 publications

(21 reference statements)

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“…[18 F]FDG, Me-4-[ 18 F]FDG and [ 99m Tc]DTPA and in excellent agreement with normal values. Also the HBF showed no difference between the two available radiotracers Me-4-[ 18 F]FDG and [ 18 F]FDG.…”

supporting

confidence: 69%

“…The presented approach uses the early phase of dynamic imaging scans and is non-invasive, provided the dynamic scan is reconstructed with a su cient high time binning and the blood pool concentration can be measured in the obtained images, respectively. The latter is possible if the eld of view of the scanner covers the upper part of the aorta, which was shown to have minor partial volume and motion effects [18,27]. In case of planar scintigraphy, performed e.g.…”

Section: Discussionmentioning

confidence: 99%

“…For the hepatic blood ow (HBF), methods vary from highly invasive such as plethysmography to more convenient methods such as ultrasound or magnetic resonance imaging (MRI) [4,6,7]. The renal blood ow (RBF), which might serve as an important parameter for the functional assessment of native and transplanted kidneys [8,9], can be determined with several minimal to non-invasive nuclear medicine methods, including planar dynamic scintigraphy and, as recently shown, also with combined positron emission tomography and MRI (PET/MRI) scans [8,[10][11][12][13][14][15][16][17][18]. A non-invasive, but rather sophisticated method to assess the cerebral blood ow (CBF) was described using the rst minutes of a dynamic PET scan [19].…”

Section: Introductionmentioning

confidence: 99%

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A novel mathematical approach to estimate the hepatic, cerebral and renal blood flow from dynamic nuclear imaging studies independently of the used radio tracer

Geist¹,

Hamböck²,

Berroterán-Infante³

et al. 2020

Preprint

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Background The blood flow (BF) is a critical determinant of organ functionality. Its assessment in the course of routine nuclear medicine examinations, including planar scintigraphy and positron emission tomography (PET), can be relevant for the diagnosis and monitoring of various conditions. The aim of this study was to investigate a new mathematical approach developed to estimate the organ BF from dynamic imaging data and to analyze if this method can be applied independent of the used radio tracer or imaging modality. The new approach uses the early phase of time activity curves extracted from animal and human dynamic scintigraphy and PET scans. Independence of tracer characteristics was evaluated with major oxygen-dependent organs (kidneys, liver, brain) of a mouse model. The approach was also applied on renal scans with two different imaging modalities from a representative cohort of 32 human subjects and compared to reference values. Results The mean organ-specific BF determined in the mouse model revealed no significant differences between the administered radiotracers and all calculated values corresponded to normal values (kidneys: 1.0-1.1 ml/min, liver: 1.4–1.6 ml/min, brain: 0.2 ml/min). In the human study cohort, the renal BFs from the two performed imaging modalities showed a good correlation (r = 0.61, p = 0.001) and a small significant difference (p = 0.047) among each other and good correlations to the reference value obtained from blood sampling (r = 0.79 and r = 0.52). Conclusions A mathematical approach was developed to assess the organ BF solely from dynamic imaging scans without the necessity of additional measurements. Preliminary data suggests that several radiotracers might be feasible to estimate the BF in major oxygen-dependent organs.

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supporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A novel mathematical approach to estimate the hepatic, cerebral and renal blood flow from dynamic nuclear imaging studies independently of the used radio tracer

Geist¹,

Hamböck²,

Berroterán-Infante³

et al. 2020

Preprint

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“…The effect was studied on the basis of a method described by Khalighi et al (2017aKhalighi et al ( , 2017b with the data set of the subjects from subject group 2 (see Table 1) who additionally had contrast-enhanced MRI examination. According to the procedure described in BK Geist et al (2018), the MRI images were used to determine an aorta volume, for which the FDG concentration was corrected for each frame to obtain a corrected AIF. MTT FDG and OE FDG from cortex and total kidney TACs of each subject was then re-calculated with the corrected AIF.…”

Section: Estimation Of Aif Correction Effectsmentioning

confidence: 99%

“…So far, the analysis of renal FDG behavior mainly focuses on FDG excretion, because the activity deposit in the bladder first of all is not further available for tumor identification (Garbarino et al 2013), and secondly, it might interfere with abdominal abnormalities (Moran et al 1999). While the kidney function parameters glomerular filtration rate and effective renal plasma flow were assessed with renal FDG TACs in our previous study (BK Geist et al 2018), to our knowledge, SF, MTT, and OE have not yet been determined with renal FDG TACs.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the kidney function parameters split function, mean transit time, and outflow efficiency using dynamic FDG-PET/MRI in healthy subjects

Geist

Baltzer

Fueger

et al. 2019

European J Hybrid Imaging

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Background: Traditionally, isotope nephrography is considered as the method of choice to assess kidney function parameters in nuclear medicine. We propose a novel approach to determine the split function (SF), mean transit time (MTT), and outflow efficiency (OE) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) dynamic positron emission tomography (PET). Materials and methods: Healthy adult subjects underwent dynamic simultaneous FDG-PET and magnetic resonance imaging (PET/MRI). Time-activity curves (TACs) of total kidneys, renal cortices, and the aorta were prospectively obtained from dynamic PET series. MRI images were used for anatomical correlation. The same individuals were subjected to dynamic renal Technetium-99 m-mercaptoacetyltriglycine (MAG3) scintigraphy and TACs of kidneys; the perirenal background and the left ventricle were determined. SF was calculated on the basis of integrals over the TACs, MTT was determined from renal retention functions after deconvolution analysis, and OE was determined from MTT. Values obtained from PET series were compared with scintigraphic parameters, which served as the reference. Results: Twenty-four subjects underwent both examinations. Total kidney SF, MTT, and OE as estimated by dynamic PET/MRI correlated to their reference values by r = 0.75, r = 0.74 and r = 0.81, respectively, with significant difference (p < 0.0001) between the means of MTT and OE. No correlations were found for cortex FDG values. Conclusions: The study proofs the concept that SF, MTT, and OE can be estimated with dynamic FDG PET/MRI scans in healthy kidneys. This has advantages for patients receiving a routine PET/MRI scan, as kidney parameters can be estimated simultaneously to functional and morphological imaging with high accuracy.

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The next era of renal radionuclide imaging: novel PET radiotracers

Werner

Chen

Lapa

et al. 2019

Eur J Nucl Med Mol Imaging

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Although single-photon-emitting radiotracers have long been the standard for renal functional molecular imaging, recent years have seen the development of positron emission tomography (PET) agents for this application. We provide an overview of renal radionuclide PET radiotracers, in particular focusing on novel 18 F-labelled and 68 Ga-labelled agents. Several reported PET imaging probes allow assessment of glomerular filtration rate, such as [ 68 Ga]ethylenediaminetetraacetic acid ([ 68 Ga]EDTA), [ 68 Ga]IRDye800-tilmanocept and 2-deoxy-2-[ 18 F]fluorosorbitol ([ 18 F]FDS)). The diagnostic performance of [ 68 Ga]EDTA has already been demonstrated in a clinical trial. [ 68 Ga]IRDye800-tilmanocept shows receptor-mediated binding to glomerular mesangial cells, which in turn may allow the monitoring of progression of diabetic nephropathy. [ 18 F]FDS shows excellent kidney extraction and excretion in rats and, as has been shown in the first study in humans. Further, due to its simple one-step radiosynthesis via the most frequently used PET radiotracer 2-deoxy-2-[ 18 F]fluoro- d -glucose, [ 18 F]FDS could be available at nearly every PET centre. A new PET radiotracer has also been introduced for the effective assessment of plasma flow in the kidneys: Re(CO) 3 - N -([ 18 F]fluoroethyl)iminodiacetic acid (Re(CO) 3 ([ 18 F]FEDA)). This compound demonstrates similar pharmacokinetic properties to its 99m Tc-labelled analogue [ 99m Tc](CO) 3 (FEDA). Thus, if there is a shortage of molybdenum-99, Re(CO) 3 ([ 18 F]FEDA would allow direct comparison with previous studies with 99m Tc. The PET radiotracers for renal imaging reviewed here allow thorough evaluation of kidney function, with the tremendous advantage of precise anatomical coregistration with simultaneously acquired CT images and rapid three-dimensional imaging capability.

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Assessing the kidney function parameters glomerular filtration rate and effective renal plasma flow with dynamic FDG-PET/MRI in healthy subjects

Cited by 28 publications

References 23 publications

A novel mathematical approach to estimate the hepatic, cerebral and renal blood flow from dynamic nuclear imaging studies independently of the used radio tracer

A novel mathematical approach to estimate the hepatic, cerebral and renal blood flow from dynamic nuclear imaging studies independently of the used radio tracer

Assessment of the kidney function parameters split function, mean transit time, and outflow efficiency using dynamic FDG-PET/MRI in healthy subjects

The next era of renal radionuclide imaging: novel PET radiotracers

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