The utilization of positron emission tomography in the evaluation of renal health and disease

Abstract

Purpose Positron emission tomography (PET) is a nuclear imaging technique that uses radiotracers to visualize metabolic processes of interest across different organs, to diagnose and manage diseases, and monitor therapeutic response. This systematic review aimed to characterize the value of PET for the assessment of renal metabolism and function in subjects with non-oncological metabolic disorders. Methods This review was conducted and reported in accordance with the PRISMA statement. Research articles reporting “kidney” or “renal” metabolism evaluated with PET imaging between 1980 and 2021 were systematically searched in Medline/PubMed, Science Direct, and the Cochrane Library. Search results were exported and stored in RefWorks, the duplicates were removed, and eligible studies were identified, evaluated, and summarized. Results Thirty reports met the inclusion criteria. The majority of the studies were prospective (73.33%, n = 22) in nature. The most utilized PET radiotracers were 15O-labeled radio water (H215O, n = 14) and 18F-fluorodeoxyglucose (18F-FDG, n = 8). Other radiotracers used in at least one study were 14(R,S)-(18)F-fluoro-6-thia-heptadecanoic acid (18F-FTHA), 18F-Sodium Fluoride (18F-NaF), 11C-acetate, 68-Gallium (68Ga), 13N-ammonia (13N-NH3), Rubidium-82 (82Rb), radiolabeled cationic ferritin (RadioCF), 11C‐para-aminobenzoic acid (11C-PABA), Gallium-68 pentixafor (68Ga-Pentixafor), 2-deoxy-2-F-fluoro-d-sorbitol (F-FDS) and 55Co-ethylene diamine tetra acetic acid (55Co-EDTA). Conclusion PET imaging provides an effective modality for evaluating a range of metabolic functions including glucose and fatty acid uptake, oxygen consumption and renal perfusion. Multiple positron emitting radiolabeled racers can be used for renal imaging in clinical settings. PET imaging thus holds the potential to improve the diagnosis of renal disorders, and to monitor disease progression and treatment response.

The Beneficial Effects of Bariatric-Surgery-Induced Weight Loss on Renal Function

“…Positron emission tomography (PET) represents the current gold standard for the assessment of tissue metabolic rates in humans in vivo. [ 18 F]FDG is the most widely used PET tracer assessing glucose uptake rates [ 69 ], but there are several other tracers that can be used for assessing different aspects of metabolism and perfusion [ 70 , 71 , 72 ]. The various PET tracers used in the study of renal function have recently been reviewed elsewhere [ 72 ].…”

“…[ 18 F]FDG is the most widely used PET tracer assessing glucose uptake rates [ 69 ], but there are several other tracers that can be used for assessing different aspects of metabolism and perfusion [ 70 , 71 , 72 ]. The various PET tracers used in the study of renal function have recently been reviewed elsewhere [ 72 ]. From a metabolic perspective, in a renal 14(R,S)-[18F]Fluoro-6-thia-heptadecanoic acid ([ 18 F]FTHA) PET study, we showed that renal free fatty acid (FFA) uptake was higher in patients with obesity compared to lean individuals and that six months following bariatric surgery renal FFA uptake was still high (and not normalized) because of the ongoing catabolic state [ 73 ].…”

Oxidation of hyperpolarized [1‐13C]pyruvate in isolated rat kidneys

“…Positron emission tomography (PET), widely applied for metabolic examinations in the brain, heart, and other tissues, is more difficult to apply for renal metabolism, in part arising from the accumulation of PET tracers in urine. 13,14 Nevertheless, a number of PET tracers have been evaluated for imaging kidney metabolism. These include 11 C-acetate, 15 O-water, and 18 F-6-thia-heptadecanoic acid ( 18 F-FTHA) for measuring renal oxidative metabolism, 15 oxygen consumption, 16 and free fatty acid uptake, 17 respectively.…”

“…A detailed understanding of intermediary metabolism in the kidneys in vivo is an important goal. Positron emission tomography (PET), widely applied for metabolic examinations in the brain, heart, and other tissues, is more difficult to apply for renal metabolism, in part arising from the accumulation of PET tracers in urine 13,14 . Nevertheless, a number of PET tracers have been evaluated for imaging kidney metabolism.…”

Letter to the Editor: 68Ga-PSMA-11 for renal cortical PET imaging

“…Dear Editor, I read with interest the systematic review by Amoabeng et al that was published in recent issue of Clinical and Translational Imaging [1]. This article reviewed the utilization of positron emission tomography (PET) studies in the evaluation of renal health and diseases.…”