Correlation between Kidney Uptake at [18F]FDG PET/CT and Renal Function

Francesco Dondi, Antonio Rosario Pisani, Nicola Maria Lucarelli, Maria Gazzilli, Anna Talin, Domenico Albano, Dino Rubini, Nicola Maggialetti, Giuseppe Rubini, Francesco Bertagna, Francesco Dondi, Antonio Rosario Pisani, Nicola Maria Lucarelli, Maria Gazzilli, Anna Talin, Domenico Albano, Dino Rubini, Nicola Maggialetti, Giuseppe Rubini, Francesco Bertagna

Abstract

Different insights into the connection between kidney [18F]fluorodesoxyglucose ([18F]FDG) uptake at positron emission tomography/computed tomography (PET/CT) and renal function have been proposed in the past. The aim of this study was therefore to assess the presence of a correlation between these two parameters. Kidney uptakes were assessed and compared to the creatinine (Cr) values and estimated glomerular filtration rate (EGFR) among different classes of renal functional impairment or kidney status. A total of 339 patients and 385 different PET/CT scans were included in this study. Significant correlations between kidney uptakes and renal function parameters were reported in most of the groups studied, with the exception of patients with Cr < 1.2 mg/dL and subjects with a kidney transplantation. Strong concordance in the assessment of renal parenchymal uptakes between the different readers was reported. To conclude, strong correlations for renal [18F]FDG uptake with Cr levels and the EGFR were reported, with the exception of the group of patients with a Cr value < 1.2 mg/dL and for the group with a kidney transplantation.

Keywords: CKD; PET/CT; [18F]FDG; chronic kidney disease; positron emission tomography.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Representative and schematic figures in coronal (A–C) and axial (D–F) projection of the 5 VOIs used for the assessment of kidney uptake at [18F]FDG PET/CT.
Figure 2
Figure 2
(A) Coronal fused [18F]FDG PET/CT images of a patient with a Cr value of 1.41 mg/dL and an EGFR of 56.9 mL/min/1.73 m2 at the moment of the scan. Stage of CKD was 3 and K, KL and KBP values were 8.85, 1.97 and 3.69, respectively. (B) Four years later, the same subjects again underwent a PET/CT scan: Cr raised to 9.12 mg/dL, EGFR dropped to 5.80 mL/min/1.73 m2 and the stage of CKD was 5. K, KL and KBP were 1.82, 0.79 and 1.01, respectively.

References

    1. Ammirati A.L. Chronic Kidney Disease. Rev. Assoc. Med. Bras. 2020;66((Suppl. S1)):s03–s09. doi: 10.1590/1806-9282.66.s1.3.
    1. Charles C., Ferris A.H. Chronic Kidney Disease. Prim. Care. 2020;47:585–595. doi: 10.1016/j.pop.2020.08.001.
    1. Inker L.A., Titan S. Measurement and Estimation of GFR for Use in Clinical Practice: Core Curriculum 2021. Am. J. Kidney Dis. 2021;78:736–749. doi: 10.1053/j.ajkd.2021.04.016.
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2020;98:S1–S115. doi: 10.1016/j.kint.2020.06.019.
    1. Casali M., Lauri C., Altini C., Bertagna F., Cassarino G., Cistaro A., Erba A.P., Ferrari C., Mainolfi C.G., Palucci A., et al. State of the art of 18F-FDG PET/CT application in inflammation and infection: A guide for image acquisition and interpretation. Clin. Transl. Imaging. 2021;9:299–339. doi: 10.1007/s40336-021-00445-w.
    1. Altini C., Lavelli V., Ruta R., Ferrari C., Nappi A.G., Pisani A., Sardaro A., Rubini G. Typical and atypical PET/CT findings in non-cancerous conditions. Hell. J. Nucl. Med. 2020;23:48–59. doi: 10.1967/s002449912005.
    1. Dondi F., Albano D., Bellini P., Volpi G., Giubbini R., Bertagna F. 18F-fluorodeoxyglucose PET and PET/computed tomography for the evaluation of immunoglobulin G4-related disease: A systematic review. Nucl. Med. Commun. 2022;43:638–645. doi: 10.1097/MNM.0000000000001566.
    1. Moran J.K., Lee H.B., Blaufox M.D. Optimization of urinary FDG excretion during PET imaging. J. Nucl. Med. 1999;40:1352–1357.
    1. Rebelos E., Mari A., Oikonen V., Iida H., Nuutila P., Ferrannini E. Evaluation of renal glucose uptake with [18F]FDG-PET: Methodological advancements and metabolic outcomes. Metabolism. 2023;141:155382. doi: 10.1016/j.metabol.2022.155382.
    1. Laffon E., Cazeau A.L., Monet A., de Clermont H., Fernandez P., Marthan R., Ducassou D. The effect of renal failure on 18F-FDG uptake: A theoretic assessment. J. Nucl. Med. Technol. 2008;36:200–202. doi: 10.2967/jnmt.107.049627.
    1. Reuter S., Schnöckel U., Edemir B., Schröter R., Kentrup D., Pavenstädt H., Schober O., Schlatter E., Gabriëls G., Schäfers M. Potential of noninvasive serial assessment of acute renal allograft rejection by 18F-FDG PET to monitor treatment efficiency. J. Nucl. Med. 2010;51:1644–1652. doi: 10.2967/jnumed.110.078550.
    1. Kidera E., Koyasu S., Hayakawa N., Ishimori T., Nakamoto Y. Association between diffuse renal uptake of 18F-FDG and acute kidney injury. Ann. Nucl. Med. 2022;36:351–359. doi: 10.1007/s12149-021-01713-5.
    1. Lovinfosse P., Weekers L., Bonvoisin C., Bovy C., Grosch S., Krzesinski J.M., Hustinx R., Jouret F. Fluorodeoxyglucose F(18) Positron Emission Tomography Coupled With Computed Tomography in Suspected Acute Renal Allograft Rejection. Am. J. Transplant. 2016;6:310–316. doi: 10.1111/ajt.13429.
    1. Hanssen O., Weekers L., Lovinfosse P., Jadoul A., Bonvoisin C., Bouquegneau A., Grosch S., Huynen A., Anglicheau D., Hustinx R., et al. Diagnostic yield of 18 F-FDG PET/CT imaging and urinary CXCL9/creatinine levels in kidney allograft subclinical rejection. Am. J. Transplant. 2020;20:1402–1409. doi: 10.1111/ajt.15742.
    1. Geist B.K., Baltzer P., Fueger B., Hamboeck M., Nakuz T., Papp L., Rasul S., Sundar L.K.S., Hacker M., Staudenherz A. Assessing the kidney function parameters glomerular filtration rate and effective renal plasma flow with dynamic FDG-PET/MRI in healthy subjects. EJNMMI Res. 2018;8:37. doi: 10.1186/s13550-018-0389-1.
    1. Fink J.C., Lodge M.A., Smith M.F., Hinduja A., Brown J., Dinits-Pensy M.Y., Dilsizian V. Pre-clinical myocardial metabolic alterations in chronic kidney disease. Cardiology. 2010;116:160–167. doi: 10.1159/000318227.
    1. Bural G.G., Torigian D.A., Sözmen M., Houseni M., Alavi A. Comparison of atherosclerotic inflammation and calcification in subjects with end stage renal disease (ESRD) on hemodialysis to normal controls utilizing 18F-FDG PET/CT. Hell. J. Nucl. Med. 2018;21:169–174. doi: 10.1967/s002449910901.
    1. Yoon H.E., Kim Y., Kim S.D., Oh J.K., Chung Y.A., Shin S.J., Yang C.W., Seo S.M. A Pilot Trial to Examine the Changes in Carotid Arterial Inflammation in Renal Transplant Recipients as Assessed by 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography Computed Tomography (PET/CT) Ann. Transplant. 2018;23:412–421. doi: 10.12659/AOT.909212.
    1. Lawal I.O., Popoola G.O., Lengana T., Ankrah A.O., Ebenhan T., Sathekge M.M. Diagnostic utility of 18F-FDG PET/CT in fever of unknown origin among patients with end-stage renal disease treated with renal replacement therapy. Hell. J. Nucl. Med. 2019;22:70–75. doi: 10.1967/s002449910962.
    1. Tek Chand K., Chennu K.K., Amancharla Yadagiri L., Manthri Gupta R., Rapur R., Vishnubotla S.K. Utility of 18 F-FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis. Hemodial. Int. 2017;21:224–231. doi: 10.1111/hdi.12471.
    1. Tseng J.R., Lin C.W., Chen S.H., Yen T.H., Lin P.Y., Lee M.H., Yen T.C. Clinical Usefulness of ¹⁸F-FDG PET/CT for the Detection of Infections of Unknown Origin in Patients Undergoing Maintenance Hemodialysis. J. Nucl. Med. 2015;56:681–687. doi: 10.2967/jnumed.114.151696.
    1. Pijl J.P., Glaudemans A.W.J.M., Slart R.H.J.A., Kwee T.C. 18F-FDG PET/CT in Autosomal Dominant Polycystic Kidney Disease Patients with Suspected Cyst Infection. J. Nucl. Med. 2018;59:1734–1741. doi: 10.2967/jnumed.117.199448.
    1. Akers S.R., Werner T.J., Rubello D., Alavi A., Cheng G. 18F-FDG uptake and clearance in patients with compromised renal function. Nucl. Med. Commun. 2016;37:825–832. doi: 10.1097/MNM.0000000000000513.
    1. Otomi Y., Arai Y., Otomo M., Irahara S., Terazawa K., Kubo M., Abe T., Shinya T., Otsuka H., Harada M. Increased physiological [18F]FDG uptake in the liver and blood pool among patients with impaired renal function. Nucl. Med. Rev. Cent. East. Eur. 2022;25:95–100. doi: 10.5603/NMR.a2022.0021.
    1. Toriihara A., Kitazume Y., Nishida H., Kubota K., Nakadate M., Tateishi U. Comparison of FDG-PET/CT images between chronic renal failure patients on hemodialysis and controls. Am. J. Nucl. Med. Mol. Imaging. 2015;5:204–211.
    1. Kode V., Karsch H., Osman M.M., Muzaffar R. Impact of Renal Failure on F18-FDG PET/CT Scans. Front. Oncol. 2017;21:155. doi: 10.3389/fonc.2017.00155.
    1. Qiao H., Bai J., Chen Y., Tian J. Kidney modelling for FDG excretion with PET. Int. J. Biomed. Imaging. 2007;2007:63234. doi: 10.1155/2007/63234.
    1. Jadoul A., Lovinfosse P., Weekers L., Delanaye P., Krzesinski J.M., Hustinx R., Jouret F. The Uptake of 18F-FDG by Renal Allograft in Kidney Transplant Recipients Is Not Influenced by Renal Function. Clin. Nucl. Med. 2016;41:683–687. doi: 10.1097/RLU.0000000000001298.
    1. Engel H., Steinert H., Buck A., Berthold T., Huch Böni R.A., von Schulthess G.K. Whole-body PET: Physiological and artifactual fluorodeoxyglucose accumulations. J. Nucl. Med. 1996;37:441–446.
    1. Jadoul A., Lovinfosse P., Bouquegneau A., Weekers L., Pottel H., Hustinx R., Jouret F. Observer variability in the assessment of renal 18F-FDG uptake in kidney transplant recipients. Sci. Rep. 2020;10:4617. doi: 10.1038/s41598-020-61032-z.

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