Kidney Week

Abstract: TH-OR39

Evaluation of Renal Blood Flow Using 64Cu-ATSM PET

Session Information

• Technology-Based Approaches in Nephrology
  November 03, 2022 | Location: W308, Orange County Convention Center‚ West Building
  Abstract Time: 04:39 PM - 04:48 PM

Category: Bioengineering

• 300 Bioengineering

Authors

• Takahashi, Naoki, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Naoki Takahashi, MD, PhD

• Nishikawa, Yudai, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Yudai Nishikawa,

• Nishikawa, Sho, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Sho Nishikawa,

• Shimamoto, Yuki, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Yuki Shimamoto,

• Nishimori, Kazuhisa, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Kazuhisa Nishimori,

• Fukushima, Sachiko, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Sachiko Fukushima,

• Morita, Sayu, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Sayu Morita,

• Kobayashi, Mamiko, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Mamiko Kobayashi,

• Kimura, Hideki, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Hideki Kimura,

• Kasuno, Kenji, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Kenji Kasuno,

• Ikawa, Masamichi, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Masamichi Ikawa,

• Tujikawa, Tetsuya, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Tetsuya Tujikawa,

• Okazawa, Hidehiko, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Hidehiko Okazawa,

• Iwano, Masayuki, Fukui Daigaku Igakubu, Yoshida-gun, Fukui, Japan

Masayuki Iwano,

Background

In patients with CKD, it is important to evaluate renal blood flow (RBF). RBF can be obtained by the clearance method, estimation from eGFR or measurement using nuclear medicine test, but all have their advantages and disadvantages. For this reason, a method to assess RBF with ASL-MRI has recently been investigated and has been shown to be reliable. Cu(II)-diacetyl-bis(4-methylthiosemicarbazonate) (Cu-ATSM) is a tracer developed for hypoxia imaging and has been reported to be able to quantify cerebral blood flow. Therefore, in this study, we performed ASL-MRI and PET imaging simultaneously and obtained the actual RBF values. Furthermore, we compared the estimated RBF (eRBF) obtained from clinical parameters with the measured RBF of both imaging methods and investigated the usefulness of PET for the evaluation of RBF.

Methods

The study consisted of 15 subjects, including 5 healthy subjects and 10 patients with various CKD. A single dose of 300-400 MBq ⁶⁴Cu-ATSM was administered, the abdomen was imaged for PET, and then ASL images were taken. Circular ROIs were placed on the upper to lower poles of the kidney cortex for PET/MRI imaging. To obtain an RBF, the mean of the 20 ROI values was calculated. eGFR was calculated from serum creatinine (sCr) and cystatin C (sCys), respectively, and eRBF was calculated using the eGFR, hematocrit and FF values. Furthermore, renal volume was calculated by integrating MRI and eRBF per 100 g of kidney weight was calculated.

Results

The RBF measured with MRI-ASL was positively correlated with eRBF by sCr (r=0.596, p<0.05) and sCys (r=0.669, p<0.01), respectively. The RBF measured with ⁶⁴Cu-ATSM was positively correlated with the RBF estimated by sCr (r=0.621, p<0.05) and sCys (r=0.591, p=0.02), respectively. The RBF measured with MRI-ASL was positively correlated with the RBF measured with ⁶⁴Cu-ATSM (r=0.714, p=0.003). The linear regression line had a slope close to 1 (0.88) and the intercept (14.1) also approximated the origin. The Bland-Altman analysis showed agreement with the RBF measured by ASL imaging and ⁶⁴Cu-ATSM imaging (Bias=-2.4, SD=24.9).

Conclusion

We report for the first time that ⁶⁴Cu-ATSM PET is useful for assessing RBF in healthy subjects and patients with various renal diseases, as well as ASL-MRI.

Funding

• Government Support – Non-U.S.