18F-FDG uptake and clearance in patients with compromised renal function

Area of Science:

• Nuclear Medicine
• Radiopharmacology
• Renal Physiology

Background:

• 2-deoxy-2-[F]fluoro-D-glucose (F-FDG) is a widely used positron emission tomography (PET) tracer.
• Renal function is crucial for the clearance of many radiopharmaceuticals.
• The impact of compromised renal function on F-FDG uptake in normal tissues requires clarification for accurate PET/CT interpretation.

Purpose of the Study:

• To investigate the influence of varying degrees of renal function on F-FDG uptake and clearance in normal tissues.
• To determine if renal impairment necessitates adjustments in F-FDG dosing or imaging protocols.

Main Methods:

• Patients were stratified into three groups based on estimated glomerular filtration rate (eGFR): normal (>90 ml/min), mild (90–60 ml/min), and moderate/severe (<60 ml/min) renal dysfunction.
• F-FDG PET/CT imaging was performed at 1, 2, and 3 hours post-injection.
• Maximum standardized uptake values (SUVmax) were quantified in various normal tissue types.

Main Results:

• F-FDG uptake decreased over time (1-3 hours) in all tissue types, regardless of renal function.
• No significant differences in mean SUV values were observed between patients with normal and compromised renal function across all tissue types and time points.
• Individual SUV variations within groups exceeded inter-group differences, and SUV values showed minimal correlation with eGFR.

Conclusions:

• Compromised renal function does not significantly alter F-FDG uptake or background clearance in normal tissues.
• Standard F-FDG PET/CT imaging protocols, including dose and timing, are appropriate for patients with renal impairment.
• No specific adjustments are required for renal-impaired patients undergoing F-FDG PET/CT.