Renal Infarction Imaged With [18F]Prostate-Specific Membrane Antigen-1007 PET/CT

Area of Science:

• Nephrology
• Radiology
• Transplant Surgery

Background:

• Renal allograft dysfunction can occur post-transplantation.
• Early diagnosis of complications like infarction is crucial for graft survival.

Purpose of the Study:

• To report a case of multifocal renal cortical infarction in a post-renal transplant patient.
• To evaluate the diagnostic utility of advanced imaging techniques in this condition.

Main Methods:

• Contrast-enhanced CT scan to assess renal graft perfusion.
• [99mTc]Tc-DMSA SPECT/CT for functional assessment of renal uptake.
• [18F]PSMA-1007 PET/CT for detailed defect localization.

Main Results:

• CT revealed multiple small perfusion defects in the renal graft cortex.
• SPECT/CT and PET/CT confirmed and further characterized these defects, indicative of multifocal renal cortical infarction.
• Infarction was presumed to originate from intraoperative emboli at the arterial anastomosis.

Conclusions:

• Multifocal renal cortical infarction is a potential complication after renal transplantation.
• Advanced imaging modalities like SPECT/CT and PET/CT are valuable in diagnosing and characterizing renal cortical infarction.
• Acetylsalicylic acid treatment demonstrated a favorable outcome in this case, suggesting its potential role in managing such complications.