Feasibility of Renal Blood Flow Measurement Using ⁶⁴Cu-ATSM PET/MRI: A Quantitative PET and MRI Study

Area of Science:

• Nuclear Medicine
• Radiochemistry
• Nephrology

Background:

• Chronic kidney disease (CKD) affects renal blood flow (RBF), a key indicator of kidney function.
• Accurate RBF assessment is crucial for managing CKD patients.
• Current methods for RBF evaluation have limitations.

Purpose of the Study:

• To evaluate the utility of 64Cu-ATSM Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) for assessing renal blood flow (RBF) in patients with chronic kidney disease (CKD).
• To compare RBF measurements obtained via 64Cu-ATSM PET/MRI with estimated RBF (eRBF) and arterial spin labeling MRI (ASL-MRI).

Main Methods:

• Five healthy controls and ten CKD patients underwent 64Cu-ATSM PET/MRI scans.
• Renal blood flow was assessed using dynamic 64Cu-ATSM PET imaging and simultaneous ASL-MRI.
• Estimated RBF (eRBF) was calculated using estimated glomerular filtration rate (eGFR) derived from serum creatinine and cystatin C levels.

Main Results:

• Significant differences in RBF were observed between CKD patients and healthy controls using both PET (124 ± 22 mL/min/100 g vs. 151 ± 20 mL/min/100 g, p < 0.05) and ASL-MRI (125 ± 30 mL/min/100 g vs. 172 ± 38 mL/min/100 g, p < 0.001).
• PET-derived RBF showed strong positive correlations with eRBF (r = 0.893, p < 0.001) and ASL-MRI RBF (r = 0.849, p < 0.001).
• ASL-MRI-derived RBF also demonstrated a strong positive correlation with eRBF (r = 0.858, p < 0.001).

Conclusions:

• 64Cu-ATSM PET/MRI is a reliable method for assessing renal blood flow in patients with CKD.
• The study validates the use of 64Cu-ATSM PET for RBF assessment, showing good correlation with ASL-MRI.
• This technique offers a promising non-invasive approach for evaluating kidney function in CKD.