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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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Imaging Studies VII: Vascular Imaging01:19

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Imaging Studies IV: Magnetic Resonance Imaging01:27

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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[18F]-PSMA-1007-PET for evaluation of kidney function.

Philipp Rassek1, Michael Schäfers1, Kambiz Rahbar1

  • 1Clinic for Nuclear Medicine, Universitiy Hospital Münster, Münster, Germany.

Nuklearmedizin. Nuclear Medicine
|August 18, 2023
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Summary

[18F]-PSMA-1007 PET/CT can accurately estimate split renal function, correlating well with MAG3 scintigraphy. This PSMA uptake in kidneys offers a valuable tool for assessing renal function in prostate cancer patients.

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Area of Science:

  • Nuclear Medicine
  • Radiopharmacy
  • Urology

Background:

  • Prostate-specific membrane antigen (PSMA) is expressed in proximal tubule cells, leading to significant renal uptake on PSMA PET scans.
  • High renal uptake on PSMA PET may provide insights into renal function, potentially reducing the need for separate imaging modalities.
  • Current evaluation for [177Lu]-PSMA therapies includes PSMA PET and [99mTc]-mercapto-acetyltriglycine (MAG3) scintigraphy for renal function assessment.

Purpose of the Study:

  • To evaluate the accuracy of [18F]-PSMA-1007 PET/CT in estimating renal function.
  • To compare PSMA PET-derived renal function parameters with those obtained from MAG3 scintigraphy.
  • To determine if PSMA uptake in the kidneys can reliably assess split renal function.

Main Methods:

  • Retrospective analysis of 73 prostate cancer patients with 93 paired PSMA PET/CT and MAG3 scintigraphy scans.
  • Calculation of split renal function from PSMA PET using relative unilateral total renal PSMA uptake (SRF_PSMA-TOTAL) and relative unilateral maximal standardized uptake value (SRF_SUV).
  • Comparison of PSMA-derived split renal function with MAG3 split renal function (SRF_MAG3) using Pearson correlation and ROC analysis.

Main Results:

  • Strong correlations were found between SRF_MAG3 and SRF_PSMA-TOTAL (r=0.872) and SRF_SUV (r=0.815).
  • SRF_PSMA-TOTAL achieved 90% sensitivity and 92% specificity for detecting relevant abnormalities in split renal function (<25%).
  • SRF_SUV demonstrated 80% sensitivity and 95% specificity for detecting these abnormalities.

Conclusions:

  • Renal [18F]-PSMA-1007 uptake effectively quantifies split renal function.
  • SRF_PSMA-TOTAL and SRF_SUV are accurate methods for assessing split renal function using PSMA PET.
  • PSMA PET imaging holds promise for evaluating renal function in prostate cancer patients undergoing therapy.