Related Experiment Video
Updated: Jul 17, 2025
High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
Published on: December 16, 2022
Feasibility of Simultaneous Quantification of Myocardial and Renal Perfusion With Cardiac Positron Emission
Jenifer M Brown1,2, Mi-Ae Park3, Marie Foley Kijewski2
1Heart and Vascular Center, Division of Cardiovascular Medicine, Department of Medicine (J.M.B., B.N.W., S.D., R.B., M.F.D.C.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Insights
This study shows that cardiac 13N-ammonia PET/CT can reliably measure renal blood flow. This allows for simultaneous assessment of heart and kidney function, aiding in the evaluation of cardiorenal diseases.
Area of Science:
- Cardiorenal physiology
- Nuclear medicine
- Cardiovascular imaging
Background:
- Evaluating cardiorenal interactions requires mechanistic tools.
- Shared pathways link heart and kidney function, including neurohormonal activation and fibrosis.
- Advanced imaging systems enable simultaneous assessment of cardiac and renal blood flow.
Purpose of the Study:
- To assess the feasibility of quantifying renal blood flow using data from myocardial perfusion PET/CT.
- To determine the reproducibility and clinical correlations of PET-derived renal blood flow.
Main Methods:
- Utilized dynamic PET image data from 13N-ammonia myocardial perfusion PET/CT to calculate renal blood flow.
- Assessed reproducibility using the intraclass correlation coefficient among three readers.
- Correlated PET-derived renal blood flow with clinical parameters and kidney biopsy histopathology.
Main Results:
- Quantification of renal blood flow was feasible in 76.7% of patients and highly reproducible (ICC 0.98).
- PET-derived renal blood flow correlated with estimated glomerular filtration rate (r=0.64) and markers of endothelial health.
- A strong negative correlation was observed between renal blood flow and histological interstitial fibrosis (r=-0.85).
Conclusions:
- 13N-Ammonia PET/CT reliably measures renal blood flow, enabling simultaneous cardiac and renal perfusion assessment.
- This technique offers a novel approach to study cardiorenal mechanisms and therapies.
Background:
Given the central importance of cardiorenal interactions, mechanistic tools for evaluating cardiorenal physiology are needed. In the heart and kidneys, shared pathways of neurohormonal activation, hypertension, and vascular and interstitial fibrosis implicate the relevance of systemic vascular health. The availability of a long axial field of view positron emission tomography (PET)/computed tomography (CT) system enables simultaneous evaluation of cardiac and renal blood flow.
Methods:
This study evaluated the feasibility of quantification of renal blood flow using data acquired during routine, clinically indicated 13N-ammonia myocardial perfusion PET/CT. Dynamic PET image data were used to calculate renal blood flow. Reproducibility was assessed by the intraclass correlation coefficient among 3 independent readers. PET-derived renal blood flow was correlated with imaging and clinical parameters in the overall cohort and with histopathology in a small companion study of patients with a native kidney biopsy.
Results:
Among 386 consecutive patients with myocardial perfusion PET/CT, 296 (76.7%) had evaluable images to quantify renal perfusion. PET quantification of renal blood flow was highly reproducible (intraclass correlation coefficient 0.98 [95% CI, 0.93-0.99]) and was correlated with the estimated glomerular filtration rate (r=0.64; P<0.001). Compared across vascular beds, resting renal blood flow was correlated with maximal stress myocardial blood flow and myocardial flow reserve (stress/rest myocardial blood flow), an integrated marker of endothelial health. In patients with kidney biopsy (n=12), resting PET renal blood flow was strongly negatively correlated with histological interstitial fibrosis (r=-0.85; P<0.001).
Conclusions:
Renal blood flow can be reliably measured from cardiac 13N-ammonia PET/CT and allows for simultaneous assessment of myocardial and renal perfusion, opening a potential novel avenue to interrogate the mechanisms of emerging therapies with overlapping cardiac and renal benefits.
Related Concept Videos
01:29Positron Emission Tomography
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body...
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...