Multiple metabolic analysis of [¹⁸F]FDG PET/CT in patients with kidney disease

This study aimed to evaluate the value of [¹⁸F]FDG PET/CT in patients with kidney disease by using multiple metabolic parameters.

A retrospective review of 182 kidney disease patients and 32 controls was conducted. Patients were categorized into acute kidney disease (AKD), AKI on CKD (A/C), and chronic kidney disease (CKD) groups, further divided by CKD stage and disease etiology. Regions of interest (ROIs) were drawn in renal cortex, liver, aorta, and lesions. SUVmax and SUVmean were measured, and ratios of renal cortex SUVmax to liver and blood pool SUVmean were calculated.

Abnormal FDG uptake was observed in 84.6 % of patients, with significantly higher SUVmax in malignant versus benign lesions. Common malignancies included multiple myeloma, lymphoma, and lung cancer. PET/CT had 89.5 % sensitivity and 100 % specificity for tumor detection. SUVs differed significantly among AKD, A/C, CKD, and normal groups. Significant differences in SUVmax and SUVmean were also found between CKD stages and primary versus secondary kidney diseases. In CKD, increased SUVmax and SUVmean correlated with lower serum creatinine and blood urea nitrogen, and increased eGFR.

For patients with kidney disease, [¹⁸F]FDG PET/CT can be used to systematically screen tumors and inflammatory lesions. And the [¹⁸F]FDG uptake of renal cortex may distinguish different types of kidney diseases and is correlated with renal function.