Radiopharmaceuticals in Renal Imaging: A Comprehensive Review of Current Applications and Future Prospects

Area of Science:

• Nuclear medicine and molecular imaging
• Renal physiology and pathophysiology
• Radiopharmaceutical chemistry

Background:

• Accurate kidney function assessment is crucial for diagnosing and managing renal diseases.
• Conventional imaging offers structural and some functional data, but nuclear medicine provides molecular-level insights.
• Renal scintigraphy has long been used, but newer PET techniques offer enhanced capabilities.

Purpose of the Study:

• To provide a comprehensive overview of functional renal imaging techniques.
• To compare established renal scintigraphy radiopharmaceuticals with emerging PET radiopharmaceuticals.
• To discuss the clinical applications and future potential of PET in renal functional imaging.

Main Methods:

• Systematic review of literature on renal scintigraphy and PET radiopharmaceuticals.
• Summary of established radiopharmaceuticals (e.g., 99mTc-DTPA, 99mTc-DMSA) for GFR and ERPF assessment.
• Overview of emerging PET tracers (e.g., 68Ga-labeled compounds, 18F-labeled compounds) for GFR, ERPF, and other renal functions.

Main Results:

• Established scintigraphy tracers like 99mTc-DTPA are used for GFR and ERPF.
• Emerging PET tracers (e.g., 68Ga-EDTA, 18F-FDS for GFR; 11C-PABA, 18F-PFH for ERPF) offer higher sensitivity and quantification.
• Additional PET tracers are being explored for mesangial function, tumors, and split renal function.

Conclusions:

• PET radiopharmaceuticals represent a significant advancement in functional renal imaging.
• These tracers provide superior sensitivity, quantification, and molecular insights compared to conventional methods.
• PET holds great promise for precision nephrology, enabling more accurate diagnosis and personalized treatment.