The following message was updated on 8/12/2022 4:55:27 PM.
[68Ga]IRDye800-tilmanocept identified by NIH as on right testing track for PET/CT imaging through mesangial (kidney) cell uptake
Molecular and functional imaging of renal disease leveraging PET radiotracers on the horizon
Navid Hasani, Faraz Farhadi, Elizabeth Theng, Moozhan Nikpanah, Cheryl Beegle, Michael Morris and Babak Saboury
Journal of Nuclear Medicine June 2022, 63 (supplement 2) 2653;
exhibit aims to provide an overview of renal PET radiotracers and
specific probes for functional and molecular imaging of kidney disease.
We discuss the individual clinical utility, advantages, and limitations
of each functional and molecular imaging radiotracer. In doing so, we
summarize the current knowledge of the pathophysiological interactions
between kidney diseases and various radiotracers, describing the role of
each tracer as a marker for diagnosis, prognosis, treatment monitoring,
molecular imaging, and as potential targets for therapeutic strategies.
tomography (CT), magnetic resonance imaging, and ultrasound have been
the dominant non-invasive imaging modalities used for the initial
assessment and staging of kidney diseases. However, these modalities are
limited by their low sensitivity to small tumors and low specificity to
renal diseases. When combined with CT, positron emission tomography
(PET) imaging allows for the assessment of paramount biological
processes related to renal pathophysiology. While PET/CT is important in
the diagnosis and treatment of a variety of cancers, its application in
functional and molecular imaging of kidneys continues to be
investigated. Considering the recent developments in specialized
radiotracers specifically designed for kidney diseases, there is
potential for the increased utility of PET in renal disease.
comprehensive literature review of PET radiotracers for functional and
molecular imaging of kidneys was conducted using PubMed® and EMBASE®
platforms for publications in 2012 or later. Functional imaging
radiotracers for kidney PET were categorized into those that1) reflect
glomerular filtration rate (GFR); 2) are secreted in the tubules
employed for measurement of effective renal plasma flow (ERPF); 3)
reflect renal blood flow; 4) are utilized for targeted evaluation of
specific renal cellular processes and derangements.
Results:Functional imaging in the setting of renal physiology and pathology:
that reflect GFR are [68Ga]ethylenediaminetetraacetic acid
([68Ga]EDTA), [68Ga] diethylenetriamine-pentaacetic acid ([68Ga]DTPA),
[68Ga] 1,4,7-triazacyclononane-1,4,7-triacetic acid ([68Ga] NOTA], [18F]
FDS (2-deoxy-2-[18F]fluorosorbitol), Cobalt-55 EDTA.
PET/CT radiotracers that may be utilized for ERPF assessment are
[18F]Re(CO)3-N-(fluoroethyl)iminodiacetic acid (FEDA),
p-[18F]fluorohippurate ([18F]PFH), Al[18F]NODA-butyric acid.
PET/CT radiotracers that reflect renal blood flow are O-15 water, rubidium-82 (Potassium-analog), Cu-PTSM, N-13-labeled ammonia.
radiotracers that reflect a specific cellular cascade such as
[68Ga]IRDye800-tilmanocept for mesangial cell uptake of tilmanocept used
for glomerular imaging
the advent of novel PET radiotracers for renal disorders, it is
critical to understand their individual functionality, sensitivity,
specificity, advantages, and limitations, as well as the current status
of relevant clinical applications. Several of the radiotracers discussed
in this exhibit have been investigated in animals or are undergoing
preliminary human clinical trials. Therefore, knowledge of these
radiotracers is crucial for future research and better understanding the
clinical indication of these renal radiotracers which may soon be
available more widely.