1. PET [ 11 C]acetate is also a perfusion tracer for kidney evaluation purposes.
- Author
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Normand G, Lemoine S, Le Bars D, Merida I, Irace Z, Troalen T, Costes N, and Juillard L
- Subjects
- Female, Humans, Kinetics, Male, Young Adult, Acetates, Carbon Radioisotopes, Kidney blood supply, Kidney diagnostic imaging, Positron-Emission Tomography, Regional Blood Flow
- Abstract
Rationale: Renal positron emission tomography (PET) functional imaging allows non-invasive and dynamic measurements of functional and metabolic parameters. [
15 O]H2 O is used as a perfusion tracer, and [11 C]acetate as an oxidative metabolism in this purpose, requiring two injections to assess those fundamental parameters. Yet, in cardiac physiology study, the high first-pass myocardial extraction fraction of [11 C]acetate allowed to use its influx rate as a blood flow marker too. Since [11 C]acetate has been characterized by a 20-25% single pass renal extraction in dogs, it could be used as a potential tracer for renal perfusion. The aim of this study was to determine whether [11 C]acetate influx rate can be used as quantitative in vivo marker of kidney perfusion in human., Methods: In 10 healthy subjects, dynamic PET acquisitions were performed after [15 O]H2 O and [11 C]acetate injections spaced by a 15-minute interval. As previously validated, with compartmental modeling of kinetics, renal perfusion and oxidative metabolism were estimated respectively with influx rate of [15 O]H2 O and efflux rate of [11 C]acetate. Additionally, influx rate of [11 C]acetate was regressed to influx rate of [15 O]H2 O., Results: Renal time activity curves of [11 C]-acetate was best fitted with a mono compartmental model compared to a bi-compartmental model (p < 0.0001). [11 C]acetate influx rate was significantly correlated with perfusion quantified with [15 O]H2 O (r2 = 0.37, p < 0.001) at baseline. This regression allowed the computation of a renal [11 C]acetate extraction fraction (EF), and further the computation of renal blood flow from its influx rate., Conclusion: In healthy subjects, over a wide range of renal perfusion, direct estimates of renal oxygen consumption as well as tissue perfusion can be obtained by PET with a single tracer [11 C]acetate. This approach needs to be validated in CKD patients, and would be of great interest to design clinical protocol aiming at evaluating ischemic nephropathies candidate to revascularization., (Copyright © 2019 Elsevier Inc. All rights reserved.)- Published
- 2019
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