PET [11C]acetate is also a perfusion tracer for kidney evaluation purposes. 2019

Gabrielle Normand, and Sandrine Lemoine, and Didier Le Bars, and Ines Merida, and Zacharie Irace, and Thomas Troalen, and Nicolas Costes, and Laurent Juillard
Department of Nephrology and Renal Functional Explorations, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; CarMeN: Cardiovasculaire, Métabolisme, Diabétologie & Nutrition-INSERM U1060/INRA U1397/Université Lyon1, France; CERMEP, MR-PET Center, Lyon, France. Electronic address: laetitia.normand@chu-lyon.fr.

Renal positron emission tomography (PET) functional imaging allows non-invasive and dynamic measurements of functional and metabolic parameters. [15O]H2O is used as a perfusion tracer, and [11C]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 [11C]acetate allowed to use its influx rate as a blood flow marker too. Since [11C]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 [11C]acetate influx rate can be used as quantitative in vivo marker of kidney perfusion in human. In 10 healthy subjects, dynamic PET acquisitions were performed after [15O]H2O and [11C]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 [15O]H2O and efflux rate of [11C]acetate. Additionally, influx rate of [11C]acetate was regressed to influx rate of [15O]H2O. Renal time activity curves of [11C]-acetate was best fitted with a mono compartmental model compared to a bi-compartmental model (p < 0.0001). [11C]acetate influx rate was significantly correlated with perfusion quantified with [15O]H2O (r2 = 0.37, p < 0.001) at baseline. This regression allowed the computation of a renal [11C]acetate extraction fraction (EF), and further the computation of renal blood flow from its influx rate. 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 [11C]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.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D007700 Kinetics The rate dynamics in chemical or physical systems.
D008297 Male Males
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D002250 Carbon Radioisotopes Unstable isotopes of carbon that decay or disintegrate emitting radiation. C atoms with atomic weights 10, 11, and 14-16 are radioactive carbon isotopes. Radioisotopes, Carbon
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000085 Acetates Derivatives of ACETIC ACID. Included under this heading are a broad variety of acid forms, salts, esters, and amides that contain the carboxymethane structure. Acetate,Acetic Acid Esters,Acetic Acids,Acids, Acetic,Esters, Acetic Acid
D049268 Positron-Emission Tomography An imaging technique using compounds labelled with short-lived positron-emitting radionuclides (such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18) to measure cell metabolism. It has been useful in study of soft tissues such as CANCER; CARDIOVASCULAR SYSTEM; and brain. SINGLE-PHOTON EMISSION-COMPUTED TOMOGRAPHY is closely related to positron emission tomography, but uses isotopes with longer half-lives and resolution is lower. PET Imaging,PET Scan,Positron-Emission Tomography Imaging,Tomography, Positron-Emission,Imaging, PET,Imaging, Positron-Emission Tomography,PET Imagings,PET Scans,Positron Emission Tomography,Positron Emission Tomography Imaging,Positron-Emission Tomography Imagings,Scan, PET,Tomography Imaging, Positron-Emission,Tomography, Positron Emission
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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