Association between diffuse renal uptake of 18F-FDG and acute kidney injury
Association between diffuse renal uptake of 18F-FDG and acute kidney injury
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DOI：
10.1007/s12149-021-01713-5
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发表时间：
2022-01-06
影响因子：
2.6
通讯作者：
Nakamoto, Yuji
中科院分区：
文献类型：
--
作者：
Kidera, Eitaro;Koyasu, Sho;Nakamoto, Yuji
目的探讨2-脱氧-2-[F-18]氟代-D-葡萄糖（FDG）肾弥漫性摄取（DRU）患者的临床特点，尤其是肾功能。方法回顾性分析40例FDGPET/CT显示DRU的患者及40例正常对照组。临床表现、影像学参数比较两组患者肾功能指标（肌酐（Cr）、肾小球滤过率（eGFR）、肌酐比值（Cr/基线）、最大肌酐比值（max-Cr-ratio）、C反应蛋白（CRP））的变化。在DRU组中，额外评价了随访FDG PET/CT扫描以确定DRU的存在。结果除抗生素使用、肌酐和eGFR外，两组临床特征无显著差异。在DRU组中，30天内接受抗生素治疗的患者明显更多（p = 0.002）。DRU组的肾脏平均SUVmax显著更高（p < 0.001），肾脏尺寸显著更大（p = 0.003）。DRU组的Cr比率和最大Cr比率显著较高（分别为p = 0.005和p < 0.001）。CRP在DRU组中显著更高（p < 0.001）。DRU组40例患者中有18例接受了第二次FDG PET/CT扫描，其中16例未显示DRU。18名患者中有6名显示急性肾损伤（阿基，即，Cr-比率>= 1.5），并在第二次扫描前恢复。6例患者在第二次扫描时均未显示DRU。结论DRU提示阿基的存在，可能是一种可逆的发现，并可能随着肾功能的改善而消失。
Objective The aim of this study was to investigate the clinical characteristics of patients with diffuse renal uptake (DRU) of 2-deoxy-2-[F-18]fluoro-d-glucose (FDG), with particular focus on renal function. Methods We retrospectively analyzed 40 patients who showed DRU on FDG PET/CT and the same number of matched controls. The clinical features, imaging parameters (the mean SUVmax of the kidneys and the kidney size), and laboratory data including renal function parameters (Cr, the serum creatinine level; estimated glomerular filtration ratio (eGFR); Cr-ratio, Cr divided by the baseline; max-Cr-ratio, the maximum serum creatinine level within 30 days divided by the baseline) and C-reactive protein (CRP) were compared between the two groups. In the DRU group, follow-up FDG PET/CT scans were additionally evaluated to determine the presence of DRU. Results No significant differences were observed in the clinical features except for antibiotic administration, Cr, and eGFR. Significantly more patients underwent antibiotic administration within 30 days in the DRU group (p = 0.002). The mean SUVmax of the kidneys was significantly higher (p < 0.001) and the kidney size was significantly larger in the DRU group (p = 0.003). Cr-ratio and max-Cr-ratio were significantly higher in the DRU group (p = 0.005 and p < 0.001, respectively). CRP was significantly higher in the DRU group (p < 0.001). Eighteen of the 40 patients in the DRU group underwent a second FDG PET/CT scan, and 16 of them did not show DRU. Six of the 18 patients showed acute kidney injury (AKI, i.e., Cr-ratio >= 1.5) at the time of the initial scan and recovered before the second scan. None of the six patients showed DRU on the second scan. Conclusion DRU indicates the presence of AKI, could be a reversible finding, and may disappear as renal function improves.