Application value of Philips Ingenuity TF PET/CT scanner imaging agent FAP in evaluating renal fibrosis.

Abstract

Objective: Chronic kidney disease (CKD) progression is accelerated by renal fibrosis, which causes abnormal extracellular matrix (ECM) accumulation. Non-invasive precision in measuring renal fibrosis is now possible with the help of advanced imaging techniques like magnetic resonance imaging (MRI) and ultrasound elastography. Fluorine-18-fibroblast activation protein (¹⁸F-FAP) is a promising Philips ingenuity TF positron emission tomography/computed tomography (PET/CT) scanner imaging target in activated fibroblasts associated with fibrotic disorders. Real-time quantification with FAP-targeted imaging improves kidney fibrosis diagnosis and guides anti-fibrotic therapies. The aim of this study is to develop reliable diagnostic and treatment techniques for renal fibrosis, Philips ingenuity TF PET/CT scanner imaging with FAP is useful.

Materials and methods: Positron emission tomography data from 100 patients in our hospital (October 2022-September 2023) was analyzed to see if renal radiotracer uptake correlated with CKD progression. Fluorine-18-FAPI-04 synthesis and Philips ingenuity TF PET/CT scanner imaging were standard. One person determined CKD stage and glomerular filtration rate (GFR) after imaging processing. Imaged renal radiotracer distribution using maximum standardized uptake value (SUVmax) and mean SUV (SUVmean). The study sought to improve renal radiotracer dispersion estimation for CKD assessment.

Results: The study reveals a complex relationship between GFR and radiotracer uptake in kidneys. At lower GFR, substantial uptake is seen, but a GFR of 15mL/min/1.73m² shows a drop to zero. Higher GFR generally correlate with increased uptake, peaking at GFR of 75 and 90mL/min/1.73m². Yet, at GFR of 115 and 120mL/min/1.73m², there is a reduction in radiotracer uptake, suggesting a nuanced association with renal function. Varied kidney SUVmax and SUVmean were significant for ¹⁸F-FAPI C (P<0.001), while baseline SUV readings were not significant. Fluorine-18-L-dihydroxyphenylalanine (¹⁸F-DOPA) and gallium-68 (⁶⁸Ga) ¹⁸F-prostate specific membrane antigen (PSMA) had significant kidney SUVmax values (P=0.05). Results suggest diverse absorption patterns for different radiotracers in kidneys and tissues.

Conclusion: Fluorine-18-FAPI is a promising noninvasive approach for evaluating and quantifying CKD grades. Its excellent CKD severity correlation and renal insights make it a transformative diagnostic tool.