{"title":"用[18F]AlF-NOTA-FAPI-04 PET/CT成像无创评估IgA肾病严重程度。","authors":"Hao Wang, Limeng He, Lijuan Feng, Weiwei Zhang, Nan Liu, Wei Zhang","doi":"10.1093/ckj/sfae340","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Renal biopsy plays a crucial role in diagnosing and assessing the severity of immunoglobulin A nephropathy (IgAN), despite being an invasive procedure with potential risk of failure. Our study focused on evaluating the capability of [<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT in identifying the extent of pathological alterations in IgAN.</p><p><strong>Methods: </strong>Twenty patients (13 males and 7 females; mean age, 44 ± 16 years) with newly diagnosed primary IgAN and 10 patients (7 males and 3 females; mean age, 51 ± 4 years) without known renal disease underwent [<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT imaging. Kidney tissues from biopsies were stained with various techniques and examined using immunofluorescence. The Oxford classification was used to evaluate pathological indicators. Immunohistochemical staining was conducted to assess α-smooth muscle actin (αSMA) and fibroblast activation protein (FAP) expression. Renal FAPI uptake measured by positron emission tomography/computed tomography (PET/CT) (maximum and mean standardized uptake value, SUV<sub>max</sub> and SUV<sub>mean</sub>) was correlated with histological findings.</p><p><strong>Results: </strong>The renal parenchymal FAPI uptake was significantly higher in IgAN patients compared with control patients (SUV<sub>max </sub>= 3.9 ± 1.3 vs 1.9 ± 0.4, SUV<sub>mean</sub> = 3.6 ± 1.2 vs 1.5 ± 0.4; all <i>P</i> < .001). We identified a significant difference in renal parenchymal FAPI uptake among the various categories of the Oxford classification. Correlation analysis revealed a positive association between SUV<sub>max</sub> and interstitial fibrosis and tubular atrophy, as well as tubulointerstitial inflammation scores in scarred cortex and non-scarred cortex (<i>r</i> = 0.637, 0.593 and 0.491, all <i>P</i> < .05), Similar associations were observed between SUV<sub>mean</sub> and these scores (<i>r</i> = 0.641, 0.592 and 0.479, all <i>P</i> < .05). Furthermore, significant positive correlations were observed between SUV<sub>max</sub> or SUV<sub>mean</sub> and the staining scores for glomerular αSMA and FAP, as well as for tubulointerstitial αSMA and FAP (all <i>P</i> < .01).</p><p><strong>Conclusion: </strong>[<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT imaging offers IgAN patients a non-invasive and reproducible auxiliary modality to monitor disease progression.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae340"},"PeriodicalIF":3.9000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632375/pdf/","citationCount":"0","resultStr":"{\"title\":\"Non-invasive assessment of IgA nephropathy severity with [<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT imaging.\",\"authors\":\"Hao Wang, Limeng He, Lijuan Feng, Weiwei Zhang, Nan Liu, Wei Zhang\",\"doi\":\"10.1093/ckj/sfae340\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Renal biopsy plays a crucial role in diagnosing and assessing the severity of immunoglobulin A nephropathy (IgAN), despite being an invasive procedure with potential risk of failure. Our study focused on evaluating the capability of [<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT in identifying the extent of pathological alterations in IgAN.</p><p><strong>Methods: </strong>Twenty patients (13 males and 7 females; mean age, 44 ± 16 years) with newly diagnosed primary IgAN and 10 patients (7 males and 3 females; mean age, 51 ± 4 years) without known renal disease underwent [<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT imaging. Kidney tissues from biopsies were stained with various techniques and examined using immunofluorescence. The Oxford classification was used to evaluate pathological indicators. Immunohistochemical staining was conducted to assess α-smooth muscle actin (αSMA) and fibroblast activation protein (FAP) expression. Renal FAPI uptake measured by positron emission tomography/computed tomography (PET/CT) (maximum and mean standardized uptake value, SUV<sub>max</sub> and SUV<sub>mean</sub>) was correlated with histological findings.</p><p><strong>Results: </strong>The renal parenchymal FAPI uptake was significantly higher in IgAN patients compared with control patients (SUV<sub>max </sub>= 3.9 ± 1.3 vs 1.9 ± 0.4, SUV<sub>mean</sub> = 3.6 ± 1.2 vs 1.5 ± 0.4; all <i>P</i> < .001). We identified a significant difference in renal parenchymal FAPI uptake among the various categories of the Oxford classification. Correlation analysis revealed a positive association between SUV<sub>max</sub> and interstitial fibrosis and tubular atrophy, as well as tubulointerstitial inflammation scores in scarred cortex and non-scarred cortex (<i>r</i> = 0.637, 0.593 and 0.491, all <i>P</i> < .05), Similar associations were observed between SUV<sub>mean</sub> and these scores (<i>r</i> = 0.641, 0.592 and 0.479, all <i>P</i> < .05). Furthermore, significant positive correlations were observed between SUV<sub>max</sub> or SUV<sub>mean</sub> and the staining scores for glomerular αSMA and FAP, as well as for tubulointerstitial αSMA and FAP (all <i>P</i> < .01).</p><p><strong>Conclusion: </strong>[<sup>18</sup>F]AlF-NOTA-FAPI-04 PET/CT imaging offers IgAN patients a non-invasive and reproducible auxiliary modality to monitor disease progression.</p>\",\"PeriodicalId\":10435,\"journal\":{\"name\":\"Clinical Kidney Journal\",\"volume\":\"17 12\",\"pages\":\"sfae340\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632375/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Kidney Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ckj/sfae340\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Kidney Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ckj/sfae340","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：肾活检在诊断和评估免疫球蛋白a肾病（IgAN）的严重程度方面起着至关重要的作用，尽管它是一种具有潜在失败风险的侵入性手术。我们的研究重点是评估[18F]AlF-NOTA-FAPI-04 PET/CT识别IgAN病理改变程度的能力。方法：20例患者(男13例，女7例；平均年龄（44±16岁），10例(男7例，女3例；平均年龄51±4岁)，无已知肾脏疾病，行[18F]AlF-NOTA-FAPI-04 PET/CT成像。用各种技术对活检的肾组织进行染色，并使用免疫荧光进行检查。病理指标采用牛津评分法。免疫组化染色检测大鼠α-平滑肌肌动蛋白（αSMA）和成纤维细胞活化蛋白（FAP）的表达。通过正电子发射断层扫描/计算机断层扫描（PET/CT）测量肾脏FAPI摄取（最大和平均标准化摄取值，SUVmax和SUVmean）与组织学结果相关。结果：IgAN患者肾实质FAPI摄取明显高于对照组(SUVmax = 3.9±1.3 vs 1.9±0.4,SUVmean = 3.6±1.2 vs 1.5±0.4；结疤皮质和非结疤皮质的所有P max、间质纤维化和小管萎缩以及小管间质炎症评分(r = 0.637、0.593和0.491，P均为平均值，这些评分(r = 0.641、0.592和0.479，P均为平均值，肾小球αSMA和FAP以及小管间质αSMA和FAP的染色评分均为P。[18F]AlF-NOTA-FAPI-04 PET/CT成像为IgAN患者提供了一种无创、可重复的辅助方式来监测疾病进展。
Non-invasive assessment of IgA nephropathy severity with [18F]AlF-NOTA-FAPI-04 PET/CT imaging.
Background: Renal biopsy plays a crucial role in diagnosing and assessing the severity of immunoglobulin A nephropathy (IgAN), despite being an invasive procedure with potential risk of failure. Our study focused on evaluating the capability of [18F]AlF-NOTA-FAPI-04 PET/CT in identifying the extent of pathological alterations in IgAN.
Methods: Twenty patients (13 males and 7 females; mean age, 44 ± 16 years) with newly diagnosed primary IgAN and 10 patients (7 males and 3 females; mean age, 51 ± 4 years) without known renal disease underwent [18F]AlF-NOTA-FAPI-04 PET/CT imaging. Kidney tissues from biopsies were stained with various techniques and examined using immunofluorescence. The Oxford classification was used to evaluate pathological indicators. Immunohistochemical staining was conducted to assess α-smooth muscle actin (αSMA) and fibroblast activation protein (FAP) expression. Renal FAPI uptake measured by positron emission tomography/computed tomography (PET/CT) (maximum and mean standardized uptake value, SUVmax and SUVmean) was correlated with histological findings.
Results: The renal parenchymal FAPI uptake was significantly higher in IgAN patients compared with control patients (SUVmax = 3.9 ± 1.3 vs 1.9 ± 0.4, SUVmean = 3.6 ± 1.2 vs 1.5 ± 0.4; all P < .001). We identified a significant difference in renal parenchymal FAPI uptake among the various categories of the Oxford classification. Correlation analysis revealed a positive association between SUVmax and interstitial fibrosis and tubular atrophy, as well as tubulointerstitial inflammation scores in scarred cortex and non-scarred cortex (r = 0.637, 0.593 and 0.491, all P < .05), Similar associations were observed between SUVmean and these scores (r = 0.641, 0.592 and 0.479, all P < .05). Furthermore, significant positive correlations were observed between SUVmax or SUVmean and the staining scores for glomerular αSMA and FAP, as well as for tubulointerstitial αSMA and FAP (all P < .01).
Conclusion: [18F]AlF-NOTA-FAPI-04 PET/CT imaging offers IgAN patients a non-invasive and reproducible auxiliary modality to monitor disease progression.
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About the Journal
Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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