肾[99mTc]DMSA定量成像预测慢性肾病患者尿[99mTc]DMSA排泄。

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-06-20 DOI:10.1186/s13550-025-01272-0

Danny Jensen, Jesper Frank Andersen, Peder Berg, Henrik Birn, Christian Flø, Jørgen Frøkiær

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引用次数: 0

摘要

背景：99mTc标记的二巯基琥珀酸（[99mTc]DMSA）是一种常用的放射性药物，用于评估肾脏灌注、结构和形态。然而，人类肾脏对[99mTc]DMSA的处理尚不清楚。对肾小管功能障碍患者的研究和动物实验表明，[99mTc]DMSA的肾脏摄取是通过肾小球滤过和随后的近端小管重吸收发生的。本研究的主要目的是研究慢性肾脏疾病（CKD）患者对[99mTc]DMSA的肾脏处理，以及与健康对照组（HC）相比，基于[99mTc]DMSA成像的病理生理意义。结果：与HC相比，CKD患者尿中[99mTc]DMSA的排泄量高1.5倍，且变化更大。HC患者的[99mTc]DMSA血浆清除率仅比CKD患者高1.1倍，但HC患者肾脏的[99mTc]DMSA摄取比CKD患者高2.6倍，且与24小时尿排泄[99mTc]DMSA呈负相关，不依赖于GFR。结论：肾[99mTc]DMSA积累与肾小球滤过后小管摄取一致。CKD患者的DMSA摄取相对较低，表明该患者组近端肾小管功能有缺陷。此外，结果表明[99mTc]DMSA摄取可以作为小管间质功能的标志。

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Quantitative renal [^99mTc]DMSA imaging predicts urinary [^99mTc]DMSA excretion in patients with chronic kidney disease.

Background: ^99mTc-labelled Dimercaptosuccinic acid ([^99mTc]DMSA) is a radiopharmaceutical commonly used to evaluate renal perfusion, structure, and morphology. However, the renal handling of [^99mTc]DMSA in humans remains unclear. Studies in humans with renal tubular dysfunction and animal experiments suggest that renal uptake of [^99mTc]DMSA occurs by glomerular filtration and subsequent proximal tubule reabsorption. The main aim of this study was to examine renal handling of [^99mTc]DMSA and the pathophysiological implications of [^99mTc]DMSA-based imaging in patients with chronic kidney disease (CKD) compared to healthy controls (HC).

Results: Urinary excretion of [^99mTc]DMSA was 1.5-fold higher and more variable in CKD patients compared to HC. While [^99mTc]DMSA plasma clearance was only 1.1-fold higher in HC, the [^99mTc]DMSA uptake in the kidneys was 2.6-fold higher in HC compared to CKD patients and correlated inversely with the 24-hour urine excretion of [^99mTc]DMSA independent of GFR.

Conclusion: Kidney [^99mTc]DMSA accumulation is consistent with tubular uptake following glomerular filtration. The relative DMSA uptake is lower in CKD patients, pointing to defective proximal tubular function in this patient group. Furthermore, the results suggest that [^99mTc]DMSA uptake could serve as a marker for tubule-interstitial function.

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.