Total-Body PET: Investigating Mechanisms in Cardiovascular-Kidney-Metabolic Syndrome.

Total-body PET is an emerging tool whose potential is being actively explored to interrogate multisystem biologic processes. Cardiovascular-Kidney-Metabolic (CKM) syndrome is increasingly recognized as a multidimensional disease driving cardiovascular and renal morbidity and mortality, but the underlying pathologic mechanisms remain incompletely understood. As mechanistic investigation moves to understand systems physiology in CKM syndrome, the ability to simultaneously assess shared biologic processes and crosstalk between the cardiovascular and renal systems is a unique strength of total-body PET. Total-body PET-CT systems can leverage existing and novel radiotracers to evaluate perfusion, fibrosis, metabolism, inflammation, and body composition. This review summarizes evidence for the assessment of cardiovascular and renal tissues with PET and discusses potential future applications for understanding mechanistic interactions between these interrelated systems using total-body PET, which could ultimately be applied to the development of targeted therapies for the benefit of patients with CKM disorders.