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Theranostics 2021; 11(12):6105-6119. doi:10.7150/thno.58682 This issue Cite

Review

Current and future perspectives on functional molecular imaging in nephro-urology: theranostics on the horizon

Yoshitaka Toyama^1,2*, Rudolf A. Werner^1,3,4*, Camilo A. Ruiz-Bedoya^5,6, Alvaro A. Ordonez^5,6, Kei Takase², Constantin Lapa⁷, Sanjay K. Jain^5,6, Martin G. Pomper^4,8,9, Steven P. Rowe^4,8,9, Takahiro Higuchi^1,3,10✉

1. Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.
2. Department of Diagnostic Radiology, Tohoku University, Sendai, Japan.
3. Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg Germany.
4. Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
5. Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland.
6. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
7. Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany.
8. The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
9. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
10. Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
* These authors contributed equally.

✉ Corresponding author: Takahiro Higuchi, M.D. PhD. Department of Nuclear Medicine/Comprehensive Heart Failure Center, University of Wuerzburg, Oberduerrbacher Strasse 6, 97080 Wuerzburg, Germany. Mail: thiguchicom, fax: +49 931 201 6 444 00, phone: +49 931 201 35455. More

Abstract

In recent years, a paradigm shift from single-photon-emitting radionuclide radiotracers toward positron-emission tomography (PET) radiotracers has occurred in nuclear oncology. Although PET-based molecular imaging of the kidneys is still in its infancy, such a trend has emerged in the field of functional renal radionuclide imaging. Potentially allowing for precise and thorough evaluation of renal radiotracer urodynamics, PET radionuclide imaging has numerous advantages including precise anatomical co-registration with CT images and dynamic three-dimensional imaging capability. In addition, relative to scintigraphic approaches, PET can allow for significantly reduced scan time enabling high-throughput in a busy PET practice and further reduces radiation exposure, which may have a clinical impact in pediatric populations. In recent years, multiple renal PET radiotracers labeled with ¹¹C, ⁶⁸Ga, and ¹⁸F have been utilized in clinical studies. Beyond providing a precise non-invasive read-out of renal function, such radiotracers may also be used to assess renal inflammation. This manuscript will provide an overview of renal molecular PET imaging and will highlight the transformation of conventional scintigraphy of the kidneys toward novel, high-resolution PET imaging for assessing renal function. In addition, future applications will be introduced, e.g. by transferring the concept of molecular image-guided diagnostics and therapy (theranostics) to the field of nephrology.

Keywords: Glomerular filtration rate, renal, kidney, renal function, positron emission tomography, nephrology, urology, molecular imaging, theranostics

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