Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique

Stine Sundgaard Langaa; Camilla Lundgreen Duus; Marie Houmaa Vrist; Frank Holden Mose; Claire Anne Fynbo; Jørn Theil; June Anita Ejlersen; Jesper Nørgaard Bech

doi:10.1111/cpf.70000

Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique

Stine Sundgaard Langaa^*, Camilla Lundgreen Duus, Marie Houmaa Vrist, Frank Holden Mose, Claire Anne Fynbo, Jørn Theil, June Anita Ejlersen, Jesper Nørgaard Bech

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (⁸²Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal ⁸²Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([^99mTc]Tc-MAG3) clearance as a first attempt to validate ⁸²Rb PET/CT for renal perfusion estimation using a reference method. Methods: Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a ⁸²Rb PET/CT scan and a [^99mTc]Tc-MAG3 clearance study. Results: ⁸²Rb clearance correlated positively with [^99mTc]Tc-MAG3 clearance in both treatment periods. The [^99mTc]Tc-MAG3-to-⁸²Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively. Conclusion: The correlation between ⁸²Rb clearance and [^99mTc]Tc-MAG3 clearance may indicate that PET/CT determined ⁸²Rb clearance can act as an estimator of renal perfusion. The [^99mTc]Tc-MAG3-to-⁸²Rb clearance ratios suggest that the extraction fraction of ⁸²Rb is higher than that of [^99mTc]Tc-MAG3, further suggesting ⁸²Rb clearance as an estimator of flow. However, further studies are warranted to validate use of ⁸²Rb PET/CT for flow estimation.

Original language	English
Article number	e70000
Journal	Clinical Physiology and Functional Imaging
Volume	45
Issue	2
ISSN	1475-0961
DOIs	https://doi.org/10.1111/cpf.70000
Publication status	Published - Mar 2025

Keywords

correlation
effective renal plasma flow
essential hypertension
interventional study
renal blood flow

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Langaa, S. S., Duus, C. L., Vrist, M. H., Mose, F. H., Fynbo, C. A., Theil, J., Ejlersen, J. A., & Bech, J. N. (2025). Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique. Clinical Physiology and Functional Imaging, 45(2), Article e70000. https://doi.org/10.1111/cpf.70000

@article{6313e00388db41508e4f33e37c0c6268,

title = "Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique",

abstract = "Background: Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal 82Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([99mTc]Tc-MAG3) clearance as a first attempt to validate 82Rb PET/CT for renal perfusion estimation using a reference method. Methods: Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a 82Rb PET/CT scan and a [99mTc]Tc-MAG3 clearance study. Results: 82Rb clearance correlated positively with [99mTc]Tc-MAG3 clearance in both treatment periods. The [99mTc]Tc-MAG3-to-82Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively. Conclusion: The correlation between 82Rb clearance and [99mTc]Tc-MAG3 clearance may indicate that PET/CT determined 82Rb clearance can act as an estimator of renal perfusion. The [99mTc]Tc-MAG3-to-82Rb clearance ratios suggest that the extraction fraction of 82Rb is higher than that of [99mTc]Tc-MAG3, further suggesting 82Rb clearance as an estimator of flow. However, further studies are warranted to validate use of 82Rb PET/CT for flow estimation.",

keywords = "correlation, effective renal plasma flow, essential hypertension, interventional study, renal blood flow",

author = "Langaa, {Stine Sundgaard} and Duus, {Camilla Lundgreen} and Vrist, {Marie Houmaa} and Mose, {Frank Holden} and Fynbo, {Claire Anne} and J{\o}rn Theil and Ejlersen, {June Anita} and Bech, {Jesper N{\o}rgaard}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.",

year = "2025",

month = mar,

doi = "10.1111/cpf.70000",

language = "English",

volume = "45",

journal = "Clinical Physiology and Functional Imaging",

issn = "1475-0961",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "2",

}

Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique. / Langaa, Stine Sundgaard; Duus, Camilla Lundgreen; Vrist, Marie Houmaa et al.
In: Clinical Physiology and Functional Imaging, Vol. 45, No. 2, e70000, 03.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique

AU - Langaa, Stine Sundgaard

AU - Duus, Camilla Lundgreen

AU - Vrist, Marie Houmaa

AU - Mose, Frank Holden

AU - Fynbo, Claire Anne

AU - Theil, Jørn

AU - Ejlersen, June Anita

AU - Bech, Jesper Nørgaard

N1 - Publisher Copyright: © 2025 The Author(s). Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

PY - 2025/3

Y1 - 2025/3

N2 - Background: Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal 82Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([99mTc]Tc-MAG3) clearance as a first attempt to validate 82Rb PET/CT for renal perfusion estimation using a reference method. Methods: Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a 82Rb PET/CT scan and a [99mTc]Tc-MAG3 clearance study. Results: 82Rb clearance correlated positively with [99mTc]Tc-MAG3 clearance in both treatment periods. The [99mTc]Tc-MAG3-to-82Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively. Conclusion: The correlation between 82Rb clearance and [99mTc]Tc-MAG3 clearance may indicate that PET/CT determined 82Rb clearance can act as an estimator of renal perfusion. The [99mTc]Tc-MAG3-to-82Rb clearance ratios suggest that the extraction fraction of 82Rb is higher than that of [99mTc]Tc-MAG3, further suggesting 82Rb clearance as an estimator of flow. However, further studies are warranted to validate use of 82Rb PET/CT for flow estimation.

AB - Background: Although numerous techniques exist for renal blood flow (RBF) estimation, none of the methods have been implemented in routine clinical practice due to their inadequacies and burdensomeness. Previously, we evaluated rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) for renal perfusion determination and found strong indications of method precision and reliability. The aim of this study was to compare renal 82Rb clearance with renal technetium-99m-mercaptoacetyltriglycine ([99mTc]Tc-MAG3) clearance as a first attempt to validate 82Rb PET/CT for renal perfusion estimation using a reference method. Methods: Ten subjects with essential hypertension underwent two treatment periods, receiving spironolactone and placebo in random order. At the end of each period, each subject completed a 82Rb PET/CT scan and a [99mTc]Tc-MAG3 clearance study. Results: 82Rb clearance correlated positively with [99mTc]Tc-MAG3 clearance in both treatment periods. The [99mTc]Tc-MAG3-to-82Rb clearance ratio was 0.83 and 0.86 in the placebo and spironolactone treatment periods, respectively. Conclusion: The correlation between 82Rb clearance and [99mTc]Tc-MAG3 clearance may indicate that PET/CT determined 82Rb clearance can act as an estimator of renal perfusion. The [99mTc]Tc-MAG3-to-82Rb clearance ratios suggest that the extraction fraction of 82Rb is higher than that of [99mTc]Tc-MAG3, further suggesting 82Rb clearance as an estimator of flow. However, further studies are warranted to validate use of 82Rb PET/CT for flow estimation.

KW - correlation

KW - effective renal plasma flow

KW - essential hypertension

KW - interventional study

KW - renal blood flow

UR - http://www.scopus.com/inward/record.url?scp=85218446321&partnerID=8YFLogxK

U2 - 10.1111/cpf.70000

DO - 10.1111/cpf.70000

M3 - Journal article

C2 - 39988762

AN - SCOPUS:85218446321

SN - 1475-0961

VL - 45

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

IS - 2

M1 - e70000

ER -

Renal clearance estimated by rubidium-82 positron emission tomography/computed tomography and technetium-99m-mercaptoacetyltriglycine clearance infusion technique

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