the study on the effectiveness of [68ga]ga-hbed-cc-diasp pet/ct in calculating gfr and predicting residual renal function after partial nephrectomy

Conditions: Kidney Neoplasms / Surgery; Glomerular Filtration Rate; Positron-Emission Tomography(PET)

Summary: in subjects with different levels of renal function and no history of renal tumors, gfr is measured using \[68ga\]ga-hbed-cc-diasp pet/ct, the gates method, and the 99mtc-dtpa dual plasma method. the consistency between the three methods is analyzed using intra-class correlation coefficient (icc), concordance correlation coefficient (ccc), and bland-altman analysis. in patients scheduled for partial nephrectomy due to renal tumors, gfr is measured using the three methods within 2 weeks before surgery and 4±1 weeks post-surgery. the percentage of postoperative residual renal function (postoperative gfr/preoperative gfr × 100%, hereafter referred to as rrf%) is calculated for each method. by comparing and overlaying preoperative and postoperative pet/ct images, the resected renal area can be delineated on the preoperative pet/ct image. based on the preoperative pet/ct and the delineated surgical area, a predictive value for postoperative gfr is calculated to obtain the predicted rrf%. a consistency analysis is then performed between the predicted rrf% and the actual rrf% measured by the three methods, using icc, ccc, and bland-altman analysis to evaluate the efficacy of \[68ga\]ga-hbed-cc-diasp pet/ct in predicting residual renal function after partial nephrectomy.

\[68ga\]ga-hbed-cc-diasp pet/ct imaging: after intravenous injection of \[68ga\]ga-hbed-cc-diasp, a scout scan, low-dose ct scan, and a 30-minute dynamic pet scan are performed sequentially. the functional renal cortex is delineated in the first pet frame showing the radiotracer filling the renal cortex. a functional renal cortex radioactivity concentration function is constructed based on a compartment model with gfr as a parameter and time as an independent variable. this function is then fitted to the time-activity curve (tac) of the functional renal cortex to obtain the gfr value. gates method and 99mtc-dtpa dual plasma method: after intravenous injection of 99mtc-dtpa, renal blood flow functional imaging is performed immediately, collecting time-activity curves from both renal areas. gfr is calculated based on the percentage (%id) of bilateral renal radiotracer uptake relative to the injected dose. blood samples of 10 ml are collected from the contralateral forearm at 1 hour and 2 hours post-injection, and gfr is calculated using the dual plasma method. in subjects with different levels of renal function and no history of renal tumors, gfr is measured using \[68ga\]ga-hbed-cc-diasp pet/ct, the gates method, and the 99mtc-dtpa dual plasma method. the consistency between the three methods is analyzed using intra-class correlation coefficient (icc), concordance correlation coefficient (ccc), and bland-altman analysis. in patients scheduled for partial nephrectomy due to renal tumors, gfr is measured using the three methods within 2 weeks before surgery and 4±1 weeks post-surgery. the percentage of postoperative residual renal function (postoperative gfr/preoperative gfr × 100%, hereafter referred to as rrf%) is calculated for each method. by comparing and overlaying preoperative and postoperative pet/ct images, the resected renal area can be delineated on the preoperative pet/ct image. based on the preoperative pet/ct and the delineated surgical area, a predictive value for postoperative gfr is calculated to obtain the predicted rrf%. a consistency analysis is then performed between the predicted rrf% and the actual rrf% measured by the three methods, using icc, ccc, and bland-altman analysis to evaluate the efficacy of \[68ga\]ga-hbed-cc-diasp pet/ct in predicting residual renal function after partial nephrectomy.

Eligibility criteria:
inclusion criteria: * age \> 18 years; * written informed consent obtained. exclusion criteria: * patients with claustrophobia or fear of radiation; * women who are planning to conceive, pregnant, or breastfeeding; * patients unable to lie flat for 30 minutes; * patients or family members who cannot understand the conditions and objectives of the study, or who refuse to participate.

Keywords: [68ga]ga-hbed-cc-diasp pet/ct glomerular filtration rate partial nephrectomy