Estimation of renal perfusion based on measurement of rubidium-82 clearance by PET/CT scanning in healthy subjects

BACKGROUND: Changes in renal blood flow (RBF) may play a pathophysiological role in hypertension and kidney disease. However, RBF determination in humans has proven difficult. We aimed to confirm the feasibility of RBF estimation based on positron emission tomography/computed tomography (PET/CT) and rubidium-82 ((82)Rb) using the abdominal aorta as input function in a 1-tissue compartment model. METHODS: Eighteen healthy subjects underwent two dynamic (82)Rb PET/CT scans in two different fields of view (FOV). FOV-A included the left ventricular blood pool (LVBP), the abdominal aorta (AA) and the majority of the kidneys. FOV-B included AA and the kidneys in their entirety. In FOV-A, an input function was derived from LVBP and from AA, in FOV-B from AA. One-tissue compartmental modelling was performed using tissue time activity curves generated from volumes of interest (VOI) contouring the kidneys, where the renal clearance of (82)Rb is represented by the K(1) kinetic parameter. Total clearance for both kidneys was calculated by multiplying the K(1) values with the volume of VOIs used for analysis. Intra-assay coefficients of variation and inter-observer variation were calculated. RESULTS: For both kidneys, K(1) values derived from AA did not differ significantly from values obtained from LVBP, neither were significant differences seen between AA in FOV-A and AA in FOV-B, nor between the right and left kidneys. For both kidneys, the intra-assay coefficients of variation were low (~ 5%) for both input functions. The measured K(1) of 2.80 ml/min/cm(3) translates to a total clearance for both kidneys of 766 ml/min/1.73 m(2). CONCLUSION: Measurement of renal perfusion based on PET/CT and (82)Rb using AA as input function in a 1-tissue compartment model is feasible in a single FOV. Based on previous studies showing (82)Rb to be primarily present in plasma, the measured K(1) clearance values are most likely representative of effective renal plasma flow (ERPF) rather than estimated RBF values, but as the accurate calculation of total clearance/flow is very much dependent on the analysed volume, a standardised definition for the employed renal volumes is needed to allow for proper comparison with standard ERPF and RBF reference methods. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40658-021-00389-0.