Rachid Abdoul, Chen Bo, Zhu Guangwen
Department of Nuclear Medicine, First Affiliated Hospital, Dalian Medical University, Dalian, China.
College of International Education, Dalian Medical University, Dalian, China.
Quant Imaging Med Surg. 2023 Aug 1;13(8):5034-5042. doi: 10.21037/qims-22-917. Epub 2023 Jun 9.
The cerebellum is less affected by normal aging or neurodegenerative diseases, the aim of this paper is to investigate the effect of renal function status on uptake of 2-deoxy-2-[F]fluoro-D-glucose (F-FDG) in human cerebellum based on independent creatinine (CRE) or blood urea nitrogen (BUN) levels.
A total of 253 patients who underwent F-FDG PET/CT scans were included. The patients were divided into groups according to renal function status: 201 patients with normal renal function, 16 patients with increase CRE, 36 patients with decrease CRE, and 31 patients with abnormal BUN. The maximum standardized uptake values were obtained in regions of interest (ROIs) for multiple tissue types (right cerebellum, right lobe of liver, right lung, bone marrow and psoas muscle at the level of the fourth lumbar vertebra). Moreover, the selected normal CRE groups were pair-matched with CRE decrease group with respect to age, sex, body mass index and glucose, respectively.
Among 253 patients who met the inclusion/exclusion criteria, the final analysis included 967 ROIs (244 cerebellum, 191 lungs, 230 muscles, 145 bone marrow, and 157 liver) from F-FDG PET/CT scans. Among patients grouped by CRE or BUN levels, the uptake of F-FDG by cerebellum was significantly decreased in patients with CRE decrease level (P=0.001). There were no statistically significant differences between the other groups. Matched-pair analysis indicated there were no significant changes in outcomes between the CRE decrease group and the age-, sex-, BMI-, and glucose-matched controls compared to pre-matching.
In patients with normal renal function and reduced CRE concentration, decrease cerebellar glucose metabolism was observed; however, no abnormal uptake of F-FDG was found in the cerebellum and other normal tissues of patients with impaired renal function. Consequently, in the study of cerebellar F-FDG metabolism, it may be necessary to consider the influence of blood CRE level.
小脑受正常衰老或神经退行性疾病的影响较小,本文旨在基于独立的肌酐(CRE)或血尿素氮(BUN)水平,研究肾功能状态对人小脑摄取2-脱氧-2-[F]氟-D-葡萄糖(F-FDG)的影响。
共纳入253例行F-FDG PET/CT扫描的患者。根据肾功能状态将患者分组:201例肾功能正常患者,16例CRE升高患者,36例CRE降低患者,31例BUN异常患者。在多个组织类型(右小脑、肝右叶、右肺、骨髓和第四腰椎水平的腰大肌)的感兴趣区域(ROI)获得最大标准化摄取值。此外,将选定的正常CRE组分别在年龄、性别、体重指数和血糖方面与CRE降低组进行配对。
在符合纳入/排除标准的253例患者中,最终分析包括来自F-FDG PET/CT扫描的967个ROI(244个小脑、191个肺、230个肌肉、145个骨髓和157个肝脏)。在按CRE或BUN水平分组的患者中,CRE降低水平的患者小脑对F-FDG的摄取显著降低(P=0.001)。其他组之间无统计学显著差异。配对分析表明,与配对前相比,CRE降低组与年龄、性别、BMI和血糖匹配的对照组之间的结果无显著变化。
在肾功能正常且CRE浓度降低的患者中,观察到小脑葡萄糖代谢降低;然而,肾功能受损患者的小脑和其他正常组织中未发现F-FDG摄取异常。因此,在小脑F-FDG代谢研究中,可能有必要考虑血CRE水平的影响。