Klinkhammer Barbara Mara, Ay Ilknur, Caravan Peter, Caroli Anna, Boor Peter
Institute for Pathology, RWTH Aachen University, Aachen, Germany.
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Nephron. 2025;149(3):149-159. doi: 10.1159/000542412. Epub 2024 Nov 1.
Diagnosing and monitoring kidney diseases traditionally rely on blood and urine analyses and invasive procedures such as kidney biopsies, the latter offering limited possibilities for longitudinal monitoring and a comprehensive understanding of disease dynamics. Current noninvasive methods lack specificity in capturing intrarenal molecular processes, hindering patient stratification and patient monitoring in clinical practice and clinical trials.
Molecular imaging enables noninvasive and quantitative assessment of physiological and pathological molecular processes. By using specific molecular probes and imaging technologies, e.g., magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, or ultrasound, molecular imaging allows the detection and longitudinal monitoring of disease activity with spatial and temporal resolution of different kidney diseases and disease-specific pathways. Several approaches have already shown promising results in kidneys and exploratory clinical studies, and validation is needed before implementation in clinical practice.
Molecular imaging offers a noninvasive assessment of intrarenal molecular processes, overcoming the limitations of current diagnostic methods. It has the potential to serve as companion diagnostics, not only in clinical trials, aiding in patient stratification and treatment response assessment. By guiding therapeutic interventions, molecular imaging might contribute to the development of targeted therapies for kidney diseases.
传统上,肾脏疾病的诊断和监测依赖于血液和尿液分析以及诸如肾活检等侵入性检查,而肾活检在纵向监测以及全面了解疾病动态方面的可能性有限。当前的非侵入性方法在捕捉肾内分子过程方面缺乏特异性,这在临床实践和临床试验中阻碍了患者分层和患者监测。
分子成像能够对生理和病理分子过程进行非侵入性定量评估。通过使用特定的分子探针和成像技术,例如磁共振成像、正电子发射断层扫描、单光子发射计算机断层扫描或超声,分子成像能够以不同肾脏疾病和疾病特异性途径的空间和时间分辨率检测并纵向监测疾病活动。几种方法已在肾脏及探索性临床研究中显示出有前景的结果,在临床实践中实施之前还需要进行验证。
分子成像提供了对肾内分子过程的非侵入性评估,克服了当前诊断方法的局限性。它不仅在临床试验中作为伴随诊断有助于患者分层和治疗反应评估,还具有这种潜力。通过指导治疗干预,分子成像可能有助于开发针对肾脏疾病的靶向治疗方法。