ArticleEuropean journal of nuclear medicine and molecular imaging2026
Prognostic significance of early cortical functional integrity measured by
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purpose99mTc-dimercaptosuccinic acid (DMSA) renal scintigraphy with single-photon emission computed tomography (SPECT) provides unique information regarding cortical functional integrity. However, it has never been tested whether the cortical functional integrity on DMSA SPECT can predict 1-year graft function. This study investigated whether early DMSA SPECT-derived quantitative parameters predict graft function at 1 year post-KT.
methodsConsecutive KT recipients from June 2022 to August 2024 who underwent DMSA SPECT at 2 weeks post-KT were included. Serum creatinine measurement and estimated glomerular filtration rate [eGFR] calculation were performed at 2 weeks (on the same day of DMSA SPECT; early eGFR) and at 1 year post-KT (follow-up eGFR). The correlation of DMSA imaging parameters with graft function was assessed by analyzing its linear correlations with early and follow-up eGFR, along with other clinical variables. The patients were classified as those having either low or high follow-up eGFR (< 60 mL/min/1.73 m2 and ≥ 60 mL/min/1.73 m2, respectively). Multivariable analyses were performed to identify imaging and clinical variables that are independently associated with low follow-up eGFR.
resultsTotal 90 KT recipients were finally included in the present analysis. They included 50 males and 40 females, with deceased-donor KT in 62 (69%). Patients with low follow-up eGFR (n = 36; 40%) had significantly higher donor’s age, lower graft weight normalized to body surface area and lower early eGFR. Among imaging parameters, planar and SPECT % injected dose (%ID), functional cortical volume, maximum and mean standardized uptake value (SUV), and SUV volume were significantly lower in patients with low follow-up eGFR. In multivariable analysis, high donor age (≥ 48 years old; odds ratio [95% confidence interval], 4.69 [1.59–13.82]), low early eGFR (< 60 mL/min/1.73 m2; 3.89 [1.33–11.42]), and low SPECT %ID (< 8.6%; 3.64 [1.25–10.55]) were independently associated with low follow-up eGFR.
conclusionCortical functional integrity measured by DMSA renal SPECT early after KT could predict graft function at 1 year, independently from other clinical factors including laboratory renal function test.
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