F18-FDG PET imaging as a diagnostic tool for immune checkpoint inhibitor-associated acute kidney injury

Shruti Gupta^{1

2

3}, Olivia Green-Lingren¹, Sudhir Bhimaniya^{3

4}, Aleksandra Krokhmal⁴, Heather Jacene^{3

4}, Marlies Ostermann⁵, Sugama Chicklore⁶, Ben Sprangers^{7

8}, Christophe M Deroose⁹, Sandra M Herrmann¹⁰, Sophia L Wells¹, Sarah A Kaunfer¹, Jessica L Ortega¹, Clara García-Carro¹¹, Michael Bold¹², Kevin L Chen¹³, Meghan E Sise^{3

14}, Pedram Heidari¹⁵, Wai Lun Will Pak¹⁶, Meghan D Lee¹⁴, Pazit Beckerman¹⁷, Yael Eshet¹⁸, Raymond K Hsu¹⁹, Miguel Hernandez Pampaloni²⁰, Arash Rashidi²¹, Norbert Avril²², Vicki Donley²¹, Zain Mithani²³, Russ Kuker²⁴, Muhammad O Awiwi²⁵, Mindy X Wang²⁶, Sujal I Shah²⁷, Michael D Weintraub^{3

28}, Heiko Schoder²⁹, Raad B Chowdhury^{1

2

3}, Harish Seethapathy^{3

14}, Kerry L Reynolds^{3

30}, Maria Jose Soler³¹, Ala Abudayyeh²⁶, Ilya Glezerman¹⁶, David E Leaf^{1

3}

Affiliations

¹ Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Adult Survivorship Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ Department of Critical Care & Nephrology, King's College London, Guy's and St. Thomas' Hospital, London, United Kingdom.
⁶ King's College London & Guy's and St. Thomas' PET Centre, London, United Kingdom.
⁷ Biomedical Research Institute, Department of Immunology and Infection, UHasselt, Diepenbeek, Belgium.
⁸ Department of Nephrology, Ziekenhuis Oost Limburg, Genk, Belgium.
⁹ Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.
¹⁰ Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
¹¹ Nephrology Department, San Carlos Clinical University Hospital, Madrid, Spain.
¹² Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota, USA.
¹³ Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
¹⁴ Department of Medicine, Division of Nephrology, and.
¹⁵ Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
¹⁶ Renal Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York, USA.
¹⁷ Institute of Nephrology and Hypertension, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Tel Aviv, Israel.
¹⁸ Department of Nuclear Imaging, Chaim Sheba Medical Center, Ramat Gan, Israel.
¹⁹ Division of Nephrology and.
²⁰ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
²¹ Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA.
²² Department of Radiology, Nuclear Medicine, University Hospitals, Cleveland, Ohio, USA.
²³ Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
²⁴ Department of Radiology, Division of Nuclear Medicine, University of Miami, Miami, Florida, USA.
²⁵ Division of Diagnostic Imaging, University of Texas Health Science Center at Houston, Houston, Texas, USA.
²⁶ Division of Internal Medicine, Section of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²⁷ Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
²⁸ Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Boston, Massachusetts, USA.
²⁹ Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
³⁰ Division of Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
³¹ Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, CSUR National Unit of Expertise for Complex Glomerular Diseases of Spain, Barcelona, Spain.

PMID: 39115940
PMCID: PMC11405038
DOI: 10.1172/JCI182275

Case Reports

F18-FDG PET imaging as a diagnostic tool for immune checkpoint inhibitor-associated acute kidney injury

Shruti Gupta et al. J Clin Invest. 2024.

. 2024 Aug 8;134(18):e182275.

doi: 10.1172/JCI182275.

Authors

Affiliations

¹ Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Adult Survivorship Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ Department of Critical Care & Nephrology, King's College London, Guy's and St. Thomas' Hospital, London, United Kingdom.
⁶ King's College London & Guy's and St. Thomas' PET Centre, London, United Kingdom.
⁷ Biomedical Research Institute, Department of Immunology and Infection, UHasselt, Diepenbeek, Belgium.
⁸ Department of Nephrology, Ziekenhuis Oost Limburg, Genk, Belgium.
⁹ Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.
¹⁰ Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
¹¹ Nephrology Department, San Carlos Clinical University Hospital, Madrid, Spain.
¹² Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota, USA.
¹³ Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
¹⁴ Department of Medicine, Division of Nephrology, and.
¹⁵ Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
¹⁶ Renal Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York, USA.
¹⁷ Institute of Nephrology and Hypertension, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Tel Aviv, Israel.
¹⁸ Department of Nuclear Imaging, Chaim Sheba Medical Center, Ramat Gan, Israel.
¹⁹ Division of Nephrology and.
²⁰ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
²¹ Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA.
²² Department of Radiology, Nuclear Medicine, University Hospitals, Cleveland, Ohio, USA.
²³ Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.
²⁴ Department of Radiology, Division of Nuclear Medicine, University of Miami, Miami, Florida, USA.
²⁵ Division of Diagnostic Imaging, University of Texas Health Science Center at Houston, Houston, Texas, USA.
²⁶ Division of Internal Medicine, Section of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²⁷ Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
²⁸ Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Boston, Massachusetts, USA.
²⁹ Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
³⁰ Division of Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
³¹ Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, CSUR National Unit of Expertise for Complex Glomerular Diseases of Spain, Barcelona, Spain.

PMID: 39115940
PMCID: PMC11405038
DOI: 10.1172/JCI182275

No abstract available

Keywords: Cancer immunotherapy; Nephrology; Oncology.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors have declared that no conflict of interest exists.

Figures

**Figure 1. F¹⁸-FDG PET-CT and ICI-AKI.**
(A) Representative F¹⁸-FDG PET-CT images at baseline (top panels) and at the time of ICI-AKI (lower panels). (B) Percentage change in SUV_mean from baseline to the time of AKI among patients with ICI-AKI (red), AKI from other causes (blue), and patients receiving ICI therapy without AKI (green). Biopsy-proven patients are represented by squares, and clinically adjudicated patients with circles. (C) ROC curve of percentage change in SUV_mean for differentiation of ICI-AKI from AKI from other causes.

See this image and copyright information in PMC

References

1. Gupta S, et al. Acute kidney injury in patients treated with immune checkpoint inhibitors. J Immunother Cancer. 2021;9(10):e003467. doi: 10.1136/jitc-2021-003467. - DOI - PMC - PubMed
1. Awiwi MO, et al. Imaging features of immune checkpoint inhibitor-related nephritis with clinical correlation: a retrospective series of biopsy-proven cases. Eur Radiol. 2023;33(3):2227–2238. doi: 10.1007/s00330-022-09158-8. - DOI - PMC - PubMed
1. Qualls D, et al. Positron emission tomography as an adjuvant diagnostic test in the evaluation of checkpoint inhibitor-associated acute interstitial nephritis. J Immunother Cancer. 2019;7(1):356. doi: 10.1186/s40425-019-0820-9. - DOI - PMC - PubMed
1. Lang N, et al. Clinical significance of signs of autoimmune colitis in 18F-fluorodeoxyglucose positron emission tomography-computed tomography of 100 stage-IV melanoma patients. Immunotherapy. 2019;11(8):667–676. doi: 10.2217/imt-2018-0146. - DOI - PubMed
1. Galligan A, et al. Increased thyroidal activity on routine FDG-PET/CT after combination immune checkpoint inhibition: temporal associations with clinical and biochemical thyroiditis. Cancers (Basel) 2023;15(24):5803. doi: 10.3390/cancers15245803. - DOI - PMC - PubMed

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F18-FDG PET imaging as a diagnostic tool for immune checkpoint inhibitor-associated acute kidney injury

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F18-FDG PET imaging as a diagnostic tool for immune checkpoint inhibitor-associated acute kidney injury

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Conflict of interest statement

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