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Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging

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Abstract

Disorders of mineral metabolism and bone disease are common complications in chronic kidney disease (CKD) patients and are associated with increased morbidity and mortality. Bone biopsies, bone scintigraphy, biochemical markers, and plain films have been used to assess bone disorders and bone turnover. Of these, functional imaging is less invasive than bone/marrow sampling, more specific than serum markers and is therefore ideally placed to assess total skeletal metabolism. 18F-sodium fluoride (NaF) PET/CT is an excellent bone-seeking agent superior to conventional bone scan in CKD patients due to its high bone uptake, rapid single-pass extraction, and minimal binding to serum proteins. Due to these properties, 18F-NaF can better assess the skeletal metabolism on primary diagnosis and following treatment in CKD patients. With the increased accessibility of PET scanners, it is likely that PET scanning with bone-specific tracers such as 18F-NaF will be used more regularly for clinical assessment and quantitation of bone kinetics. This article describes the pattern of scintigraphic/functional appearances secondary to musculoskeletal alterations that might occur in patients with CKD.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kuwait Cancer Control Centre, Kuwait City, Kuwait

    Sharjeel Usmani

  2. Jack Brignall PET/CT Centre, Castle Hill Hospital, Cottingham, UK

    Najeeb Ahmed

  3. Cancer Research Group, Hull York Medical School, University of Hull, York, UK

    Najeeb Ahmed

  4. Royal Free Hospital NHS Trust, London, UK

    Gopinath Gnanasegaran

  5. Jaber Al-Ahmad Molecular Imaging Center, Kuwait City, Kuwait

    Fahad Marafi

  6. Antwerp University Hospital Belgium, Edegem, Belgium

    Tim van den Wyngaert

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Guarantor of integrity: Sharjeel Usmani; Study concepts/design: Sharjeel Usmani, Gopinath Gnanasegaran, Najeeb Ahmed, Fahad Marafi, and Tim Van den Wyngaert; Literature research: Sharjeel Usmani, Najeeb Ahmed, Gopinath Gnanasegaran, and Tim Van den Wyngaert; Data acquisition: Sharjeel Usmani; Image analysis/interpretation: Sharjeel Usmani, Najeeb Ahmed, Gopinath Gnanasegaran, and Tim Van den Wyngaert; Manuscript preparation: Sharjeel Usmani, Gopinath Gnanasegaran, Najeeb Ahmed, and Tim Van den Wyngaert; Manuscript definition of intelletual content: Sharjeel Usmani, Gopinath Gnanasegaran, Fahad Marafi, Najeeb Ahmed, and Tim Van den Wyngaert; Manuscript editing: Sharjeel Usmani, Gopinath Gnanasegaran, Najeeb Ahmed, Fahad Marafi, and Tim Van den Wyngaert; Manuscript revision/review: Sharjeel Usmani, Gopinath Gnanasegaran, Fahad Marafi, Najeeb Ahmed, and Tim Van den Wyngaert; Manuscript final version approval: Sharjeel Usmani, Gopinath Gnanasegaran, Fahad Marafi, Najeeb Ahmed, and Tim Van den Wyngaert.

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Usmani, S., Ahmed, N., Gnanasegaran, G. et al. Update on imaging in chronic kidney disease-mineral and bone disorder: promising role of functional imaging. Skeletal Radiol 51, 905–922 (2022). https://doi.org/10.1007/s00256-021-03905-6

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