Reviewed by Lexie CornerMay 1 2025
Researchers at the Technical University of Munich (TUM) have developed a method to detect early signs of kidney damage caused by certain cancer treatments. Using an AI-powered algorithm to analyze CT scans, the team was able to identify patterns associated with treatment-related kidney stress.
CT scans are routinely taken during cancer treatment. Image Credit: Technical University of Munich
The researchers also observed similar changes in the spleen. These findings could help inform earlier adjustments to treatment plans in the future, potentially reducing the risk of organ damage.
The study, conducted by teams from the University Hospital’s radiology and nuclear medicine departments, analyzed data from 121 patients undergoing lutetium-177 PSMA therapy for prostate cancer.
This relatively new form of targeted nuclear medicine—known as radioligand therapy—shows promise for treating specific tumor types. However, one possible side effect is a decline in kidney function during treatment.
In an earlier study, we found that patients whose kidney function worsened after lutetium-177 PSMA therapy showed changes in kidney structure. Since it is not feasible to routinely take tissue samples, we wanted to explore whether these changes could be detected using less invasive methods.
Dr. Lisa Steinhelfer, Study Lead Author, Technical University of Munich
Kidney Volume May Serve as a Biomarker
Dr. Steinhelfer and her team opted for a patient-friendly approach that required no additional procedures. Since blood tests and CT scans are already part of standard cancer care, the researchers focused on identifying early signs of kidney damage within this routinely collected data.
They found that changes in kidney volume were a strong predictor of future damage. While factors like kidney length or patient age were unreliable, a drop in kidney volume of 10% or more within the first six months of treatment strongly correlated with a significant decline in kidney function over the following six months.
“These changes in kidney volume are very subtle. They can easily be missed during routine image assessments because clinicians are mainly focused on tracking tumors and other critical findings,” explained Matthias Eiber, Professor and one of the Study’s Senior Authors, alongside Professor Rickmer Braren.
“In contrast, image analysis algorithms, if properly trained, can reliably detect even these minor changes,” added Dr. Friederike Jungmann, who shares First Authorship with Dr. Steinhelfer.
Method Could be Useful Across Multiple Cancer Therapies
If it becomes clear that a patient is at increased risk of kidney impairment after six months of treatment, both the number of therapy cycles and the dosage can be individually adjusted. This would allow for a more personalized treatment approach.
Dr. Lisa Steinhelfer, Study Lead Author, Technical University of Munich
Two prospective studies are currently underway at TUM University Hospital to further evaluate this approach.
In earlier research, Dr. Steinhelfer’s team also demonstrated that changes in spleen size may serve as an early indicator of disruptions in blood cell production.
Many cancer therapies can affect liver function or the hematopoietic system. I believe our approach could help identify a wide range of treatment-related side effects much earlier than currently possible.
Dr. Lisa Steinhelfer, Study Lead Author, Technical University of Munich
Journal Reference:
Steinhelfer, L., et al. (2025) Automated CT Measurement of Total Kidney Volume for Predicting Renal Function Decline after 177Lu Prostate-specific Membrane Antigen–I&T Radioligand Therapy. Radiology. doi.org/10.1148/radiol.240427.