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Published in: Abdominal Radiology 5/2021

01-05-2021 | Kidneys, Ureters, Bladder, Retroperitoneum

Estimation of renal function using kidney dynamic contrast material-enhanced CT perfusion: accuracy and feasibility

Authors: Seokmin Jeong, Sung Bin Park, In Ho Chang, Jungho Shin, Byung Hoon Chi, Hyun Jeong Park, Eun Sun Lee

Published in: Abdominal Radiology | Issue 5/2021

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Abstract

Purpose

To measure glomerular filtration rates (GFRs) using kidney dynamic contrast material-enhanced (DCE)-CT perfusion scans and correlate them with estimated GFRs (eGFRs).

Materials and methods

Split-bolus CT urography, including pre-contrast and nephrographic-excretory phase imaging, was performed with a kidney DCE-CT perfusion scan protocol. We analysed 55 patients with suspected renal disease. All CT acquisitions were obtained on a 256-slice CT scanner for 3.5 min continuously with shallow breathing. Renal volume, perfusion and permeability values were calculated using a dedicated prototype software. Based on Patlak plots, split and total renal GFR values were determined. Paired t-tests, Pearson’s correlation analysis and Bland-Altman plots were used for comparisons between kidney DCE-CT perfusion scan-derived GFR (CT-GFR) and the corresponding eGFR value. The p values < 0.05 were considered statistically significant.

Results

The mean CT-GFR was 91.19 ± 20.71 mL/min/1.73 m2. The eGFR values based on the CKD-EPI and MDRD equations were 89.64 ± 19.74 mL/min/1.73 m2 and 89.50 ± 24.89 mL/min/1.73 m2, respectively. No statistically significant differences were found between CT-GFR and eGFRs (p > 0.05). Excellent correlation and agreement between CT-GFR and eGFRs (correlation coefficient r = 0.91 for CKD-EPI and 0.84 for MDRD equations, respectively) were confirmed.

Conclusion

Kidney DCE-CT perfusion is an accurate and feasible technique to assess renal function.
Appendix
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Literature
1.
go back to reference Wang T, Xu Y, Yang G, et al. (2019) Measurement of Glomerular Filtration Rate Using Multiphasic Computed Tomography in Patients With Unilateral Renal Tumors: A Feasibility Study. Frontiers in Physiology 10:1209CrossRef Wang T, Xu Y, Yang G, et al. (2019) Measurement of Glomerular Filtration Rate Using Multiphasic Computed Tomography in Patients With Unilateral Renal Tumors: A Feasibility Study. Frontiers in Physiology 10:1209CrossRef
2.
go back to reference Chang J, Kim S, Jung J, et al. (2011) Assessment of glomerular filtration rate with dynamic computed tomography in normal Beagle dogs. Journal of veterinary science 12:393-399CrossRef Chang J, Kim S, Jung J, et al. (2011) Assessment of glomerular filtration rate with dynamic computed tomography in normal Beagle dogs. Journal of veterinary science 12:393-399CrossRef
3.
go back to reference Daghini E, Juillard L, Haas JA, et al. (2007) Comparison of mathematic models for assessment of glomerular filtration rate with electron-beam CT in pigs. Radiology 242:417-424CrossRef Daghini E, Juillard L, Haas JA, et al. (2007) Comparison of mathematic models for assessment of glomerular filtration rate with electron-beam CT in pigs. Radiology 242:417-424CrossRef
4.
go back to reference Kwon SH, Saad A, Herrmann SM, et al. (2015) Determination of single-kidney glomerular filtration rate in human subjects by using CT. Radiology 276:490-498CrossRef Kwon SH, Saad A, Herrmann SM, et al. (2015) Determination of single-kidney glomerular filtration rate in human subjects by using CT. Radiology 276:490-498CrossRef
5.
go back to reference You S, Ma X, Zhang C, et al. (2018) Determination of single-kidney glomerular filtration rate (GFR) with CT urography versus renal dynamic imaging Gates method. European Radiology 28:1077-1084CrossRef You S, Ma X, Zhang C, et al. (2018) Determination of single-kidney glomerular filtration rate (GFR) with CT urography versus renal dynamic imaging Gates method. European Radiology 28:1077-1084CrossRef
6.
go back to reference Ingelfinger JR, Marsden PA (2013) Estimated GFR and Risk of Death—Is Cystatin C Useful? The New England journal of medicine 369:974CrossRef Ingelfinger JR, Marsden PA (2013) Estimated GFR and Risk of Death—Is Cystatin C Useful? The New England journal of medicine 369:974CrossRef
7.
go back to reference Murata K, Baumann NA, Saenger AK, et al. (2011) Relative performance of the MDRD and CKD-EPI equations for estimating glomerular filtration rate among patients with varied clinical presentations. Clinical Journal of the American Society of Nephrology 6:1963-1972CrossRef Murata K, Baumann NA, Saenger AK, et al. (2011) Relative performance of the MDRD and CKD-EPI equations for estimating glomerular filtration rate among patients with varied clinical presentations. Clinical Journal of the American Society of Nephrology 6:1963-1972CrossRef
8.
go back to reference Stevens LA, Coresh J, Greene T, Levey AS (2006) Assessing kidney function—measured and estimated glomerular filtration rate. New England Journal of Medicine 354:2473-2483CrossRef Stevens LA, Coresh J, Greene T, Levey AS (2006) Assessing kidney function—measured and estimated glomerular filtration rate. New England Journal of Medicine 354:2473-2483CrossRef
9.
go back to reference Becker J, Babb J, Serrano M (2013) Glomerular filtration rate in evaluation of the effect of iodinated contrast media on renal function. American Journal of Roentgenology 200:822-826CrossRef Becker J, Babb J, Serrano M (2013) Glomerular filtration rate in evaluation of the effect of iodinated contrast media on renal function. American Journal of Roentgenology 200:822-826CrossRef
10.
go back to reference Yuan X, Tang W, Shi W, et al. (2018) Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique. European radiology 28:2763-2771CrossRef Yuan X, Tang W, Shi W, et al. (2018) Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique. European radiology 28:2763-2771CrossRef
11.
go back to reference Hackstein N, Bauer J, Hauck EW, et al. (2003) Measuring single-kidney glomerular filtration rate on single-detector helical CT using a two-point Patlak plot technique in patients with increased interstitial space. American Journal of Roentgenology 181:147-156CrossRef Hackstein N, Bauer J, Hauck EW, et al. (2003) Measuring single-kidney glomerular filtration rate on single-detector helical CT using a two-point Patlak plot technique in patients with increased interstitial space. American Journal of Roentgenology 181:147-156CrossRef
12.
go back to reference Blomley M, Dawson P (1996) The quantification of renal function with enhanced computed tomography. The British journal of radiology 69:989-995CrossRef Blomley M, Dawson P (1996) The quantification of renal function with enhanced computed tomography. The British journal of radiology 69:989-995CrossRef
13.
go back to reference Miles K, Leggett D, Bennett G (1999) CT derived Patlak images of the human kidney. The British journal of radiology 72:153-158CrossRef Miles K, Leggett D, Bennett G (1999) CT derived Patlak images of the human kidney. The British journal of radiology 72:153-158CrossRef
14.
go back to reference Hackstein N, Wiegand C, Rau WS, Langheinrich AC (2004) Glomerular filtration rate measured by using triphasic helical CT with a two-point Patlak plot technique. Radiology 230:221-226CrossRef Hackstein N, Wiegand C, Rau WS, Langheinrich AC (2004) Glomerular filtration rate measured by using triphasic helical CT with a two-point Patlak plot technique. Radiology 230:221-226CrossRef
15.
go back to reference Choi DK, Choi SM, Park BH, et al. (2015) Measurement of renal function in a kidney donor: a comparison of creatinine-based and volume-based GFRs. European radiology 25:3143-3150CrossRef Choi DK, Choi SM, Park BH, et al. (2015) Measurement of renal function in a kidney donor: a comparison of creatinine-based and volume-based GFRs. European radiology 25:3143-3150CrossRef
16.
go back to reference Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex-and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257:158-166CrossRef Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex-and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257:158-166CrossRef
17.
go back to reference Patlak CS, Blasberg RG, Fenstermacher JD (1983) Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. Journal of Cerebral Blood Flow & Metabolism 3:1-7CrossRef Patlak CS, Blasberg RG, Fenstermacher JD (1983) Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. Journal of Cerebral Blood Flow & Metabolism 3:1-7CrossRef
18.
go back to reference Tsushima Y, Blomley MJ, Kusano S, Endo K (1999) Use of contrast-enhanced computed tomography to measure clearance per unit renal volume: a novel measurement of renal function and fractional vascular volume. American journal of kidney diseases 33:754-760CrossRef Tsushima Y, Blomley MJ, Kusano S, Endo K (1999) Use of contrast-enhanced computed tomography to measure clearance per unit renal volume: a novel measurement of renal function and fractional vascular volume. American journal of kidney diseases 33:754-760CrossRef
19.
20.
go back to reference Levey AS, Stevens LA, Schmid CH, et al. (2009) A new equation to estimate glomerular filtration rate. Annals of internal medicine 150:604-612CrossRef Levey AS, Stevens LA, Schmid CH, et al. (2009) A new equation to estimate glomerular filtration rate. Annals of internal medicine 150:604-612CrossRef
21.
go back to reference Prigent A. Monitoring renal function and limitations of renal function tests. Seminars in nuclear medicine: Elsevier, 2008:32-46. Prigent A. Monitoring renal function and limitations of renal function tests. Seminars in nuclear medicine: Elsevier, 2008:32-46.
22.
go back to reference Yuan X, Zhang J, Quan C, et al. (2016) A simplified whole-organ CT perfusion technique with biphasic acquisition: preliminary investigation of accuracy and protocol feasibility in kidneys. Radiology 279:254-261CrossRef Yuan X, Zhang J, Quan C, et al. (2016) A simplified whole-organ CT perfusion technique with biphasic acquisition: preliminary investigation of accuracy and protocol feasibility in kidneys. Radiology 279:254-261CrossRef
23.
go back to reference Shankar JJS, Lum C, Sharma M (2010) Whole-brain perfusion imaging with 320-MDCT scanner: reducing radiation dose by increasing sampling interval. American Journal of Roentgenology 195:1183-1186CrossRef Shankar JJS, Lum C, Sharma M (2010) Whole-brain perfusion imaging with 320-MDCT scanner: reducing radiation dose by increasing sampling interval. American Journal of Roentgenology 195:1183-1186CrossRef
24.
go back to reference Yuan X, Zhang J, Tang K, et al. (2017) Determination of glomerular filtration rate with CT measurement of renal clearance of iodinated contrast material versus 99mTc-DTPA dynamic imaging “gates” method: A validation study in asymmetrical renal disease. Radiology 282:552-560CrossRef Yuan X, Zhang J, Tang K, et al. (2017) Determination of glomerular filtration rate with CT measurement of renal clearance of iodinated contrast material versus 99mTc-DTPA dynamic imaging “gates” method: A validation study in asymmetrical renal disease. Radiology 282:552-560CrossRef
25.
go back to reference Wang L, Liu B, Wu Xw, et al. (2012) Correlation between CT attenuation value and iodine concentration in vitro: Discrepancy between gemstone spectral imaging on single‐source dual‐energy CT and traditional polychromatic X‐ray imaging. Journal of medical imaging and radiation oncology 56:379-383CrossRef Wang L, Liu B, Wu Xw, et al. (2012) Correlation between CT attenuation value and iodine concentration in vitro: Discrepancy between gemstone spectral imaging on single‐source dual‐energy CT and traditional polychromatic X‐ray imaging. Journal of medical imaging and radiation oncology 56:379-383CrossRef
Metadata
Title
Estimation of renal function using kidney dynamic contrast material-enhanced CT perfusion: accuracy and feasibility
Authors
Seokmin Jeong
Sung Bin Park
In Ho Chang
Jungho Shin
Byung Hoon Chi
Hyun Jeong Park
Eun Sun Lee
Publication date
01-05-2021
Publisher
Springer US
Published in
Abdominal Radiology / Issue 5/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02826-7

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