Top

Published in:

02-12-2023 | Urography | Original Article

Non-contrast-enhanced magnetic resonance urography for measuring split kidney function in pediatric patients with hydronephrosis: comparison with renal scintigraphy

Authors: Kangwen He, Dongyi Wan, Shichao Li, Guanjie Yuan, Mengmeng Gao, Yunfeng Han, Zhen Li, Daoyu Hu, Xiaoyan Meng, Yonghua Niu

Published in: Pediatric Nephrology | Issue 5/2024

Abstract

Background

Split kidney function (SKF) is critical for treatment decision in pediatric patients with hydronephrosis and is commonly measured using renal scintigraphy (RS). Non-contrast-enhanced magnetic resonance urography (NCE-MRU) is increasingly used in clinical practice. This study aimed to investigate the feasibility of using NCE-MRU as an alternative to estimate SKF in pediatric patients with hydronephrosis, compared to RS.

Methods

Seventy-five pediatric patients with hydronephrosis were included in this retrospective study. All patients underwent NCE-MRU and RS within 2 weeks. Kidney parenchyma volume (KPV) and texture analysis parameters were obtained from T2-weighted (T2WI) in NCE-MRU. The calculated split KPV (SKPV) percent and texture analysis parameters percent of left kidney were compared with the RS-determined SKF.

Results

SKPV showed a significant positive correlation with SKF (r = 0.88, p < 0.001), while inhomogeneity was negatively correlated with SKF (r = − 0.68, p < 0.001). The uncorrected and corrected prediction models of SKF were established using simple and multiple linear regression. Bland–Altman plots demonstrated good agreement of both predictive models. The residual sum of squares of the corrected prediction model was lower than that of the uncorrected model (0.283 vs. 0.314) but not statistically significant (p = 0.662). Subgroup analysis based on different MR machines showed correlation coefficients of 0.85, 0.95, and 0.94 between SKF and SKPV for three different scanners, respectively (p < 0.05 for all).

Conclusions

NCE-MRU can be used as an alternative method for estimating SKF in pediatric patients with hydronephrosis when comparing with RS. Specifically, SKPV proves to be a simple and universally applicable indicator for predicting SKF.

Graphical Abstract

Available only for authorised users

Majd M, Bar-Sever Z, Santos AI, De Palma D (2018) The SNMMI and EANM procedural guidelines for diuresis renography in infants and children. J Nucl Med 59:1636–1640. https://doi.org/10.2967/jnumed.118.215921CrossRefPubMedPubMedCentral

Arora S, Yadav P, Kumar M, Singh SK, Sureka SK, Mittal V, Ansari MS (2015) Predictors for the need of surgery in antenatally detected hydronephrosis due to UPJ obstruction–a prospective multivariate analysis. J Pediatr Urol 11:241–248. https://doi.org/10.1016/j.jpurol.2015.02.008CrossRef

Radmayr C, Bogaert G, Burgu B, Castagnetti MS, Dogan HS, Kelly FO, Quaedackers J, Rawashdeh YFH, Silay MS, T Hoen LA, Kennedy UK, Gnech M, Skott M, van Uitert A, Zachou A, Darraugh JA, Radmayr C, Bogaert G, Burgu B, Castagnetti MS, Dogan HS, Kelly FO, Quaedackers J, Rawashdeh YFH, Silay MS, T Hoen LA, Kennedy UK, Gnech M, Skott M, van Uitert A, Zachou A, Darraugh JA (2023) EAU Guidelines on paediatric urology. ISBN 978–94–92671–19–6

McDaniel BB, Jones RA, Scherz H, Kirsch AJ, Little SB, Grattan-Smith JD (2005) Dynamic contrast-enhanced MR urography in the evaluation of pediatric hydronephrosis: part 2, anatomic and functional assessment of ureteropelvic junction obstruction [corrected]. AJR Am J Roentgenol 185:1608–1614. https://doi.org/10.2214/AJR.04.1574CrossRefPubMed

Bar-Sever Z, Shammas A, Gheisari F, Vali R (2022) Pediatric nephro-urology: overview and updates in diuretic renal scans and renal cortical scintigraphy. Semin Nucl Med 52:419–431. https://doi.org/10.1053/j.semnuclmed.2021.12.002CrossRefPubMed

Taylor AT (2014) Radionuclides in nephrourology, part 1: radiopharmaceuticals, quality control, and quantitative indices. J Nucl Med 55:608–615. https://doi.org/10.2967/jnumed.113.133447CrossRefPubMed

Liu W, Zhu Y, Zhu X, Yang G, Xu Y, Tang L (2015) CT-based renal volume measurements: correlation with renal function in patients with renal tumours. Clin Radiol 70:1445–1450. https://doi.org/10.1016/j.crad.2015.09.005CrossRefPubMed

Li J, Xun Y, Li C, Han Y, Shen Y, Hu X, Hu D, Liu Z, Wang S, Li Z (2020) Estimation of renal function using unenhanced computed tomography in upper urinary tract stones patients. Front Med (Lausanne) 7:309. https://doi.org/10.3389/fmed.2020.00309ADSCrossRefPubMed

Halleck F, Diederichs G, Koehlitz T, Slowinski T, Engelken F, Liefeldt L, Friedersdorff F, Fuller TF, Magheli A, Neumayer HH, Budde K, Waiser J (2013) Volume matters: CT-based renal cortex volume measurement in the evaluation of living kidney donors. Transpl Int 26:1208–1216. https://doi.org/10.1111/tri.12195CrossRefPubMed

10.

Luyckx VA, Brenner BM (2010) The clinical importance of nephron mass. J Am Soc Nephrol 21:898–910. https://doi.org/10.1681/ASN.2009121248CrossRefPubMed

11.

Chung AD, Schieda N, Shanbhogue AK, Dilauro M, Rosenkrantz AB, Siegelman ES (2016) MRI evaluation of the urothelial tract: pitfalls and solutions. AJR Am J Roentgenol 207:W108–W116. https://doi.org/10.2214/AJR.16.16348CrossRefPubMed

12.

Dickerson EC, Dillman JR, Smith EA, DiPietro MA, Lebowitz RL, Darge K (2015) Pediatric MR urography: indications, techniques, and approach to review. Radiographics 35:1208–1230. https://doi.org/10.1148/rg.2015140223CrossRefPubMed

13.

Gallo-Bernal S, Patino-Jaramillo N, Calixto CA, Higuera SA, Forero JF, Lara FJ, Góngora C, Gee MS, Ghoshhajra B, Medina HM (2022) Nephrogenic systemic fibrosis in patients with chronic kidney disease after the use of gadolinium-based contrast agents: a review for the cardiovascular imager. Diagnostics (Basel) 12:1816. https://doi.org/10.3390/diagnostics12081816CrossRefPubMed

14.

Khrichenko D, Darge K (2010) Functional analysis in MR urography - made simple. Pediatr Radiol 40:182–199. https://doi.org/10.1007/s00247-009-1458-4CrossRefPubMed

15.

Giganti F, Antunes S, Salerno A, Ambrosi A, Marra P, Nicoletti R, Orsenigo E, Chiari D, Albarello L, Staudacher C, Esposito A, Del MA, De Cobelli F (2017) Gastric cancer: texture analysis from multidetector computed tomography as a potential preoperative prognostic biomarker. Eur Radiol 27:1831–1839. https://doi.org/10.1007/s00330-016-4540-yCrossRefPubMed

16.

Gillies RJ, Kinahan PE, Hricak H (2016) Radiomics: images are more than pictures, they are data. Radiology 278:563–577. https://doi.org/10.1148/radiol.2015151169CrossRefPubMed

17.

Lu J, Hu D, Tang H, Hu X, Shen Y, Li Z, Peng Y, Kamel I (2019) Assessment of tumor heterogeneity: differentiation of periampullary neoplasms based on CT whole-lesion histogram analysis. Eur J Radiol 115:1–9. https://doi.org/10.1016/j.ejrad.2019.03.021CrossRefPubMed

18.

Park H, Kim KA, Jung JH, Rhie J, Choi SY (2020) MRI features and texture analysis for the early prediction of therapeutic response to neoadjuvant chemoradiotherapy and tumor recurrence of locally advanced rectal cancer. Eur Radiol 30:4201–4211. https://doi.org/10.1007/s00330-020-06835-4CrossRefPubMed

19.

Kline TL, Korfiatis P, Edwards ME, Bae KT, Yu A, Chapman AB, Mrug M, Grantham JJ, Landsittel D, Bennett WM, King BF, Harris PC, Torres VE, Erickson BJ (2017) Image texture features predict renal function decline in patients with autosomal dominant polycystic kidney disease. Kidney Int 92:1206–1216. https://doi.org/10.1016/j.kint.2017.03.026CrossRefPubMedPubMedCentral

20.

Yu B, Huang C, Fan X, Li F, Zhang J, Song Z, Zhi N, Ding J (2022) Application of MR imaging features in differentiation of renal changes in patients with stage III type 2 diabetic nephropathy and normal subjects. Front Endocrinol (Lausanne) 13:846407. https://doi.org/10.3389/fendo.2022.846407CrossRefPubMed

21.

Grzywińska M, Jankowska M, Banach-Ambroziak E, Szurowska E, Dębska-Ślizień A (2020) Computation of the texture features on T2-weighted images as a novel method to assess the function of the transplanted kidney: primary research. Transplant Proc 52:2062–2066. https://doi.org/10.1016/j.transproceed.2020.02.084CrossRefPubMed

22.

Gates GF (1983) Split renal function testing using Tc-99m DTPA. A rapid technique for determining differential glomerular filtration. Clin Nucl Med 8:400–407. https://doi.org/10.1097/00003072-198309000-00003CrossRefPubMed

23.

Warady BA, Chadha V (2007) Chronic kidney disease in children: the global perspective. Pediatr Nephrol 22:1999–2009. https://doi.org/10.1007/s00467-006-0410-1CrossRefPubMedPubMedCentral

24.

Tang Y, Yamashita Y, Namimoto T, Abe Y, Nishiharu T, Sumi S, Takahashi M (1996) The value of MR urography that uses HASTE sequences to reveal urinary tract disorders. AJR Am J Roentgenol 167:1497–1502. https://doi.org/10.2214/ajr.167.6.8956584CrossRefPubMed

25.

Lange D, Helck A, Rominger A, Crispin A, Meiser B, Werner J, Fischereder M, Stangl M, Habicht A (2018) Renal volume assessed by magnetic resonance imaging volumetry correlates with renal function in living kidney donors pre- and postdonation: a retrospective cohort study. Transpl Int 31:773–780. https://doi.org/10.1111/tri.13150CrossRefPubMed

26.

Shi W, Liang X, Wu N, Zhang H, Yuan X, Tan Y (2020) Assessment of split renal function using a combination of contrast-enhanced CT and serum creatinine values for glomerular filtration rate estimation. AJR Am J Roentgenol 215:142–147. https://doi.org/10.2214/AJR.19.22125CrossRefPubMed

27.

Lal H, Singh P, Yadav P, Singh A, Singh UP, Sureka SK, Kapoor R (2020) Role of preoperative MR volumetry in patients with renal cell carcinoma for prediction of postoperative renal function after radical nephrectomy and nephron sparing surgery. Int Braz J Urol 46:234–241. https://doi.org/10.1590/S1677-5538.IBJU.2019.0217CrossRefPubMedPubMedCentral

28.

Siedek F, Haneder S, Dörner J, Morelli JN, Chon SH, Maintz D, Houbois C (2019) Estimation of split renal function using different volumetric methods: inter- and intraindividual comparison between MRI and CT. Abdom Radiol (NY) 44:1481–1492. https://doi.org/10.1007/s00261-018-1857-9CrossRefPubMed

29.

Liang P, Xu C, Tripathi P, Li J, Li A, Hu D, Kamel I, Li Z (2021) One-stop assessment of renal function and renal artery in hypertensive patients with suspected renal dysfunction: non-enhanced MRI using spatial labeling with multiple inversion pulses. Eur Radiol 31:94–103. https://doi.org/10.1007/s00330-020-07088-xCrossRefPubMed

30.

Li Q, Wang D, Zhu X, Shen K, Xu F, Chen Y (2018) Combination of renal apparent diffusion coefficient and renal parenchymal volume for better assessment of split renal function in chronic kidney disease. Eur J Radiol 108:194–200. https://doi.org/10.1016/j.ejrad.2018.10.002CrossRefPubMed

31.

Liang P, Li S, Xu C, Li J, Tan F, Hu D, Kamel I, Li Z (2021) Assessment of renal function using magnetic resonance quantitative histogram analysis based on spatial labeling with multiple inversion pulses. Ann Transl Med 9:1614. https://doi.org/10.21037/atm-21-2299CrossRefPubMedPubMedCentral

32.

Zhang YD, Wu CJ, Wang Q, Zhang J, Wang XN, Liu XS, Shi HB (2015) Comparison of utility of histogram apparent diffusion coefficient and R2* for differentiation of low-grade from high-grade clear cell renal cell carcinoma. AJR Am J Roentgenol 205:W193–W201. https://doi.org/10.2214/AJR.14.13802CrossRefPubMed

33.

Liu HF, Wang Q, Du YN, Ding JL, Zhang JG, Xing W (2021) Whole-liver histogram analysis of blood oxygen level-dependent functional magnetic resonance imaging in evaluating hepatic fibrosis. Ann Palliat Med 10:2567–2576. https://doi.org/10.21037/apm-20-1753CrossRefPubMed

34.

Wang S, Meng M, Zhang X, Wu C, Wang R, Wu J, Sami MU, Xu K (2018) Texture analysis of diffusion weighted imaging for the evaluation of glioma heterogeneity based on different regions of interest. Oncol Lett 15:7297–7304. https://doi.org/10.3892/ol.2018.8232CrossRefPubMedPubMedCentral

35.

Mo X, Chen W, Chen S, Chen Z, Guo Y, Chen Y, Wu X, Zhang L, Chen Q, Jin Z, Li M, Chen L, You J, Xiong Z, Zhang B, Zhang S (2023) MRI texture-based machine learning models for the evaluation of renal function on different segmentations: a proof-of-concept study. Insights Imaging 14:28. https://doi.org/10.1186/s13244-023-01370-4CrossRefPubMedPubMedCentral

36.

Jiang Z, Wang Y, Ding J, Yu S, Zhang J, Zhou H, Di J, Xing W (2020) Susceptibility weighted imaging (SWI) for evaluating renal dysfunction in type 2 diabetes mellitus: a preliminary study using SWI parameters and SWI-based texture features. Ann Transl Med 8:1673. https://doi.org/10.21037/atm-20-7121CrossRefPubMedPubMedCentral

37.

Chandarana H, Rosenkrantz AB, Mussi TC, Kim S, Ahmad AA, Raj SD, McMenamy J, Melamed J, Babb JS, Kiefer B, Kiraly AP (2012) Histogram analysis of whole-lesion enhancement in differentiating clear cell from papillary subtype of renal cell cancer. Radiology 265:790–798. https://doi.org/10.1148/radiol.12111281CrossRefPubMed

38.

Breysem L, De Rechter S, De Keyzer F, Smet MH, Bammens B, Van Dyck M, Hofmans M, Oyen R, Levtchenko E, Mekahli D (2018) 3DUS as an alternative to MRI for measuring renal volume in children with autosomal dominant polycystic kidney disease. Pediatr Nephrol 33:827–835. https://doi.org/10.1007/s00467-017-3862-6CrossRefPubMed

39.

Damasio MB, Bodria M, Dolores M, Durand E, Sertorio F, Wong M, Dacher JN, Hassani A, Pistorio A, Mattioli G, Magnano G, Vivier PH (2019) Comparative study between functional MR urography and renal scintigraphy to evaluate drainage curves and split renal function in children with congenital anomalies of kidney and urinary tract (CAKUT). Front Pediatr 7:527. https://doi.org/10.3389/fped.2019.00527CrossRefPubMed

40.

Brown BP, Simoneaux SF, Dillman JR, Rigsby CK, Iyer RS, Alazraki AL, Bardo D, Chan SS, Chandra T, Dorfman SR, Garber MD, Moore MM, Nguyen JC, Peters CA, Shet NS, Siegel A, Waseem M, Karmazyn B (2020) ACR Appropriateness Criteria® Antenatal Hydronephrosis-Infant. J Am Coll Radiol 17:S367–S379. https://doi.org/10.1016/j.jacr.2020.09.017CrossRefPubMed

41.

Rodigas J, Kirsch H, John U, Seifert P, Winkens T, Stenzel M, Mentzel HJ (2018) Static and functional MR urography to assess congenital anomalies of the kidney and urinary tract in infants and children: comparison with MAG3 renal scintigraphy and sonography. AJR Am J Roentgenol 211:193–203. https://doi.org/10.2214/AJR.17.17891CrossRefPubMed

42.

Houat AP, Guimarães C, Takahashi MS, Rodi GP, Gasparetto T, Blasbalg R, Velloni FG (2021) Congenital anomalies of the upper urinary tract: a comprehensive review. Radiographics 41:462–486. https://doi.org/10.1148/rg.2021200078CrossRefPubMed

43.

Mahmoud H, Buchanan C, Francis ST, Selby NM (2016) Imaging the kidney using magnetic resonance techniques: structure to function. Curr Opin Nephrol Hypertens 25:487–493. https://doi.org/10.1097/MNH.0000000000000266CrossRefPubMed

44.

Peperhove M, Vo CV, Jang MS, Gutberlet M, Hartung D, Tewes S, Warnecke G, Fegbeutel C, Haverich A, Gwinner W, Lehner F, Bräsen JH, Haller H, Wacker F, Gueler F, Hueper K (2018) Assessment of acute kidney injury with T1 mapping MRI following solid organ transplantation. Eur Radiol 28:44–50. https://doi.org/10.1007/s00330-017-4943-4CrossRefPubMed

45.

Serai SD, Hu HH, Ahmad R, White S, Pednekar A, Anupindi SA, Lee EY (2020) Newly developed methods for reducing motion artifacts in pediatric abdominal MRI: tips and pearls. AJR Am J Roentgenol 214:1042–1053. https://doi.org/10.2214/AJR.19.21987CrossRefPubMed

46.

Brink A (2022) Pitfalls of radionuclide renal imaging in pediatrics. Semin Nucl Med 52:432–444. https://doi.org/10.1053/j.semnuclmed.2021.12.001CrossRefPubMed

Title: Non-contrast-enhanced magnetic resonance urography for measuring split kidney function in pediatric patients with hydronephrosis: comparison with renal scintigraphy
Authors: Kangwen He
Dongyi Wan
Shichao Li
Guanjie Yuan
Mengmeng Gao
Yunfeng Han
Zhen Li
Daoyu Hu
Xiaoyan Meng
Yonghua Niu
Publication date: 02-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Urography
Scintigraphy
Published in: Pediatric Nephrology / Issue 5/2024
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-023-06224-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Non-contrast-enhanced magnetic resonance urography for measuring split kidney function in pediatric patients with hydronephrosis: comparison with renal scintigraphy

Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical Abstract

Please log in to get access to this content

Other articles of this Issue 5/2024

Medication patterns and dosing guidance in pediatric patients supported with intermittent hemodialysis or continuous kidney replacement therapy

Effect of peritoneal dialysate on bioelectrical impedance analysis variability in pediatric patients receiving peritoneal dialysis

Characteristics and predictors of chronic kidney disease in children with myelomeningocele: a nationwide cohort study

Ocular manifestations of renal ciliopathies

The impact of tubular dysfunction and its relationship with acute kidney injury in children

Complement gene mutations in children with C3 glomerulopathy: do they affect the response to mycophenolate mofetil?