Determination of split renal function in voluntary renal donors by multidetector computed tomography and nuclear renography: How well do they correlate?

Abstract

Background The use of computed tomography (CT) for estimation of split renal function (SRF) has been reported previously. However, most of these studies have small samples, and many do not account for the renal attenuation at CT. Objective The aim of this study was to compare multidetector computed tomography (MDCT) volumetry-attenuation-based SRF with that obtained via Tc99m-diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy in voluntary renal donors. Methods Between January 2017 and January 2020, 526 voluntary renal donors were enrolled prospectively. All donors underwent contrast CT and DTPA scan before surgery. The semiautomatic region of interest (ROI) tool was applied slice by slice on axial CT images acquired in the arterial phase. The renal contour was drawn semiautomatically with mouse clicks around the renal parenchyma, and the renal volume was ascertained. Using renal volume and attenuation, SRF was determined and compared with results obtained at DTPA imaging. Results The mean age was 44.91 ± 10.97 years (mean ± s.d.). There was no significant difference in SRF based on DTPA and MDCT volumetry for the left kidney (49.18% ± 3.40% vs. 49.15% ± 3.38%, p = 0.540) and for the right kidney (50.82% ± 3.40% vs. 50.86% ± 3.39%, p = 0.358). A very good correlation was observed between the two methods for the left kidney ( r = 0.953, p = 0.000) and the right kidney ( r = 0.955, p = 0.000). On simple linear regression analysis, 90.8% of DTPA SRF values for the left kidney and 91.3% of DTPA SRF values for the right kidney could be predicted correctly using the corresponding MDCT SRF values. Conclusion MDCT volumetry-attenuation-derived estimation of SRF for living renal donors could be an alternative to renal scintigraphy-based SRF estimation.

Flow Disturbances: Competing Interests in a Case of Hypertensive Emergency

“…Although not performed in this case, methods such as renal nuclear scintigraphy and CTbased volumetry with assessment of contrast attenuation can be used to definitively determine the relative contribution of each kidney to overall glomerular filtration rate. 15,16 Renal artery involvement in acute descending aortic dissection is relatively common, with reported renal artery involvement and impaired renal perfusion in 8% to 16% depending on the dissection type and detection modality, with sensitivity increased with modern imaging techniques. 17,18 The risk of morbidity and mortality is increased in patients with acute kidney injury, associated with 5% to 10% in-hospital mortality.…”

“…Although not performed in this case, methods such as renal nuclear scintigraphy and CT-based volumetry with assessment of contrast attenuation can be used to definitively determine the relative contribution of each kidney to overall glomerular filtration rate. 15,16…”

CT volumetry performs better than nuclear renography in predicting estimated renal function one year after living donation

“…Total parenchymal and renal cortex volume evaluations have both been described. In some studies, only selected donors with asymmetric image evaluation by CT scan or renal ultrasonography were evaluated by nuclear renography [10,12,[19][20][21]. Halleck et al [10], in a retrospective evaluation of 167 consecutive living kidney donors, [10] found a strong correlation between CT-measured split cortex volume (3D reconstruction volume calculation) and MAG3-measured split renal function (R = 0.93; P < 0.001).…”

Can CT or MRI volumetry substitute scintigraphy in living kidney donor evaluation? A systematic review

“…Only three of the studies included were prospective design [ 3 , 10 , 11 ]. The samples sizes varied considerably, ranging from 12 patients [ 12 ] to 835 patients [ 13 ].…”

“…The samples sizes varied considerably, ranging from 12 patients [ 12 ] to 835 patients [ 13 ]. Furthermore, the timeframe for the included cohorts varied widely, ranging from 1997–2001 [ 14 ] to 2017–2020 [ 11 ]. A comprehensive breakdown of the main characteristics of the included studies is provided in Table 1 .…”