Estimation of renal function using kidney dynamic contrast material-enhanced CT perfusion: accuracy and feasibility
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KIDNEYS, URETERS, BLADDER, RETROPERITONEUM
Estimation of renal function using kidney dynamic contrast material‑enhanced CT perfusion: accuracy and feasibility Seokmin Jeong1 · Sung Bin Park1 · In Ho Chang2 · Jungho Shin3 · Byung Hoon Chi2 · Hyun Jeong Park1 · Eun Sun Lee1 Received: 29 July 2020 / Revised: 1 October 2020 / Accepted: 10 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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 m 2. 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. Keywords Tomography · Spiral computed · Tomography · X-ray computed · Glomerular filtration rate · Perfusion imaging Abbreviations CKD-EPI Chronic Kidney Disease Epidemiology Collaboration CM Contrast material DCE Dynamic contrast material-enhanced eGFR Estimated glomerular filtration rate Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00261-020-02826-7) contains supplementary material, which is available to authorized users. * Sung Bin Park [email protected] 1
Department of Radiology, Chung‑Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok‑ro, Dongjak‑gu, Seoul 06973, Korea
2
Department of Urology, Chung‑Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
3
Department of Internal Medicine, Chung‑Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
GFR Glomerular filtration rate MDRD Modification of Diet in Renal Disease Scr Serum creatinine level TAC Time-attenuation curve
Introduction The glomerular filtration rate (GFR) is remained as the best overall index
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