Renal perfusional cortex volume for arterial input function measured by semiautomatic segmentation technique using MDCT angiographic data with 0.5-mm collimation.

OBJECTIVE The purpose of this study was to evaluate the usefulness of renal perfusional cortex volume for arterial input function. MATERIALS AND METHODS This retrospective study included 45 potential kidney donors--33 patients with aortic dissection and 12 patients with renovascular hypertension--who underwent both MDCT angiography with 0.5-mm collimation and renal (99m)Tc-diethylenetriamine pentaacetic acid (DTPA) scanning using the modified Gates method. Each perfusional cortex volume for the arterial input function and parenchymal volume was measured by semiautomatic segmentation using the region-growing technique. Linear regression analysis and correlation coefficients were used to assess the impact of the cortical volume, parenchymal volume, and renal scanning glomerular filtration rate (GFR) on estimated GFR (eGFR) using a modified Modification of Diet in Renal Disease (MDRD) equation. RESULTS The correlation coefficient was higher for the total renal DTPA GFR adjusted for body surface area, weight-adjusted perfusion cortex volume, and adjusted total parenchyma volume in rank (r = 0.712, 0.642, 0.510, respectively, p< 0.0001 for each). The coefficient of the right renal perfusional cortex volume percent with a mean value of 52.1% ± 10.1% was 0.826 (p < 0.0001) for the right renal DTPA GFR percent with a mean value of 51.0% ± 12.1% (range, 22.0-89.5%), although the value for the right renal parenchymal volume percent with a mean value of 49.5% ± 5.5% was 0.764 (p < 0.0001). CONCLUSION Weight-adjusted perfusional cortex volume for arterial input function can be measured clinically and may replace renal DTPA scanning using the modified Gates method.

[1]  Y. Onodera,et al.  Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function. , 2011, European journal of radiology.

[2]  R. Roman,et al.  Relationship between renal perfusion pressure and blood flow in different regions of the kidney. , 1993, The American journal of physiology.

[3]  E B Pedersen,et al.  New tools in diagnosing renal artery stenosis. , 2000, Kidney international.

[4]  G F Gates,et al.  Split Renal Function Testing Using Tc–99m DTPA: A Rapid Technique for Determining Differential Glomerular Filtration , 1983, Clinical nuclear medicine.

[5]  M. Cirillo,et al.  Measurement of Glomerular FiltrationRate by the 99m< /sup>Tc-DTPA Renogram Is Less Precise than Measured and Predicted Creatinine Clearance , 1999, Nephron.

[6]  S. Ito,et al.  Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease , 2007, Clinical and Experimental Nephrology.

[7]  K. Zou,et al.  Correlation and simple linear regression. , 2003, Radiology.

[8]  J. Damilakis,et al.  Image segmentation in treatment planning for prostate cancer using the region growing technique. , 2001, The British journal of radiology.

[9]  A. Arai,et al.  Submillisievert median radiation dose for coronary angiography with a second-generation 320-detector row CT scanner in 107 consecutive patients. , 2013, Radiology.

[10]  S. Busque,et al.  Preoperative renal volumes as a predictor of graft function in living donor transplantation. , 2004, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[11]  Xinjian Chen,et al.  An automatic method for renal cortex segmentation on CT images: evaluation on kidney donors. , 2012, Academic radiology.

[12]  Y. Tsushima,et al.  Determination of glomerular filtration rate per unit renal volume using computerized tomography: correlation with conventional measures of total and divided renal function. , 2001, The Journal of urology.

[13]  E. Klotz,et al.  CT perfusion technique for assessment of early kidney allograft dysfunction: preliminary results , 2013, European Radiology.

[14]  Yingli Lu,et al.  Region growing method for the analysis of functional MRI data , 2003, NeuroImage.

[15]  N. Shuke,et al.  Asymmetric Abnormality of Renal Perfusion with Symmetric Function in Aortic Dissection , 1992, Clinical nuclear medicine.

[16]  Fei Yang,et al.  Erratum to "Automatic Renal Cortex Segmentation Using Implicit Shape Registration and Novel Multiple Surfaces Graph Search" , 2012, IEEE Trans. Medical Imaging.

[17]  T. El-Diasty,et al.  Digital subtraction angiography in potential live-kidney donors: A study of 1000 cases , 1994, Abdominal Imaging.

[18]  Fei Yang,et al.  Automatic Renal Cortex Segmentation Using Implicit Shape Registration and Novel Multiple Surfaces Graph Search , 2012, IEEE Transactions on Medical Imaging.

[19]  P. O’Reilly,et al.  Nephroptosis: a cause of renal pain and a potential cause of inaccurate split renal function determination. , 1988, British journal of urology.

[20]  T. Pilgram,et al.  Renal measurements on CT angiograms: correlation with graft function at living donor renal transplantation. , 2012, Radiology.