Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique

  • XiaoDong Yuan
  • Wei Tang
  • WenWei Shi
  • Libao Yu
  • Jing Zhang
  • Qing Yuan
  • Shan You
  • Ning Wu
  • Guokun Ao
  • Tingting Ma
Computed Tomography
  • 44 Downloads

Abstract

Objectives

To develop a convenient and rapid single-kidney CT-GFR technique.

Methods

One hundred and twelve patients referred for multiphasic renal CT and 99mTc-DTPA renal dynamic imaging Gates-GFR measurement were prospectively included and randomly divided into two groups of 56 patients each: the training group and the validation group. On the basis of the nephrographic phase images, the fractional renal accumulation (FRA) was calculated and correlated with the Gates-GFR in the training group. From this correlation a formula was derived for single-kidney CT-GFR calculation, which was validated by a paired t test and linear regression analysis with the single-kidney Gates-GFR in the validation group.

Results

In the training group, the FRA (x-axis) correlated well (r = 0.95, p < 0.001) with single-kidney Gates-GFR (y-axis), producing a regression equation of y = 1665x + 1.5 for single-kidney CT-GFR calculation. In the validation group, the difference between the methods of single-kidney GFR measurements was 0.38 ± 5.57 mL/min (p = 0.471); the regression line is identical to the diagonal (intercept = 0 and slope = 1) (p = 0.727 and p = 0.473, respectively), with a standard deviation of residuals of 5.56 mL/min.

Conclusion

A convenient and rapid single-kidney CT-GFR technique was presented and validated in this investigation.

Key Points

• The new CT-GFR method takes about 2.5 min of patient time.

• The CT-GFR method demonstrated identical results to the Gates-GFR method.

• The CT-GFR method is based on the fractional renal accumulation of iodinated CM.

• The CT-GFR method is achieved without additional radiation dose to the patient.

Keywords

Tomography, X-ray computed Glomerular filtration rate Radioisotope renography Prospective studies Humans 

Abbreviations

CM

Contrast material

CMk

Amount of CM accumulated in the kidney (in units of mgI)

CMtotal

Total amount of CM injected (in units of mgI)

CT-GFR

GFR determined by the CT method

F

Conversion factor between iodine concentration and CT number enhancement

FRA

Fractional renal accumulation = CMk/CMtotal

Gates-GFR

GFR determined by the Gates method

GFR

Glomerular filtration rate

99mTc-DTPA

99mTc diethylenetriaminepentaacetic acid

Notes

Acknowledgements

We thank Mr. Kolo from Toshiba Medical Systems Corporation for English language editing.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Yuan XiaoDong.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Yuan XiaoDong) has significant statistical expertise.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• prospective

• observational

• performed at one institution

Supplementary material

330_2017_5289_MOESM1_ESM.docx (70 kb)
ESM 1 (DOCX 70 kb)

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiologythe 309th Hospital of Chinese People’s Liberation ArmyBeijingPeople’s Republic of China
  2. 2.Department of RadiologyFudan University Shanghai Cancer CenterShanghaiPeople’s Republic of China
  3. 3.Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiPeople’s Republic of China
  4. 4.Department of Hepatobiliary Surgerythe 309th Hospital of Chinese People’s Liberation ArmyBeijingPeople’s Republic of China
  5. 5.Department of Urologythe 309th Hospital of Chinese People’s Liberation ArmyBeijingPeople’s Republic of China

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