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

  • Computed Tomography
  • Published:
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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.

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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

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Acknowledgements

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

Funding

This study has received funding by National Natural Science Foundation of China (NO.81671680, NO.81570679, and NO.81200547) and Beijing NOVA program (NO.Z161100004916141)

Author information

Author notes

  1. XiaoDong Yuan and Wei Tang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, the 309th Hospital of Chinese People’s Liberation Army, 17 Heishanhu Road, Haidian District, Beijing, 100091, People’s Republic of China

    XiaoDong Yuan, WenWei Shi, Jing Zhang, Shan You, Ning Wu, Guokun Ao & Tingting Ma

  2. Department of Radiology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People’s Republic of China

    Wei Tang

  3. Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Shanghai, 200032, People’s Republic of China

    Wei Tang

  4. Department of Hepatobiliary Surgery, the 309th Hospital of Chinese People’s Liberation Army, 17 Heishanhu Road, Haidian District, Beijing, 100091, People’s Republic of China

    Libao Yu

  5. Department of Urology, the 309th Hospital of Chinese People’s Liberation Army, 17 Heishanhu Road, Haidian District, Beijing, 100091, People’s Republic of China

    Qing Yuan

Authors
  1. XiaoDong Yuan
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  2. Wei Tang
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  6. Qing Yuan
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  7. Shan You
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Corresponding author

Correspondence to XiaoDong Yuan.

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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

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Yuan, X., Tang, W., Shi, W. et al. Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique. Eur Radiol 28, 2763–2771 (2018). https://doi.org/10.1007/s00330-017-5289-7

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  • DOI: https://doi.org/10.1007/s00330-017-5289-7

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