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European Radiology

, Volume 28, Issue 3, pp 1077–1084 | Cite as

Determination of single-kidney glomerular filtration rate (GFR) with CT urography versus renal dynamic imaging Gates method

  • Shan You
  • XianWu Ma
  • ChangZhu Zhang
  • Qiang Li
  • WenWei Shi
  • Jing Zhang
  • XiaoDong Yuan
Computed Tomography

Abstract

Objectives

To present a single-kidney CT-GFR measurement and compare it with the renal dynamic imaging Gates-GFR.

Materials and methods

Thirty-six patients with hydronephrosis referred for CT urography and 99mTc-DTPA renal dynamic imaging were prospectively included. Informed consent was obtained from all patients. The CT urography protocol included non-contrast, nephrographic, and excretory phase imaging. The total CT-GFR was calculated by dividing the CT number increments of the total urinary system between the nephrographic and excretory phase by the products of iodine concentration in the aorta and the elapsed time, then multiplied by (1- Haematocrit). The total CT-GFR was then split into single-kidney CT-GFR by a left and right kidney proportionality factor. The results were compared with single-kidney Gates-GFR by using paired t-test, correlation analysis, and Bland-Altman plots.

Results

Paired difference between single-kidney CT-GFR (45.02 ± 13.91) and single-kidney Gates-GFR (51.21 ± 14.76) was 6.19 ± 5.63 ml/min, p<0.001, demonstrating 12.1% systematic underestimation with ±11.03 ml/min (±21.5%) measurement deviation. A good correlation was revealed between both measurements (r=0.87, p<0.001).

Conclusion

The proposed single-kidney CT-GFR correlates and agrees well with the reference standard despite a systematic underestimation, therefore it could be a one-stop-shop for evaluating urinary tract morphology and split renal function.

Key points

A new CT method can assess split renal function

Only using images from CT urography and the value of haematocrit

A one-stop-shop CT technique without additional radiation dose

Keywords

Computed tomography (CT) CT urography Glomerular filtration rate (GFR) Split renal function One-stop-shop technique 

Abbreviations

GFR

glomerular filtration rate

99mTc-DTPA

99mTc diethylenetriamine pentaacetic acid

CM

contrast material

SCr

serum creatinine

CTNIurinary-system

CT number increments of the urinary system between the nephrographic and excretory phases.

Productsconcentr-time

Products of iodine concentration in the aorta and the time interval between the nephrographic and excretory phases.

Notes

Funding

This study has received funding by National Natural Science Foundation of China (NO. 81671680)

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

• experimental

• performed at one institution

Supplementary material

330_2017_5061_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 16 kb)

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of GraduateHebei North UniversityZhangjiakou CityPeople’s Republic of China
  2. 2.Department of RadiologyQiqihar Chinese Medicine HospitalQigihar CityPeople’s Republic of China
  3. 3.Department of RadiologyThe 309th Hospital of Chinese People`s Liberation ArmyBeijingPeople’s Republic of China

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