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Feasibility of triphasic CT with a modified two-point Patlak plot to determine spit kidney glomerular filtration rate in clinical practice

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Abstract

Purpose

To investigate whether triphasic CT with a simplified Patlak plot can be used in clinical practice for the estimate of split kidney glomerular filtration rate (SKGFR).

Materials and methods

The animal experiment included 15 rabbits that underwent 40 dynamic contrast-enhanced CT scans of the kidneys with 1.5 s time interval. Patlak-derived SKGFR was obtained using standard forty-point, two-point (unenhanced phase, arterial phase t α, and portovenous phase t β), and a modified two-point (MTP) (unenhanced, t α, t β, and a virtual t τ [t τ = (t α + t β)/2]) image data, respectively. The MTP-Patlak plot approach was then validated in 13 patients who underwent a triphasic renal contrast-enhanced CT examination. SKGFR measured by 99mTc-DTPA clearance was as a standard reference.

Results

MTP-Patlak significantly reduced input function errors than two-point Patlak (21.1 ± 16.2 % vs 30.8 ± 15.2 %, p < 0.01) and showed good concordance with standard Patlak for measurement of SKGFR in animal experiment (1.20 ± 0.38 mL/g/min vs 1.51 ± 0.43 mL/g/min; linear correlation coefficient r = 0.87, p < 0.001). Human study showed that mean SKGFR was 45.7 mL/min (range, 26.5–86.2 mL/min) obtained from 99mTc-DTPA, and 38.2 mL/min (range, 18.6–79.3 mL/min) obtained from triphasic CT using MTP-Patlak plot. Linear correlation between the two methods was r = 0.75 (p < 0.01). The mean difference between SKGFRs as determined with the two methods was 7.4 ± 9.0 mL/min.

Conclusion

The MTP-Patlak approach, featured with simplicity, is feasible in a clinically indicated CT examination for the evaluation of split renal function.

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China

    Yu-Dong Zhang, Chen-Jiang Wu & Hai-Bin Shi

  2. Department of Nuclear Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210009, China

    Chen-Qi Xue

  3. Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210009, China

    Jun Tao & Wan-Li Zhou

Authors
  1. Yu-Dong Zhang
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  4. Jun Tao
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Corresponding author

Correspondence to Yu-Dong Zhang.

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Funding

This study was funded by the National Natural Science Foundation of China (NSFC; Grant 81301191) and by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD; JX10231801).

Conflict of Interest

All authors of this study declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research Involving Animal Participants

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Zhang, YD., Xue, CQ., Wu, CJ. et al. Feasibility of triphasic CT with a modified two-point Patlak plot to determine spit kidney glomerular filtration rate in clinical practice. Abdom Radiol 42, 226–235 (2017). https://doi.org/10.1007/s00261-016-0858-9

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  • DOI: https://doi.org/10.1007/s00261-016-0858-9

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