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A novel method for estimating the urine drainage time from the renal collecting system

  • Special Section: Quantitative Imaging
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Partial obstruction of the upper urinary tract is a common urological pathology that leads to progressive atrophy and dysfunction of the kidney. Most methods for evaluating the urine drainage rate, to assess the severity of partial obstruction, involve injection of markers into the blood stream and therefore the filtration rate from the blood effects the drainage rate. This study presents a novel method for assessing the drainage rate from the upper urinary tract by analyzing sequential fluoroscopic images from a routine nephrostogram, in which contrast material is introduced directly into the renal collecting system.

Methods

Fluoroscopic images from 36 nephrostograms, following percutaneous nephrolithotomy, were retrospectively evaluated, 19 with a dilated renal pelvis. A radiological model for calculating the radiopacity of the renal pelvis, which reflects the amount of contrast material in each sequential image, was developed. Using this model, an algorithm was designed for generating a drainage curve and calculating the “drainage time” t1/2 in which half of the contrast material has drained from the renal pelvis.

Results

Analysis of images of a step-wedge phantom made of an increasing number of contrast material layers showed that the calculated radiopacity of each step was proportional to the amount of contrast material, independent of the background attenuation. Analysis of the nephrostograms showed that the drainage curves highly fitted an exponential function (R = 0.961), with a significantly higher t1/2 for dilated cases.

Conclusion

The developed method may be used for a quantitative and accurate estimation of the urine drainage rate.

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Funding

No funds, Grants, or other support was received from any organization for the submitted work.

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Authors and Affiliations

  1. The Applied Physics Department, The Jerusalem College of Technology, Jerusalem, Israel

    Talia Yeshua, Ori Gleisner, Victor Neeman & Isaac Leichter

  2. Radiology Department, Haddasah Medical Center, Jerusalem, Israel

    Richard Lederman & Isaac Leichter

  3. Urology Department, Haddasah Medical Center, Jerusalem, Israel

    Mordechai Duvdevani

Authors
  1. Talia Yeshua
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  2. Ori Gleisner
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  3. Richard Lederman
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  4. Victor Neeman
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  5. Mordechai Duvdevani
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  6. Isaac Leichter
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Contributions

All authors contributed to the study conception and design. Prof. MD provided the nephrostograms and Dr. RL analyzed them clinically. The radiological model was developed by TY, IL, and VN. The step-wedge phantom was developed by VN, OG, and IL. TY and OG developed the algorithm, performed the measurements on the phantom and processed the nephrostogram images. The first draft of the manuscript was written by IL, TY, and RL and all the other authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Talia Yeshua.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of Hadassah Medical Center who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of Hadassah Medical Center.

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Yeshua, T., Gleisner, O., Lederman, R. et al. A novel method for estimating the urine drainage time from the renal collecting system. Abdom Radiol 46, 2647–2655 (2021). https://doi.org/10.1007/s00261-020-02880-1

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