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. 2018 Jul;28(7):2763-2771. doi: 10.1007/s00330-017-5289-7. Epub 2018 Feb 9.

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

MeSH terms

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Iodine
  • Kidney / diagnostic imaging*
  • Kidney Diseases / diagnostic imaging*
  • Kidney Diseases / physiopathology
  • Kidney Function Tests / methods
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / physiopathology
  • Male
  • Middle Aged
  • Radioisotope Renography / methods
  • Radiopharmaceuticals
  • Regression Analysis
  • Technetium Tc 99m Pentetate
  • Tomography, X-Ray Computed / methods
  • Young Adult

Substances

  • Contrast Media
  • Radiopharmaceuticals
  • Iodine
  • Technetium Tc 99m Pentetate