Comprehensive comparative study of computed tomography-based estimates of split renal function for potential renal...

Area of Science:

• Radiology
• Nephrology
• Transplant Surgery

Background:

• Accurate split renal function assessment is crucial for potential kidney donors.
• Nuclear renography is the current standard but can be time-consuming and resource-intensive.
• Computed tomography (CT) offers a potentially faster imaging alternative.

Purpose of the Study:

• To evaluate a novel modified CT ellipsoid method for split renal function.
• To compare its accuracy and efficiency against other CT-derived metrics.
• To assess its utility in determining kidney dominance for transplantation.

Main Methods:

• Retrospective analysis of 38 potential renal donors with CT and nuclear renography.
• Evaluation of 6 CT-based methods for split renal function estimation.
• Comparison of CT methods with nuclear renography for correlation, reproducibility, and ease of use.

Main Results:

• Four CT methods, including the modified ellipsoid, showed strong correlation (r=0.79-0.84) with nuclear renography.
• The modified ellipsoid method demonstrated high accuracy (SDs <3.0%) and good interobserver agreement.
• This CT method significantly reduced post-processing time compared to other techniques.
• All CT methods achieved excellent agreement (97.4%-100%) in identifying the dominant kidney.

Conclusions:

• CT-based split renal function assessment is a viable alternative to nuclear renography for potential kidney donors.
• The modified CT ellipsoid method is accurate, reproducible, and efficient.
• This technique can reliably guide kidney selection for transplantation, simplifying pre-operative evaluation.