Renal perfusional cortex volume for arterial input function measured by semiautomatic segmentation technique using...

Area of Science:

• Nephrology
• Radiology
• Medical Imaging

Background:

• Assessing kidney function is crucial for managing renal diseases and evaluating potential kidney donors.
• Traditional methods like renal diethylenetriamine pentaacetic acid (DTPA) scanning provide estimates of glomerular filtration rate (GFR).
• The arterial input function is vital for accurate GFR estimation in dynamic renal imaging studies.

Purpose of the Study:

• To evaluate the clinical utility of renal perfusional cortex volume as a measure for arterial input function.
• To compare the effectiveness of perfusional cortex volume with established renal scanning techniques.

Main Methods:

• A retrospective analysis of 45 potential kidney donors (33 with aortic dissection, 12 with renovascular hypertension) was conducted.
• Patients underwent multi-detector computed tomography (MDCT) angiography and renal (99m)Tc-diethylenetriamine pentaacetic acid (DTPA) scanning.
• Perfusional cortex volume and parenchymal volume were measured using semiautomatic segmentation; linear regression and correlation coefficients assessed their impact on estimated GFR (eGFR).

Main Results:

• Weight-adjusted perfusion cortex volume demonstrated a strong correlation with total renal DTPA GFR (r = 0.642, p < 0.0001).
• The right renal perfusional cortex volume percentage showed a high correlation with the right renal DTPA GFR percentage (r = 0.826, p < 0.0001).
• Perfusional cortex volume measurements were found to be clinically feasible and reliable.

Conclusions:

• Weight-adjusted perfusional cortex volume is a clinically measurable parameter for arterial input function.
• Renal perfusional cortex volume may serve as a viable alternative to traditional renal DTPA scanning using the modified Gates method.
• This approach offers a potentially more efficient and accurate method for renal function assessment.